Patient presents with left wrist discomfort after a FOOSH type injury. Value of the semi-supinated view.
No prior surgeries, carcinoma or corticosteroid/opioid regimen reported.
What do you see?
The positioning required for a semi-supinated view (Norgaard view) to visualize metacarpal heads. (1)
PA view of left wrist- shows cortical incongruity of the distal metaphysis with V-shape defect when compared to the 5th. MC.
Value of the semi-supinated view showing a transversely oriented radiolucency consistent with fracture . The MCP joint is spared.
DISCUSSION: The Norgaard or “Ball-catchers” view requires the medial (ulnar) aspect of the hands to be closely approximated with the palms up and the hands obliqued 45 degrees. This view is commonly employed when evaluating for rheumatoid arthritis. (3)
REFERENCES:
- http://www.radtechonduty.com/2011/12/ap-oblique-bilateral-projection-hand.html
- Fracture of the base of the little finger metacarpal: importance of the “ball-catcher” radiographic view
DOI: 10.1016/0736-4679(91)90321-6 - https://www.ncbi.nlm.nih.gov/books/NBK565865/