Forearm x-ray is indicated if there is a suspected diaphyseal fracture of both forearm bones, an isolated diaphyseal fracture of the ulna or radius. The procedure is carried out without preparation. The standard study is performed in two projections (straight and lateral). Before forearm x-ray, the patient is seated sideways to the table. To take a picture in a direct projection, the patient’s arm is slightly bent at the elbow joint and placed on the table with the palm up. For an X-ray in a lateral projection, flexion in the elbow joint is strengthened, and the arm is rotated so that it rests on the table with the edge of the palm.
X-rays can be prescribed in the presence of the following indications:
- mechanical injury of the forearm as a result of a fall, impact, bruise;
- redness in the forearm area;
- difficult hand movement;
- pain in the forearm both at rest and in motion;
- suspicion of tumor neoplasms.
X-rays are also prescribed to monitor the healing of the fracture and the fusion of surgically connected fragments of the forearm bones. To assess the effectiveness of therapy aimed at eliminating signs of arthrosis or arthritis, an X-ray can also be prescribed. Since this study provides minimal radiation exposure, it can be carried out several times a month without fear (radiation standards are set in SanPiNs).
What will show
On the X-ray you can see:
- the relative position of the forearm bones;
- joints of the forearm bones and their entry into the joint;
- fractures and cracks on the bones;
- foci of necrosis on the bones;
- signs of arthritis or arthrosis;
- inflammatory and purulent diseases of bone tissue;
- neoplasms of a malignant or benign nature.
Forearm x-ray is a procedure that does not require special training. The patient is only required to take off metal jewelry, watches and undress to the waist. The radiologist should be warned before shooting about the presence of metal prostheses, implants, if any, in the body. In rare cases, when the fracture is complex and the patient cannot take off his clothes, radiography can be carried out in clothes. Special lead aprons are used to protect body parts that do not participate in the study.
Methodology of conducting
For a more accurate diagnosis, X-rays are made in several projections. The pictures are taken in a row, while the patient changes his position. To get an image in a direct projection, the patient’s arm is bent at the elbow and carefully placed on a special table of the X-ray machine. The palm should “look” up. To shoot in a side projection, you need to bend the sore arm at the elbow joint, and then turn it so that the edge of the palm rests against the surface of the table. The picture is taken within a few seconds, while the patient should not move.
In cases of fractures of one or both forearm bones, X-rays are performed in 2 mutually perpendicular projections. Such a survey allows you to see the fracture area in detail, visualize bone fragments, and also understand the direction of their displacement. In the images, the forearm bones are visualized as white longitudinal elements. By means of the elbow joint, they are connected in the upper part with the humerus, and from below, through the wrist joint, with the bones of the wrist.
A fracture on the bone is visualized as a gray or black stripe with uneven contours. This strip (it is called the “break line”) it can completely or partially tear the anatomical structure of the bone. The fracture line can have different directions – transverse, longitudinal, oblique. It depends on the type of fracture.
If the fracture is comminuted, several fracture lines will be visible in the picture. It will also be possible to understand from the picture how the bone fragments are displaced and what size they are. It is worth noting that when deciphering and describing the images, the radiologist does not make a specific diagnosis. He simply describes the picture he saw, indicates pathologies, if any. The diagnosis is made by the attending physician on the basis of the conclusion.
The humerus is the longest and largest in the upper limb. The proximal part of it should be connected to the shoulder blade. The distal end of the forearm bone is a block and a head, which are part of the elbow joint together with the radius and ulna. Forearm x-ray should normally depict homogeneous bones in composition, without darkening, interruptions of contours, tumors and foci of necrosis.
Forearm fracture symptoms
The bones of the forearm are conditionally divided into types relative to the trunk:
- the distal part is located near the joint of the hand;
- in the center of the forearm is the middle part;
- the proximal part is located in close proximity to the elbow joint.
A fracture can occur in any part of the forearm, but the most fragile is the place near the entrance to the joint. It is here that the thinnest bones are located. The first sign of a fracture, of course, is a painful sensation in the forearm area. It can appear when moving or persist constantly, including at rest. It is difficult for the patient to control the arm, flexion in the elbow or in the area of the wrist joint is difficult. Some time after the fracture, swelling and hematoma may appear on the arm. In some cases, when the fracture is small, a person may not feel the above symptoms at first. Such fractures are often confused with bruises and delayed with going to the doctor, which leads to complications.