X-rays - Stress, Stecher view

Two additional radiographs of the wrist are important for detecting injuries, namely the stress radiograph in the ball grip and the Stecher view. See how these are performed.

• In the stress view, the patient grips a rubber ball firmly. The wrist does not take an extended position as the forearm is padded. The carpal bones form a ring system held together with ligaments. The ball grip exposes the ring system to an axial load. In the dynamic form of scapholunate ligament rupture, there arises a gap between the scaphoid and lunate bones in the interrupted ring system.

• The Stecher view provides a better visualization of the scaphoid. Under rest, the scaphoid is flexed palmarwards by approx. 45 degrees, which results in a shortened projection in the dorsopalmar view. This is reduced by the patient closing the fist and simultaneously maximizing ulnar deviation of the wrist. Both procedures bring the scaphoid into a horizontal position with parallel alignment to the detector plane.

In the case of an acute wrist injury, radiographs should be completed with the stress and Stecher views after no fracture was visible in the initial radiographs in two planes.

Tags: Hand, Wrist, X-ray, Stress view, Stecher view