As described by Forrester , the musculoskeletal system anywhere in the body can be divided into the A, B, C, D′ S, starting with S. “S” stands for soft tissues, “B” is bone mineralization, “C” is cortex, cartilage, and joint-space abnormalities, and “D” is distribution of abnormalities. The application of these principles will help keep one from missing major observations. Starting with “S”, the recognition of soft-tissue abnormalities will point to an area of major abnormality and should alert one to look a second or third time at the center of the area of soft-tissue swelling to see if there is an underlying abnormality. The soft tissues dorsally over the carpal bones are normally concave. When the soft tissues over the dorsum of the wrist are straight or convex, swelling is suspect. The pronator fat line lying volar to the distal radius may indicate deep swelling. Normally it should be straight or concave , but when it is convex outward then deep swelling should be suspect. Soft-tissue swelling along the radial and ulnar styloids may be seen with synovitis or trauma.
KeywordsMetabolic Bone Disease Giant Cell Tumor Glomus Tumor Carpal Bone Renal Osteodystrophy
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- 1.Forrester DM, Nesson JW (1973) The ABC’s of arthritis (introduction). In: Forrester DM, Nesson JW (eds) The radiology of joint disease. WB Saunders, Philadelphia, p 3Google Scholar
- 2.Curtis DJ, Downey EF Jr (1992) Soft tissue evaluation in trauma. In: Gilula LA (ed) The traumatized hand and wrist. Radiographic and anatomy correlation. WB Saunders, Philadelphia, pp 45–63Google Scholar
- 3.Gilula LA (1979) Carpal injuries: analytic approach and case exercise. AJR Am J Roentgeonol 133:503–517Google Scholar
- 4.Yin Y, Mann FA, Gilula LA, Hodge JC (1996) Roentgenographic approach to complex bone abnormalities. In: Gilula LA, Yin Y (eds) Imaging of the wrist and hand. WB Saunders, Philadelphia, pp 293–318Google Scholar
- 5.Gilula LA, Totty WG (1992) Wrist trauma: roentgenographic analysis. In: Gilula LA (ed) The traumatized hand and wrist. Radiographic and anatomy correlation. WB Saunders, Philadelphia, pp 221–239Google Scholar
- 7.Garcia-Elias M, Dobyns JH, Cooney WP, Linscheid RL (1989) Traumatic axial dislocations of the carpus. J Hand Surg 14A:446–457Google Scholar
- 11.Forrester DM, Nesson JW (1973) The radiology of joint disease. WB Saunders, PhiladelphiaGoogle Scholar