RADIOGRAPHY OF THE HAND, FINGERS & THUMB

RADIOGRAPHY OF THE HAND, FINGERS & THUMB

FINGERS (2nd 5th) - PA Projection Patient Position: Seated; hand ; elbow on IR table top Part Position: Fingers centered to IR unless protocol is

Central Ray: Perpendicular to Structures Shown: Note can be done in cases of trauma.

Criteria for Evaluation: Long axis of finger should be aligned with of IR No of digit. Concavity the phalangeal and an of soft tissue on each side of phalanges Open

FINGERS (2 nd 5 th ) Oblique Projection Patient Position: Seated; hand ; elbow on tabletop

Part Position: Fingers Rotate hand until ( degrees). Digits are to IR Central Ray: to PIP joint Structures Shown:

Criteria for Evaluation: should be aligned with long axis of IR Digit degrees with no of adjacent digits. Open

Oblique finger Error: Obliqued, of metacarpals overlapped. To correct oblique finger only degrees.

FINGERS (2nd-5th) Lateral Projection Patient Position: Seated, on IR Part Position: to be examined Close Hand should be

Part Position (Continued): ( ) surface for 2nd or 3rd finger ( ) surface for 4th or 5th finger NOTE: may be done either way (radial or ulnar side down)

Central Ray: Structures:

Criteria for Evaluation: should be aligned with long axis of IR Fingernail in surface of phalanges Head of phalanx is and to IR Open

THUMB AP Projection Patient Position: Seated, elbow or Part Position: Hand in extreme ( ) rotation Fingers Thumb adjusted to ( )

Central Ray: Structures Shown:

THUMB PA Projection Patient Position: Seated Elbow Part Position: Hand in position Thumb to IR Note: Increased OID in magnification

Central Ray: Structures Shown: Criteria for Evaluation (AP or PA) should be aligned with long axis of IR Open of soft tissue on

THUMB PA Oblique Patient Position: Seated Elbow Part Position: Projection Hand with slight deviation Thumb is ; no rotation of

Central Ray: Structures Shown: Criteria for evaluation

THUMB Lateral Projection Patient Position: Seated Elbow Part Position: Hand Hand in position Arch hand until is obtained

Central Ray: Structures Shown: Criteria for evaluation Thumbnail in surface of proximal phalanx open

HAND PA Projection Patient Position: Seated on tabletop Elbow Part Position: Hand surface on IR

Central Ray: Structures Shown: Note: Thumb is in position

Criteria for Evaluation: should be aligned with long axis of IR Digits slightly No rotation of. appearance of of shaft of MC and phalanges. Thumb is in the position. An of soft tissue on each side of 2 nd 5 th phanalges Open

PA hand positioning error: Fingers are ; poor visualization of. No. Note extra digit (polydactyl).

PA hand positioning error: Wrist not in of IR, causes rotation of. First and second MCP joints are

HAND PA Oblique Projection Patient Position: Seated Elbow Part Position: hand, rotate entire hand and wrist º joints form a º angle to IR Fingers ( to IR if possible) and

Central Ray: Structures Shown:

Oblique Hand Criteria for Evaluation The IP and MP joints should be visible as, and the phalanges should be demonstrated without. The fingers should be with the IR The 2 nd & 3 rd metacarpal heads should. The 3 rd through 5 th metacarpal heads should

Oblique Hand Error: hand rotated, fingers position. To correct: oblique the hand and the fingers.

Oblique Hand Error: hand rotated, fingers. To correct: oblique the hand and fingers.

Oblique Hand Error: hand rotated & 2 nd digit. To correct; rotate the hand and 2 nd digit.

HAND Lateral Projection (In Flexion) Patient Position: Seated Elbow Part Position: Fingers in and Thumb to IR Hand in position

Central Ray: Structures Shown:

HAND Lateral Projection (In Extension) Patient Position: Seated Elbow ( ) side of hand on IR Part Position: Fingers Thumb at Hand in position

Central Ray: Structures Shown:

NOTE: Fan lateral used to

Lateral Hand Criteria for Evaluation should be aligned with long axis of IR The should be superimposed. The 2 nd -5 th metacarpals should be. The 2 nd -5 th phalanges should be.

Lateral Hand Error: hand, fingers not, metacarpals not, and radius and ulna not. Hand with the IR. To correct: Place hand and forearm and in alignment with IR. Rotate the hand

HANDS AP Oblique Projection Norgaard Method - Ball-Catcher s Projection rotation with aspect of the hand closest to the IR. For in MCP joints

AP Oblique Projection

Situation: A radiograph of a PA projection of the hand reveals that he distal radius and ulna and the carpals are cut off the image. The CR was centered to the 3 rd proximal interphalangeal joint. Solution: Repeat the projection with the CR centered to the joint to correct this problem. Answer:

Situation: A patient arrives in radiology with a metal foreign body in the palm of the hand. Which projections of the hand should be performed on the patient to confirm the location of the foreign body? Solution: and. Answer