Hand Flashcards
What are the essential projections for a hand x-ray?
PA, fan lateral, and PA oblique
What should the patients position be for a hand x-ray? (lateral, fan lateral, and PA oblique)
seat the patient at the end of the radiographic table
adjust the patient’s height so that the forearm is resting on the table
What should the part position be like for a PA hand?
Hint: think forearm and digits
palmar surface on IR
forearm on table
extend and separate digits to prevent soft tissue overlap
center third MCP joint to IR
Where should the central ray enter for a PA hand?
perpendicular to third MCP joint
what should the collimation be like for a hand x-ray?
1 inch on all sides including 1 inch proximal to the ulnar styloid
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anatomy from fingertips to distal radius and ulna
slightly separate digits with no sift tissue overlap
Evaluation criteria - What should be visible on the metacarpal and phalangeal bodies?
equal concavity of the metacarpal and phalangeal bodies
equal amount of soft tissue on both sides of the phalanges
equal distance between the metacarpal heads
evaluation criteria - what should be visible in the center of each distal phalanx?
the nail
evaluation criteria - What joint spaces should be visible in a PA hand image and what does it indicate?
MCP and IP joints. It indicates that the hand is flat on the IR
part position - what part should be on the table besides the hand?
the forearm
part position - what angle should the palm and MCP joints be in for a PA oblique hand?
45 degree angle
Where should the the central ray be for a PA oblique hand?
perpendicular to third MCP joint
What structures should be shown in a PA oblique hand?
anatomy from fingertips to distal radius and ulna
digits separated slightly with no overlap of their soft tissues
45 degree rotation of anatomy
Evaluation - What does the 45 degree rotation of anatomy do in a PA oblique hand
think metacarpal bodies 2-5 and fourth and fifth
it decreases the amounts of separation between metacarpal bodies 2-5
it causes the partial superimposition of the third fourth, and fifth metacarpal bases and heads
eval criteria - Why is it important to have the digits parallel in a PA oblique hand?
so that you get open IP joint spaces
What should the part position be like for a fan lateral hand image?
forearm on table with elbow flexed 90 degrees and hand resting on medial surface
part position - what should happen to the palm of the hand and the radial and ulnar styloid processes when the hand is in a fan lateral position?
the ulnar and radial styloid processes should be superimposed and perpendicular to IR
the palm of the hand should be perpendicular to the IR
Where should the central ray enter for a fan lateral hand?
perpendicular to the second MCP point
what are the structures shown in a fan lateral position?
anatomy from fingertips to distal radius and ulna
eval - what should happen to the distal radius and ulna in a fan lateral hand position?
they should be superimposed
