0:01

Here's a person who has pain over the dorsum

0:04

of the wrist After punching an object,

0:07

we have three projections of the hand,

0:10

and as we look at our frontal projection, we can identify

0:13

that distal radius and ulnar are intact.

0:15

There's a small calcification next to the ulnar styloid,

0:19

probably within the tendon.

0:21

Carpal arcs are maintained.

0:23

So if we zoom in on the wrist,

0:25

you can see the proximal carpal row arc is maintained here.

0:29

Distal aspect of the proximal carpal bones is maintained.

0:32

Base of the distal carpal row is maintained.

0:35

But if we look along the carpal metacarpal junction,

0:38

we can see a parallelism through the articular surface here,

0:43

which is then lost over the base of the ring finger.

0:47

So that's suspicious for an injury.

0:50

We go to our lateral projection, that's

0:53

where the patient is hurting, as we can see

0:55

by the arrow placed here.

0:57

There's also some posterior displacement of the base

1:00

of the metacarpal oblique projection.

1:04

Also suspicious that there is a subluxation event here.

1:08

Going back to the frontal,

1:10

there's also this discontinuity

1:13

along the base of the metacarpal.

1:15

So based on the radiographic findings here,

1:18

we would consider a dislocation

1:20

or fracture, dislocation of the ring finger.

1:24

Carpal metacarpal articulation.

Case: CMC Injury

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