Study of the Hand

PA Projection

1. Seat the patient at the end of the table;
2. Lower limbs remote from the radiation;
3. Support the forearm and arm;
4. Hand in pronation with the fingers in extension;
5. The palmar surface of the hand resting on IP;
6. Spread the fingers slightly.

Central ray perpendicular to the third MCP joint.

 Evaluation Criteria:

• No rotation;
• Hand centered and aligned with the center of collimation;
• Visualization of a distal third of the forearm, wrist joint and distal phalanges;
• Open MCP and interphalangeal joints, indicating that the hand is placed flat on the IP;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).

 

PA oblique Projection

1. Seat the patient at the end of the table;
2. Lower limbs away from the radiation;
3. Forearm resting on the table;
4. Hand in oblique position so that all digits are free of overlapping and profile;
5. Adjust the obliquity of the hand so that the MCP joints form an angle of approximately 45º with IP.

Central ray perpendicular to the third MCP joint.

 Evaluation Criteria:

• Visualization of a distal third of the forearm, wrist joint and distal phalanges;
• Slight overlap of the bases and heads of the metacarpals (2nd to 5th);
• Spaces between the third, fourth and fifth metacarpals reduced;
• Opening interphalangeal and metacarpophalangeal joints;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).

 

Study of the Thumb (First Digit)

PA Projection

1. Seat the patient at the end of the table;
2. Lower limbs away from the radiation;
3. Hand in profile position;
4. The remaining digits away from the thumb.

Central ray is perpendicular to the interphalangeal joint or metacarpophalangeal.

 

Evaluation Criteria:

• No rotation of the thumb;
• View all the digit including the metacarpophalangeal (MCP) joint;
• Open interphalangeal and MCP joint spaces without overlap of the bones;
• Digit centered and aligned in the center of collimation;
• Not visualization the soft tissue of adjacent fingers;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).

 

Lateral Projection

1. Seat the patient at the end of the table;
2. Lower limbs remote from the radiation;
3. Support the forearm and arm;
4. The side of the thumb resting on the IP;
5. Flexion of the fingers.

Central ray is perpendicular to the interphalangeal joint or metacarpophalangeal.

 

Evaluation Criteria:

• Thumb strictly in profile;
• View all the digit including the metacarpophalangeal joint;
• Open interphalangeal and MCP joint spaces;
• Finger centered and aligned in the center of collimation;
• Not visualization the soft tissue of adjacent fingers;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).