Revision 2 for 'Wrist (carpal bridge view)'

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Wrist: carpal bridge view

The carpal bridge view an additional view to the three view series of the wrist and carpal bones. It is used to asses the dorsal aspect of the scaphoid,lunate and the triquetrum.

Patient position

  • patient is seated alongside the table
  • dorsal aspect of affected wrist is placed on the detector in felxion
  • flex the wrist as much as tolerable to the patient 

Technical factors

  • tangential projection
  • centering point
    • mid carpal region
    • the central ray is angled approximately 45 degrees to the long axis of the forearm 
  • collimation
    • laterally to the skin margins
    • dorsal to the skin margins 
    • ventral to the carpometacarpal joint 
  • orientation  
    • portrait
  • detector size
    • 18 cm x 24 cm
  • exposure
    • 50-60 kVp
    • 3-5 mAs
  • SID
    • 100 cm
  • grid
    • no

Image technical evaluation

There should be a clear outline of the dorsal aspect of the carpal bones with no superimposition.

The articulation between the distal radius and the ulna is open or has little superimposition 1.

Practical points

This is a very specialized projection and it can cause the patient significant pain if not performed properly, yet it can be very helpful in imaging triquetrum fractures. It is best to demonstrate to the patient physically what you plan to do before making them perform it, this way they are not in discomfort for long.

 

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