Wrist joint x-ray is an radiography examination, the indication for which in traumatology is a suspicion of fractures and fractures of the distal parts of the radius and ulna, fractures, dislocations and fractures of the wrist bones. In other areas of medicine, the method is used for developmental anomalies, degenerative-dystrophic changes, purulent and tumor processes. The procedure does not require preparation, can be performed on an outpatient basis or in a hospital setting. During gestation and in childhood, wrist joint x-ray is recommended to be replaced by alternative methods due to the high radiation load.
Indications
Wrist joint x-ray is prescribed for suspected fracture of the radius in a typical place, Galeazzi fracture (fracture of the lower third of the radius in combination with dislocation of the head of the ulna), fractures of the awl processes of the ulna and radius, fractures, dislocations and fractures of the wrist bones. Indications for research in orthopedics are arthrosis and malformations. In rheumatology, the technique is used to assess the condition of joints in rheumatoid arthritis and a number of other diseases. In purulent surgery, the procedure is used for arthritis of the wrist joint, in oncology – if benign and malignant neoplasms of this area are suspected.
Methodology of conducting
Clinical manifestations of damage to the wrist joint are often similar to the symptoms of damage to the wrist bones, therefore, radiography is carried out in such a way that the lower thirds of the forearm bones, the joint area, the wrist bones and the proximal parts of the metacarpal bones are visible simultaneously in the image. Usually, the study is performed in two projections. Standard radiographs do not always make it possible to recognize minor changes in the wrist bones, therefore, if damage to these anatomical structures is suspected, additional images are prescribed in two oblique projections: the oblique palm and the oblique back.
To take a picture in a direct projection, the patient’s arm is bent at the elbow joint and placed palm down. At the same time, the palm should be pressed tightly against the table, otherwise there may be distortions of the relative position of the bones on the X-ray. For a side shot of the wrist joint, the patient’s hand is placed on the table with the edge of the palm. During radiography in additional oblique projections, the patient’s hand lies on the table with the edge of the palm at an angle of 45 degrees to the table (in the back or in the palm side). From the side of the slope, a special pillow is placed under the brush.
What shows
Traumatic injuries
Traumatic injuries, such as fractures, dislocations, cracks, dislocations– are the first thing that can be detected on an X-ray of the wrist joint. The wrist bones, whose X-ray showed a fracture, have dark stripes of different localization, size and direction in the picture.
It is possible to diagnose “Dislocation” by X-ray if the picture shows that the articular surfaces of the forearm bones are crossed or the gap between the bones of the wrist joint is not visible.
Rheumatic lesions
Rheumatic lesions can be observed, for example, in the pathology of the connective tissue of the joint (rheumatoid arthritis, scleroderma) or in inflammatory diseases affecting the bone tissue of the hands and wrists.
Typical signs of arthritis of the hands are cystic changes, visualized on X-rays already at the early stages of the development of rheumatoid pathology. They are usually small in size and rounded in shape. Advanced stages of arthritis are characterized by the formation of large and dense bone erosions.
Contraindications
The negative effect of ionizing radiation from X-rays determines a number of prohibitions for hand and wrist joint x-ray .
Pregnancy
During pregnancy, women should not be X-rayed, since ionizing radiation can have a negative impact on the development of the fetus. However, in some cases, when, for example, we are talking about a serious comminuted fracture of the hand, an X-ray is carried out. At the same time, the woman’s stomach is carefully covered with a protective vest or apron.
Children under 15
Children under the age of 14-15 are also considered a contraindication for X-rays. Ionizing radiation can negatively affect an immature child’s body, and the main danger lies in the high probability of malignant degeneration of cells entering the irradiation zone. In this regard, children are rarely prescribed X-rays. As an alternative, the most informative, but at the same time safe method of diagnosing the condition of the bones of the hand and wrist, MRI can be used.
