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Congress: ECR24
Poster Number: C-17016
Type: EPOS Radiologist (educational)
Authorblock: Y. Yan, V. Kalia, G. Garvin, V. Kalia; London, ON/CA
Disclosures:
Yi Yan: Nothing to disclose
Vishal Kalia: Nothing to disclose
Gregory Garvin: Nothing to disclose
Vibhuti Kalia: Nothing to disclose
Keywords: Musculoskeletal bone, CT, Digital radiography, MR, Computer Applications-3D, Trauma
Learning objectives Explore the approach and search pattern in diagnosing carpal instability across different imaging modalities. Describe the evaluation process for patients with carpal instability, focusing on the four subtypes of Mayo classification with examples.
Read more Background Carpal instability, a complex condition resulting from ligamentous disruption, involves various patterns and numerous intrinsic and extrinsic ligaments within the wrist. It is distinct from carpal misalignment and is characterized by joint instability under physiological loads, potentially leading to gradual articular collapse if untreated. Accurate diagnosis and effective treatment require a comprehensive understanding of normal wrist anatomy.
Read more Findings and procedure details Correct positioning during imaging The initial step in evaluating wrist radiographs involves ensuring adequate image quality. Proper positioning for the PA projection includes the shoulder abducted 90 degrees and the elbow flexed at 90 degrees, with parallel alignment of the radius and ulna. A correctly positioned PA view reveals the extensor carpi ulnaris groove.[img]1[img]For the lateral projection, the elbow is flexed to 90 degrees and adducted against the trunk, with the distal forearm and hand resting on the ulnar side. A...
Read more Conclusion Comprehending carpal instability can be intricate and demanding, necessitating a foundation in anatomy and pathophysiology. This knowledge is essential for interpreting imaging studies such as radiographs, CT, and MRI, facilitating a comprehensive and insightful diagnosis in instances of wrist instability. Familiarity with the prevalent approach and classification system for wrist instability employed by numerous hand surgeons is particularly beneficial. It enhances communication between the radiologist and the referring physician, fostering a more meaningful discussion about the diagnosis and potential treatment...
Read more References 1.         Wolfe SW, Garcia-Elias M, Kitay A. Carpal instability nondissociative. J Am Acad Orthop Surg 2012;20:575-585. DOI: 10.5435/JAAOS-20-09-575.2.         Beeker RW, Rehman UH. Carpal Ligament Instability. In: StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Uzma Rehman declares no relevant financial relationships with ineligible companies., 2023.3.         Flores DV, Umpire DF, Mejia Gomez C, et al. Carpal Instability: Anatomy, Kinematics, Imaging, and Classification. Radiographics 2021;41:E155-E156. DOI: 10.1148/rg.2021210044.4.         Lee DJ, Elfar JC. Carpal Ligament Injuries, Pathomechanics, and Classification. Hand Clin 2015;31:389-398. DOI: 10.1016/j.hcl.2015.04.011.5.         Loisel...
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