Upper Limb Projections Flashcards
Standard hand projections
PA
PA oblique
PA Hand settings
3rd MCP joint
45
2.5
PA Oblique Hand settings
3rd MCP joint
45
2.5
Supplementary hand projections
PA both hands
Lateral
Norgaard
What is PA both hands used for?
Metabolic diseases and Arthritis
Use of Norgaard
RA
Lateral Hand postitioning
2nd MCP joint
50
4.5
Norgaard positioning
AP 45 deg Int rotation C: in-between hands at MCP joints 45 2.5
Standard finger projections
PA
PA Oblique
Lateral
PA Finger Positioing
PA
PIP joint
42
2
PA finger oblique
45 degree rotation, radial side elevated
PIP
42
2
Finger lateral
2nd and 3rd = radial aspect on plate 4th and 5th = ulna aspect on plate PIP 42 2
Thumb Projections
AP/PA
PA Oblique
Lateral
AP thumb positioning
Internal rotation of hand to give clear projection of thumb
MCP joint
42
2
PA thumb positioning
Ulna side in contact with plate thumb immobilised MCP joint 42 2
Standard kVp and mAs for fingers and thumb
42
2
PA thumb oblique postioing
Place hand palm down in natural position
MCP joint
42
2
Thumb lateral positioing
from PA oblique , raise fingers by rolling hand onto radial aspect
MCP joint
42
2
Standard Wrist projections
PA
PA oblique
LAteral
PA wrist position
fingers slightly curled forearm flat on plate C: midway between radial and ulna styloid processes 50 2.8
PA oblique wrist position
45 deg rotation (radial side elevated)
C: midway between radial and ulna styloid processes
50
3.2
Lateral wrist position
SI both styloid processes Thumb in PA position Radial side elevated C: radial styloid 55 3.6
Standard Scaphoid projections
PA (ulna deviation)
PA Oblique (Ulna deviation)
Lateral (ulna devation)
Stecher
Stecher view positioning
PA (ulna deviation)
C: 2cm distal and medial to radial styloid
20 deg beam angulation
can be done at various angles 5,10,15,20,25,30
Additional scaphoid projection
Macroradiography
Decrease FFD and increase ODD
Standard Forearm projections
AP
Lateral
AP forearm postion
WES
C: middle of fore arm
50
3.6
Lateral forearm position
WES SI styloid processes digits and thumb in AP position C: middle of forearm 52 4
What can be done if the 2 standard forearm projections are unavailable due to present pathology?
PA Wrist with Lateral Elbow and Lateral Wrist with AP
Elbow. (Modified Forearm Series)
Standard elbow projections
AP
AP external oblique
Lateral
AP elbow position
WES
C: midway between humeral epicondyles
50
4
AP external oblique elbow position
WES 40-45 deg ext rotation (ulna side up) C: midway between humeral epicondyles 50 4.5
Lateral elbow position
WES flex elbow to 90 deg Ulna aspect in contact with plate (will SI styloid processes) or hand PA and elevated off table C: lat epicondyle 52 4
Additional elbow views
elbow in partial flexion
radial head Capitulum view
Elbow partial flexion position
same as AP elbow but forearm is lifted up and away from imaging plate.
C: over elbow joint
OR
forearm in contact but humerus elevated away from imaging plate
Radial head capitulum view
same as lateral elbow but angle ray 45 degree medially (towards patient shoulder)