HAND X RAY

hand x ray AP and Lateral projection normal hand x ray and broken hand xray

hand x ray

PA PROJECTION HAND X RAY VIEWS
ANATOMIC STRUCTURES

Distal radius and ulna
Carpals
Metacarpals
Phalanges
thumb x ray (oblique projection)
All articulations of the hand
FILM SIZE
10 X 12 in. (24 x 30 cm)
Divide film in half, crosswise

PATIENT POSITION

Seat patient at end of table to place entire upper extremity in same horizontal plane as film.
Place lead shield over patient to protect gonads.

PART POSITION

Flex elbow (about 90°) and pronate hand (palm down).on unmasked 1/2 of cassette with fingers slightly separated.
Align long axis of unmasked 2 of cassette with long axis of hand and forearm.
Center unmasked 1/2 of cassette to level of metacarpophalangeal joints.

CENTRAL RAY

Direct central ray perpendicular to 3rd metacarpophalangeal joint.

IMAGE CRITERIA

Entire hand should be seen without rotation for normal hand x ray (as evidenced by equal concavities of both sides of shafts of phalanges and metacarpals). Metacarpophalangcal and interphalangeal joint spaces should be opened (requiring hand to be placed flat on cassette).
Phalanges should be separated with no overlapping of bone or soft tissue.
Distal radius and ulna should be seen without rotation

hand x ray views

LATERAL FAN PROJECTION FOR LEFT AND RIGHT HAND X RAY

ANATOMIC STRUCTURES
Distal radius and ulna
Carpals
Metacarpals
Phalanges
FILM SIZE
8 x 10 in. (18 x 24 cm), lengthwise

PATIENT POSITION

Seat patient at end of table to place entire upper extremity in same horizontal plane as film
Place lead shield over patient to protect gonads.

PART POSITION

Flex elbow (about 90°) and place hand in lateral position thumb side up) with fingers placed on a sponge wedge in a fanned position
Align long axis of cassette with long axis of hand and forearm.
Center cassette at level of metacarpophalangeal joints.
Place thumb parallel to film.

CENTRAL RAY

Direct central ray perpendicular to level of metacarpophalangeal joints

IMAGE CRITERIA

Phalanges should be seen free of superimposition, except at proximal ends.
Metacarpals, carpals, and distal radius and ulna should be superimposed
Thumb should be free of superimposition.

PA OBLIQUE PROJECTION
ANATOMIC STRUCTURES

Distal radius and ulna
Carpals
Metacarpals
Phalanges
FILM SIZE
10 x 12 in. (24 x 30 cm)
Divide film in half, crosswise

PATIENT POSITION

Seat patient at end of table to place entire upper extremity in same horizontal plane as film
Place lead shield over patient to protect gonads.

PART POSITION

Flex elbow (about 90°) and pronate hand (palm down) on unmasked, of cassette
Align long axis of unmasked, of cassette with long axis of hand and forearm.
Center unmasked half of cassette to level of metacarpophalangeal joints.
Oblique hand toward the lateral so that metacarpophalangeal joints form a 45° angle with plane of film.
Use radiolucent immobilization device to support hand in proper position and to prevent bending of fingers

CENTRAL RAY

Direct central ray perpendicular to 3rd metacarpophalangcal joint.

IMAGE CRITERIA

Entire hand should be seen with fingers well separated and interphalangeal joint spaces open (if interphalangeal joint spaces are overlapped, fingers were not adequately extended)
Metacarpals should be seen with minimal overlapping of shafts, bases, and heads (if no overlap, there is insufficient obliquity of hand, if excessive overlap, there is too much obliquity of hand).
Metacarpophalangeal joint spaces should be open
Distal radius and ulna should be seen with some superimposition

Read More https://getetech.com/skull-x-ray-positioning-anatomy-and-lateral-view-of-skull/  

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