Indications for imaging
Rheumatoid arthritis,
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Anatomy Demonstrated
Hand Rt Anatomy
Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy
Saunders, London
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Basic Patient Position
The patient stands alongside the end of the table elbow extended
palm upwards, hand flexed 40 degrees at the metacarpo
phalangeal joints posterior aspect of the fingers in contact with
the cassette, and the wrist supported as required.
Hand Rt Brewertons Patient Position
From Special Techniques in Orthopaedic Radiography W J Stripp)
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Radiation protection
Direct lead rubber gonad protection using a "half
apron".
Ensure the lower limbs and torso are not below the table top in
the primary beam.
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Central Ray
The vertical central ray is angled 20 degrees laterally across
the table and directed to he head of the third
metacarpal.
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Exposure Factors
| Kv |
mAS |
FFD (cm) |
Grid |
Focus |
AEC |
Cassette |
| 55 |
5 |
100 |
No |
Fine |
No |
24 x 30 cm |
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Evaluation of the Image
ID and markers must be present and correct in the appropriate
area of the film
Evidence of collimation on four sides equally around the
centering point.
Limits of the examination, proximally the radio and ulna carpal
joints, distally the tips of the distal phalanges, laterally the
skin margins of first and fifth digits.
metacarpo phalangeal joints should be open and the shafts of the
second to fifth metacarpals should be symmetrical.
Exposure, adequate penetration to visualise all bone detail and
low enough contrast to visualise the soft tissues.
Hand Rt Brewertons
From Special Techniques in Orthopaedic
Radiography W J Stripp) |
Related Projections
Hand PD "Ball catching for rheumatoid)
Hand DP Oblique
Fingers Lat.
Thumb AP
Thumb Lat. Wrist AP
Wrist Lat
Wrist Oblique
Wrist AP Angled for Scaphoid
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Additional modalities
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