![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrZ7FJPJAp0xxFbYpsebpFH-q5nkixqzRhc5CfBefuOa7uQ1_sY_Lu_S_X9Y7r8Y-a1hmjhijPiVFT-IbSYEhl_jnNXvnosUkeSmfl7JQqqe0WJjhPAamLtBRB6Og_TUIc-7_8_XGgFw/s280/soft_tissue_pa_wrist_radiograph.jpg)
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6l-RqJYsQ-nKQ8IJPPUZjT0hQNhUwBUFkWHZaCph3NCO6iREW-Z3tAycRs5hfto3Jo7PpD8bkrirGNfsC4xYu6s04GtfqMVpd-lT9A4gXcRyY70LGdVIbG5BcTbv4c1j014bdtKgq2w/s280/soft_tissue_lat_wrist_radiograph.jpg)
Two images demonstrate five fat planes on the PA wrist radiograph, and four fat planes on the lateral wrist radiograph that should be scrutinized on any wrist radiography interpretation.
Facts:
- Soft tissue swelling is almost always seen in one or more compartments in cases of acute fracture or dislocation
- When swelling is observed on a trauma wrist radiograph, all soft tissue areas should be examined thoroughly and the assumption is that they may be a fracture or dislocation associated with swelling
- Abnormal fat planes = fat plane is convex out of the underlying bone, or loss of its distinct plane
What Do They Suggest?
- Dorsal hand swelling -> 2nd through 5th metacarpal injury
- Dorsal wrist swelling -> carpal fractures or wrist dislocation
- Dorsal radial swelling -> forearm fractures
- Pronator fat pad swelling -> forearm fractures
- Thenar swelling -> thumb fractures
- Hypothenar swelling -> 2nd through 5th metacarpal injury
- Scaphoid swelling -> carpal fractures
- Pararadial swelling -> forearm injury
- Paraulnar swelling -> forearm fracture
Reference:
Curtis DJ, Downey, Jr., EF, Brower AC, et al. Importance of soft-tissue evaluation in hand and wrist trauma: statistical evaluation. AJR 1984; 142:781-788.
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