E5002. Radiology of Carpal Bone Fractures: Beyond the Scaphoid
  1. Jeffers Nguyen; Yale University School of Medicine
  2. Kimia Kani; University of Maryland School of Medicine
  3. Felix Chew; Department of Radiology, University of Washington
  4. Jack Porrino; Yale University School of Medicine
Carpal injuries can easily go undetected, delaying diagnosis, and resulting in inadequate management and treatment. Significant morbidity can arise from instability caused by undetected carpal ligamentous and osseous disruptions. We provide an overview of relevant carpal anatomy and review the mechanisms of injury, classifications, imaging findings, treatment, and complications of carpal injuries (excluding the scaphoid).

Educational Goals / Teaching Points
Appreciate the epidemiology of carpal injuries (excluding scaphoid fractures). Understand the limitations of clinical assessment and radiography in evaluating suspected carpal fractures. Be familiar with the relevant anatomy, mechanisms of action, classifications, imaging assessment (diagnostic workup and follow-up imaging), treatment, and complications of carpal injuries.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
After briefly overviewing the epidemiology of carpal fractures and relevant anatomy (osseous, vascular, and ligamentous structures), there will be a deeper dive into each carpal bone, further expounding on their respective classification systems, mechanisms of action, diagnostic workup, treatment, and complications. Representative radiography, CT, and MR images will be provided.

Carpal fractures are rare injuries. Delayed diagnosis or failure to recognize can lead to disabling sequelae of the wrist. Knowledge of mechanism of action and anatomy can greatly inform diagnosis and management. CT and MRI can be powerful tools to identify occult carpal fractures and illuminate the complexities of fractures for appropriate management.