A painful and swollen wrist
- By: Marcel J H Ariës, J A M Lemmens, M Brink, J J W Ploegmakers
A 70 year old woman fell forward and landed on her hands. Afterwards, her right wrist was painful and swollen. The right wrist looked as if it was displaced dorsally and it was painful in circular and axial compression.
In the A-P (fig 1a) and lateral views (fig 1b) of the wrist, the radius and ulna are clearly delineated. The carpal bones and the carpal joints can be seen on the A-P view. The lateral view shows a correct superposition of the ulna over the radius, indicating a correct lateral positioning of the wrist. The radial inclination and palmar (forward) angulation can be determined in both views.
The information in the conventional radiograph not only confirms the clinical suspicion of a fracture, but is also a helpful asset in determining treatment. In adults, most distal radius fractures should be treated by closed reduction (a manual procedure to position bone fragments