Indications for imaging
Injury, ? rheumatoid arthritis, ?acromegaly, bone pain.
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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 sits alongside the end of the table elbow flexed
palm downwards, or at the end of the table with he elbow flexed
at 90 degrees, hand and wrist flat on the cassette the elbow may
need a small pad to promote contact of the hand with the cassette. The
fingers can be spread slightly.
 
Hand Rt DP Patient Position
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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 directed tot 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 DP
http://www.vh.org |
Related Projections
Hand DP "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
RNI may be helpful in some conditions.
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