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Wrist and Hand

  • Louis A. Gilula

Abstract

As described by Forrester [1], 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 [2], 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.

Keywords

Metabolic Bone Disease Giant Cell Tumor Glomus Tumor Carpal Bone Renal Osteodystrophy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

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Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Louis A. Gilula
    • 1
  1. 1.Radiology, Orthopaedic Surgery and Plastic and Reconstructive SurgeryWashington University School of Medicine, Mallinckrodt Institute of RadiologySt. LouisUSA

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