Upper Limb Chapter 5

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Upper LimbChapter 5

• Chapter 5

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Upper Limb

• Hand and wrist
• Forearm
• Humerus
• Shoulder girdle

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Anatomy
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Forearm

• Consists of the radius and ulna
• Articulate proximally and distally at the
  radioulnar joint
• Both bones have a styloid process distally
• Head of ulna is at the distal end
• Head of radius is at the proximal end
• Radius is shorter than the ulna
• Radius is the only bone directly involved with
  the wrist joint

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More forearm

• The ulna is the longer of the two bones
• Its primarily involved with the formation of the
  elbow
• During the act of pronation, the radius crosses
  over the ulna near the upper third of the forearm

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True Lateral Elbow

• 90 degree flexion for demonstration of the fat
  pads
• You should visualize three concentric arcs on the
  lateral elbow they are the trochlear sulcus,
  the rounded edges of the capitulum and the medial
  ridge of the trochlea
• The elbow space should be open and the arcs
  should appear concentric

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Wrist joint movement

• Ulnar deviation or scaphoid projection used for
  opening up the carpals of opposite side
  scaphoid, trapezium and trapezoid
• Radial deviation done to visualize the hamate,
  pisiform, triquetrum and lunate

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Supination vs. Pronation of forearm

• Forearms should (if at all possible) be
  radiographed in the AP or supinated position
• Pronation causes cross-over of the bones in the
  forearm

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The Oblique Elbows Explained

• Lateral rotation- separates radius and ulna
• Medial rotation- superimposes radius and ulna

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The Fat About Fat Pads

• Changes within the joint capsule of the elbow
  alter the normal position of the fat pads, which
  may be the only indicator of an abnormality in
  the upper limbs (wrists and elbow)

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General Information about Upper Limb Imaging

• Class discussion

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Pathologies of the Upper Limb

• Please review the pathologies on page 142

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Fingers

• PA
• PA oblique
• Lateral

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Thumb
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Hand

• PA
• PA Oblique
• Lateral (fan or straight)
• AP oblique- bilateral (ball-catchers, Norgaard)

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Wrist

• PA
• PA Oblique
• Lateral (lateromedial)

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Forearm

• AP
• Lateral

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Elbow

• AP (fully extended and partially extended)
• Obliques (lateral and medial)
• Lateral

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Humerus

• AP
• Lateral