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MDCT and Radiography of Wrist Fractures: Radiographic Sensitivity and Fracture Patterns

Rodney D. Welling1, Jon A. Jacobson1, David A. Jamadar1, Suzanne Chong1, Elaine M. Caoili1 and Peter J. L. Jebson2

1 Department of Radiology, University of Michigan, 1500 E Medical Center Dr., TC-2910L, Ann Arbor, MI 48109-0326.
2 Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI.


Figure 1
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Fig. 1A —17-year-old boy with right scaphoid proximal pole and volar lunate fractures, neither of which was described in prospective radiography report, although patient had five radiographic views of wrist. Posteroanterior radiograph shows area of fracture (arrow).

 

Figure 2
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Fig. 1B —17-year-old boy with right scaphoid proximal pole and volar lunate fractures, neither of which was described in prospective radiography report, although patient had five radiographic views of wrist. Lateral radiograph shows no obvious fracture.

 

Figure 3
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Fig. 1C —17-year-old boy with right scaphoid proximal pole and volar lunate fractures, neither of which was described in prospective radiography report, although patient had five radiographic views of wrist. Sagittal reformatted CT scans through scaphoid (S in C) and lunate (L in D) show fractures (arrows).

 

Figure 4
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Fig. 1D —17-year-old boy with right scaphoid proximal pole and volar lunate fractures, neither of which was described in prospective radiography report, although patient had five radiographic views of wrist. Sagittal reformatted CT scans through scaphoid (S in C) and lunate (L in D) show fractures (arrows).

 

Figure 5
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Fig. 2A —43-year-old man with fractures of right triquetral body and dorsal scaphoid, neither of which was described in prospective radiography report. Semipronated oblique radiograph of wrist shows no obvious fracture.

 

Figure 6
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Fig. 2B —43-year-old man with fractures of right triquetral body and dorsal scaphoid, neither of which was described in prospective radiography report. Axial CT image through triquetrum (T) shows fracture (straight arrow). Note dorsal scaphoid (S) avulsion fracture (curved arrow).

 

Figure 7
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Fig. 3A —39-year-old man with left pisiform fracture prospectively described in radiography report. Posteroanterior radiograph (A) and axial CT image (B) show pisiform fracture (arrows).

 

Figure 8
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Fig. 3B —39-year-old man with left pisiform fracture prospectively described in radiography report. Posteroanterior radiograph (A) and axial CT image (B) show pisiform fracture (arrows).

 

Figure 9
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Fig. 4A —60-year-old woman with right trapezial ridge and dorsal scaphoid avulsion fractures, neither of which was described on prospective radiography report. Semipronated radiograph shows no obvious fracture.

 

Figure 10
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Fig. 4B —60-year-old woman with right trapezial ridge and dorsal scaphoid avulsion fractures, neither of which was described on prospective radiography report. Semisupinated radiograph shows dorsal scaphoid fracture (arrow).

 

Figure 11
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Fig. 4C —60-year-old woman with right trapezial ridge and dorsal scaphoid avulsion fractures, neither of which was described on prospective radiography report. Axial CT images at level of trapezium (T in C) and scaphoid (S in D) show fractures (arrows).

 

Figure 12
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Fig. 4D —60-year-old woman with right trapezial ridge and dorsal scaphoid avulsion fractures, neither of which was described on prospective radiography report. Axial CT images at level of trapezium (T in C) and scaphoid (S in D) show fractures (arrows).

 

Figure 13
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Fig. 5A —23-year-old woman with left trapezoid and dorsal hamate fractures, neither of which was described, and third metacarpal base fracture that was described in prospective radiography report. Semipronated radiograph shows fracture (curved arrow) of metacarpal.

 

Figure 14
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Fig. 5B —23-year-old woman with left trapezoid and dorsal hamate fractures, neither of which was described, and third metacarpal base fracture that was described in prospective radiography report. Axial CT image shows fractures (arrows) of trapezoid (T) and hamate (H).

 

Figure 15
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Fig. 6A —34-year-old man with right capitate fracture not described and hamate body fracture that was described in prospective radiography report. Posteroanterior wrist radiograph shows hamate body fracture (arrows) and no obvious capitate fracture.

 

Figure 16
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Fig. 6B —34-year-old man with right capitate fracture not described and hamate body fracture that was described in prospective radiography report. Axial CT image shows fractures (arrows) of hamate body (H) and capitate (C).

 

Figure 17
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Fig. 7A —21-year-old woman with left hook of hamate fracture that was not described and ulnar styloid fracture that was described in prospective radiography report. Patient did not have carpal tunnel views. Lateral wrist radiograph shows no obvious hamate fracture.

 

Figure 18
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Fig. 7B —21-year-old woman with left hook of hamate fracture that was not described and ulnar styloid fracture that was described in prospective radiography report. Patient did not have carpal tunnel views. Axial CT image at level of hamate (H) hook shows fracture (arrow).

 

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