Upper extremities
Norgaard Method "Ball Catcher's Position"
Situation: A patient comes to the radiology department for a hand series to evaluate early evidence of rheumatoid arthritis. Which special position can be used in addition to the routine hand projections to evaluate this patient?
Wrist set up
Slightly arch the hand at the MCP joints by flexing the digits to place the wrist in close contact with the IR
Metacarpal articulate with the phalanges at their distal ends. The metacarpophalangeal (MCP) articulation are
Synovial ellipsoidal joints -flexion, extension, abduction, addiction, circumduction
Lateromedial in flexion hand
Useful when a hand injury prevents patients from extending fingers for a lateral -fingers are in flexion (when they can't bend them straight)
Burman Method
What AP Projection (with hyperflexion of the wrist,mangled 45-degrees towards the elbow) demonstrates the first CMC joint?
CMC joint
carpometacarpal joint
hinge joint movement
flexion and extension
synovial joint
freely movable joint
Lateral first digit
Clench fist to make thumb go to side
carpometacarpal joint
Connects the metacarpals to the distal carpals -top of the wrist bones
For the lateral third and fourth digit
Elevate them and place their long axes parallel with the plane of the IR
The interphalangeal articulations between the phalanges are synovial hinge type and allow for what
Flexion and extension
Lateral projection of digits
For second and third digit, have patients hand rest on the lateral or radial side (side near thumb) -for fourth or fifth digit have it test on the medial or ulnar side (pinky)
Oblique first digit
Hand resting normally -has oblique normally
Because the first digit on it has two phalanges, the joint between the two phalanges is simply called
IP joint
Collimation for digits
1 inch on all sides
folio method (skiers thumb)
PA stress view of a thumb, tests hyperextension of thumb -ulnar collateral ligament rupture in the MCP joint of thumb -tightly wrap rubber band around thumbs and place a roll of medical tape between
Digits numbered
1-6 Thumb is 1, pinky is 6
The ip joints are names by their location
Proximal interphalangeal (PIP) or distal interphalangeal (DIP)
Ap projection of thumb
ROBERT method -used to show arthritic changes, fractures, displacement of the first CMC joint
For the lateral second and fifth digit
Rest them directly on the IR
PA first digit
Rest thumb on a radio graphic support or hold it up with a stick -central ray to MCP joint
Lateral projection hand central ray
Second digit MCP
Norgaard Method
what is the proper name for the position referred to as the "ball-catcher's position)
Wrist central ray
-perpendicular to the mid carpal area Radiocarpal joint
Ap first digit
Palm of thumb is touching IR -hand is kind of flipped upside down
Central ray for norgaard method
Perpendicular to a point midway between both hands at the level of the MCP joints
Central ray for hand
Perpendicular to the 3rd MCP joint; except for LATERAL
MCP
metacarpophalangeal joint -knuckle joint
radiocarpal joint
pertaining to the joint between the radius and wrist
