Physical and radiographic identification of the bones of the wrist by junior doctors.

Abstract

Accurate clinical and radiographic examination of a wrist is required to diagnose injury. Knowledge of basic wrist anatomy is the key to ensuring a complete assessment. We tested junior doctors' basic knowledge of the bony anatomy of the wrist. We asked 102 trainees in accident and emergency and orthopaedic departments to palpate nine landmarks on uninjured subjects and then asked them to name the carpal bones on a plain wrist radiograph. No doctor identified all nine landmarks clinically. Only 60% could accurately name all eight carpal bones on a plain radiograph. This study highlights a lack of basic anatomical and radiographic knowledge that is required for examination of the wrist in the hospital setting and discusses issues that may relate to this in medical training.