Pediatric Distal Forearm and Wrist Injury

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after May 25, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 2.25
Procedures: 2.25
Head, Spine, and Musculoskeletal: 2.25

Magnetic Resonance Imaging: 2.25
Procedures: 2.25
Musculoskeletal: 2.25

Nuclear Medicine Technology: 1.00
Procedures: 1.00
Other Imaging Procedures: 1.00

Radiography: 2.25
Procedures: 2.25
Extremity Procedures: 2.25

Registered Radiologist Assistant: 2.25
Procedures: 2.25
Musculoskeletal and Endocrine Sections: 2.25

Outline

1. Introduction
2. Development, Anatomy, and Radiologic-Anatomic Considerations
3. Distal Forearm Fractures
   1. Buckle Fractures
   2. Greenstick Fractures
   3. Complete or Displaced Fractures
   4. Physeal Injuries
4. Galeazzi and Galeazzi-equivalent Fractures
   1. Bone Contusion
   2. Carpal Fractures
   3. Scaphoid Fractures
5. Other Carpal Bone Fractures
6. Carpal Dislocations
7. Chronic Overuse Injuries
8. Conclusion

Objectives

Upon completion of this course, students will:

1. identify what patient demographic has growth plates
2. list differences between the pediatric and adult skeleton
3. describe the structure of the carpus at birth
4. list the order of carpal development
5. describe the articulation of the wrist
6. recite in order both the proximal and distal rows of carpal bones
7. recognize the pisiform as a sesamoid bone
8. describe ulnar variance
9. list the bones that align longitudinally in a laterally neutral wrist image
10. specify the amount of space between the scaphoid and lunate in a mature carpus
11. list the four most common distal radius fractures seen in children
12. explain where buckle fractures most commonly occur in the pediatric wrist
13. list views that are helpful in identifying subtle wrist injuries
14. specify the percentage of occurrence of sub-type Salter-Harris fractures
15. state radiographic findings that indicate further evaluation of occult type 1 fractures
16. describe what portion of the bones is involved in a Salter-Harris type IV fracture
17. list the Salter-Harris fracture classification types
18. explain where most Salter-Harris type V fractures occur
19. note the prevalence of Galeazzi fractures
20. specify the number of weeks for a bone contusion to heal
21. identify which imaging modality detects bone contusion
22. state the most frequently fractured carpal bone in children
23. list risk factors for increased chance of multiple scaphoid fractures
24. specify the modalities that best demonstrate pediatric lunate injuries
25. express which carpal is the last to ossify
26. describe how capitate fractures occur
27. classify the four stages of lesser arc injuries
28. verbalize the key finding on lateral wrist radiographs that helps diagnose carpal dislocation
29. describe changes noted in Salter-Harris type 1 fractures of the distal radius
30. note factors associated with chronic overuse injuries of the wrist and hand