Hand

Question 1

Hand

X-Ray Series

Answer 1

Routine Views

• PA
• Lateral Oblique
• Lateral

Optional Views

• Ap Bilateral Oblique - Ballcatcher - assess for early arthritis

Question 2

PA Hand

Answer 2

Cassette - 24x30cm, horizontal, divided in halves or 18x24

Positioning - pt sitting and elbow bent to 90 and resting on table and place hand on one half of the cassette and cover the other half with lead sheeting.

Stabilization - elbow on the table with arm as flat as possible, sandbag over forearm to immobilize needed after consent

Shielding - Gonad shielding/lead apron

Instructions - forearm pronated with palm flat on image, fingers separated

SID - 100cm

Central Ray - centred on 3rd MCP joint and perpendicular to image

Tube Tilt - 0

Collimation - M-L, all tissues of the hand and fingers. S-I, must include distal radius, ulna and soft tissues of the finger tips

Children 50 and adults 60

Marker Placement - lateral to the anatomy

Question 3

Lateral Hand

Answer 3

• Cassette - 24x30cm, horizontal, divided in halves or 18x24
• Positioning - pt sitting and elbow bent to 90 and resting on table and place hand on one half of the cassette and cover the other half with lead sheeting.
• Stabilization - elbow on the table with arm as flat as possible, stablize with a sponge
• Shielding - Gonad shielding/lead apron
• Instructions - pt places medial side of 5th digit against cassette and makes ok sign. Make sure metacarpals are superimposed
• SID - 100cm
• Central Ray - centred on 2nd MCP joint and perpendicular to image
• Tube Tilt - 0
• Collimation - M-L, all tissues of the hand and fingers. S-I, must include distal radius, ulna and soft tissues of the finger tips
• Children 50 and adults 60
• Marker Placement - anterior to the anatomy

Question 4

Lateral Oblique Hand

Answer 4

Cassette - 24x30cm, horizontal, divided in halves or 18x24

Positioning - pt sitting and elbow bent to 90 and resting on table and place hand on one half of the cassette and cover the other half with lead sheeting.

Stabilization - elbow on the table with arm as flat as possible, 45 sponge under hand

Shielding - Gonad shielding/lead apron

Instructions - No knees under table. pt rests hand against a 45 sponge with fingers separation

SID - 100cm

Central Ray - centred on 2nd MCP joint and perpendicular to image

Tube Tilt - 0

Collimation - M-L, all tissues of the hand and fingers. S-I, must include distal radius, ulna and soft tissues of the finger tips

Children 50 and adults 60

Marker Placement - anterior to the anatomy

Question 5

AP Bilateral Oblique Hand

Ballcatchers

Answer 5

Cassette - 24x30cm, horizontal

Positioning - pt sitting with no knees under table, elbows bent to 90 and resting on table.

Places hands on 45 sponge in a palms up position and slightly cupped and fingers slightly separated.

Stabilization - pt rests on forearm and elbows on table and 45 sponges

Shielding - Gonad shielding/lead apron, turn head away

Instructions - Places hands on 45 sponge in a palms up position and slightly cupped and fingers slightly separated.

SID - 100cm

Central Ray - space between the two hands and perpendicular to image plate

Tube Tilt - 0

Collimation - M-L, all tissues of the hand and fingers. S-I, must include distal radius, ulna and soft tissues of the finger tips

Children 50 and adults 60

Marker Placement - lateral to the anatomy