Upper Limb xray

Question 1

hand dp patient position

Answer 1

alongside table affected arm nearest
pronate forearm
fingers separated and relax
radial ulnar styloid processes equidistant from detector

Question 2

hand dp centring point

Answer 2

head of third metacarpal

Question 3

hand dp essential image characteristics

Answer 3

all joints demonstrated
collimation: distal radius and ulna, soft tissue of fingertips

Question 4

hand dp oblique position

Answer 4

rotate externally 45 from dp
fingers still separated

Question 5

hand oblique centring point

Answer 5

head second metacarpal

Question 6

hand dp oblique essential image characteristics

Answer 6

heads of metacarpals not superimposed
collimation: distal radius and ulna, soft tissue of fingertips

Question 7

hand lateral position

Answer 7

rotate externally 90 from dp
extend fingers, abduct thumb
radial ulnar styloid processes, carpals, metacarpals superimposed

Question 8

hand lateral centring point

Answer 8

head second metacarpal

Question 9

hand lateral essential image characteristics

Answer 9

collimation: distal radius and ulna, soft tissue of fingertips

Question 10

wrist pa position

Answer 10

alongside table affected arm nearest
flex elbow 90 flex fingers slightly, pronated
shoulder and forearm at same level
mid ulnar deviation
radial ulnar styloid processes equidistant from detector

Question 11

wrist pa centring point

Answer 11

midway between radial ulnar styloid processes

Question 12

wrist pa essential image characteristics

Answer 12

no rotation
collimation: distal third radius ulna, proximal 2/3 metacarpals, all carpals

Question 13

wrist lateral position

Answer 13

alongside table affected side nearest
extend elbow
rotated 90 so radial ulnar styloids superimposed

Question 14

wrist lateral centring point

Answer 14

radial styloid process

Question 15

wrist lateral essential image characteristics

Answer 15

no rotation of wrist
collimation: proximal 2/3 metacarpals, carpals and distal third of radius and ulna

Question 16

AP elbow position

Answer 16

seated next to table affected side nearest
extend arm, supinate
medial and lateral epicondyles equidistant from detector

Question 17

ap elbow centring point

Answer 17

2.5cm below middle of medial and lateral epicondyles of humerus

Question 18

ap elbow collimation

Answer 18

distal 1/3 humerus, proximal 1/3 radius and ulna

Question 19

lateral elbow position

Answer 19

seated next to table, affected arm nearest
elbow flex 90, palm 90 to detector

Question 20

lateral elbow centring point

Answer 20

lateral epicondyle humerus

Question 21

lateral elbow essential image characteristics

Answer 21

epicondyles superimposed
collimation: distal 1/3 humerus, proximal 1/3 radius ulnar

Question 22

dp fingers position

Answer 22

seat next to table, affected side nearest
pronated, extend and separate fingers

Question 23

dp finger centring point

Answer 23

proximal interphalangeal joint of affected finger

Question 24

dp finger essential image characteristics

Answer 24

include unaffected finger for comparison
collimation: fingertips and distal 1/3 metacarpals

Question 25

lateral middle and index fingers position

Answer 25

medially rotate arm fully extend index finger, slightly flex middle remaining fingers fully flex into palm

Question 26

lateral middle and index finger centring point

Answer 26

proximal interphalangeal joint of affected finger

Question 27

lateral middle and index finger collimation

Answer 27

metacarpal distal 1/3 fingertips

Question 28

lateral ring and little finger position

Answer 28

medial aspect little finger contact detector fully extend little, slightly flex ring, rest fully flexed

Question 29

lateral ring and little finger centring point

Answer 29

proximal interphalangeal joint of affected finger

Question 30

lateral ring and little finger collimation

Answer 30

distal 1/3 metacarpal, fingertips

Question 31

thumb ap (wall stand) position

Answer 31

back of hand placed on detector thumb fully AP

Question 32

thumb ap (sitting) position

Answer 32

face away from table, arm extend back lean forward to lower shoulder

Question 33

thumb ap centring point

Answer 33

first metacarpo-phalangeal joint

Question 34

thumb ap essential image characteristics

Answer 34

carpo metacarpo joint included collimation: tip, distal 1/3 metacarpal, trapezium

Question 35

lateral thumb position (sitting)

Answer 35

seated alongside table, flex elbow, pronated lateral part of thumb contacts detector

Question 36

lateral thumb position (erect)

Answer 36

place palm on wall detector flex fingers so thumb is lateral

Question 37

lateral thumb centring point

Answer 37

first metacarpo-phalangeal joint

Question 38

lateral thumb collimation

Answer 38

tip carpo-metacarpal joint distal 1/3 metacarpal

Question 39

clavicle pa position

Answer 39

faces vertical detector midpoint clavicle in centre head turned to side, rotate affected shoulder arrested respiration

Question 40

clavicle pa centring point

Answer 40

midpoint of clavicle

Question 41

clavicle pa essential image characteristics

Answer 41

should be parallel so no foreshortening collimation: sterno-clavicular and acromioclavicular joints seen

Question 42

clavicle AP position

Answer 42

back to wall stand can angle 15 degrees towards shoulder as already 30 cranially head turn awayc

Question 43

clavicle ap centring point

Answer 43

midpoint of clavicle

Question 44

shoulder girdle AP 15 position

Answer 44

stand back to detector rotate 15degrees toward bad side arm abducted and supine turn head away

Question 45

shoulder girdle AP 15 centring point

Answer 45

coracoid process of scapula

Question 46

shoulder girdle AP 15 image characteristics

Answer 46

humerus head slight overlap glenoid cavity but separate from acromion process collimation: proximal 1/3 humerus, inferior angle of scapula, whole clavicle, sternoid clavicular joint

Question 47

forearm AP position

Answer 47

seat next to table affected side nearest elbow fully extend arm abduct and supine shoulder same level radial ulnar styloid processes, medial lateral epicondyles equidistant from detector

Question 48

forearm AP centring point

Answer 48

middle of forearm

Question 49

forearm AP collimation

Answer 49

from wrist joint to elbow joint

Question 50

forearm lateral position

Answer 50

flex elbow 90 from AP position medial aspect contacts detector radial ulnar styloid processes, medial lateral epicondyles superimposed

Question 51

forearm lateral centring point

Answer 51

midway forearm

Question 52

forearm lateral collimation

Answer 52

from wrist joint to elbow joint

Question 53

shoulder axial position

Answer 53

seated next unaffected side closer lean toward table flex elbow and abduct arm slight angle tube

Question 54

shoulder axial centring point

Answer 54

head of humerus/mid GH joint

Question 55

shoulder axial collimation

Answer 55

acromion process, glenoid cavity head of humerus

Question 56

AP humerus position

Answer 56

back touches detector rotate toward affected side medial lateral humeral epicondyles equidistant from detector

Question 57

AP humerus centring point

Answer 57

midway between shoulder and elbow

Question 58

AP humerus collimation

Answer 58

shoulder to elbow, proximal 1/4 radius ulna

Question 59

lateral humerus position

Answer 59

front touches detector abduct arm, but arm still touches detector hand in front of stomach area

Question 60

lateral humerus centring point

Answer 60

midway between shoulder and elbow

Question 61

lateral humerus collimation

Answer 61

GH and acromioclavicular joint elbow joint and proximal 1/4 radius ulna