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X-ray of the wrist joint for a child and an adult
Last reviewed: 23.11.2021
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Because X-rays provide an image of the dense structure of bones, X-rays of any joints, including those of the wrist, are the classic method for the initial diagnosis of joint injuries and diseases.
Indications for the procedure
Mandatory fluoroscopy of the wrist joint (which connects the hand to the forearm and consists of eight bones) is performed for acute or chronic pain in the wrist - often with joint contracture and other symptoms that may result from:
- bone cracks or fractures;
- dislocation of the joint;
- bone hypoplasia or the presence of additional bone structures;
- arthrosis or arthritis; [1]
- periostitis (pathological changes in the periosteum) and osteochondrosis of the wrist;
- joint deformity associated with osteoarthritis, the formation of osteophytes or calcifications. [2]
More information in the material - Causes of pain in the wrist joint .
Examination of the wrist joint using an X-ray makes it possible to visualize bone structures (ligaments and muscles are not visible on an X-ray) and to identify existing abnormalities, as well as to carry out differential diagnostics, establishing the etiology of the lesions and confirming the diagnosis.
In addition, on the basis of X-ray examination of the wrist joint and hand, the results of treatment are evaluated, in particular, bone fusion (callus formation) in fractures.
X-rays of the intact wrist are also needed before surgery for carpal tunnel syndrome.
Technique of the x-ray of the wrist joint
With a survey and sighting fluoroscopy of the hand and its wrist joint, the technique is identical; for details of protecting the rest of the body, read the publication - Hand X - ray .
However, some peculiarities of hand placement in cases of wrist fracture should be taken into account. To obtain the most informative images, pictures are needed both in frontal projection (from the back side - with the elbow deviation of the wrist, from the side of the palm - with bent phalanges of the fingers), and in the side - with the wrist tilted forward and backward. And with a fracture affecting the scaphoid bone of the joint, also in an oblique projection.
The conclusion that the X-ray of the wrist joint is normal is made when, when studying the obtained X-ray images and comparing the image with the norm, no pathological changes in the articular bone structures are detected, that is, their location and the spaces between them correspond to the normal anatomy of the wrist joint .
X-ray signs of fracture of the wrist joint
As already noted, X-rays for the most common fracture of the wrist joint - its navicular bone - are performed in different projections on the arm bent at the elbow. [3]
The diagnosis of a fracture of the wrist joint is supported by visualized signs, in particular:
- with a fracture without displacement - the presence of an enlightenment band on the line of bone damage;
- destruction of the outer (cortical) layer of the bone;
- displacement of the bones, causing deformation of the wrist;
- the presence of bone fragments or comminuted fragments in a segmented fracture.
Each X-ray image - according to the protocols available to radiologists - is accompanied by a detailed description of all the characteristics of the identified pathological changes in bone structures (with the measurement of the parameters of bone displacement and localization of their fragments in millimeters and degrees). [4]
Reviews
As the radiologists themselves note, not in all cases, X-ray examination of the wrist joint can reveal its pathological changes. The same fracture affecting the scaphoid is difficult to visualize with X-rays, so additional diagnostic examinations, such as MRI and bone scintigraphy, are often used.