Indications for imaging
Injury, ? rheumatoid arthritis, bone pain.
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Anatomy Demonstrated
Hand Lt DP 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 hand is
then rotated laterally 35 to 45 degrees laterally and supported
so that the fingers are parallel to the film.
Hand Rt DP Oblique Position
(Support removed to show 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 to the 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
The center of the 1st to 5th metacarpal shafts should not
overlap, the heads of the 1st and 2nd metacarpals should be
separated.
Exposure, adequate penetration to visualise all bone detail and
low enough contrast to visualise the soft tissues.
Hand Rt DP Oblique Radiograph
http://www.vh.org
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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 useful.
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