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Fingers Hand & Wrist
Position
| Question | Answer |
|---|---|
| Distal Carpals | Trapezium, Trapezoid, Capitate, Hamate |
| Proximal Carpals | Pisiform, Triquetrum, Lunate, Scaphoid/Navicular |
| Anatomical Snuff Box | Overlies the Scaphoid bone **Most frequently fractured carpal bone |
| AP Thumb | Position:Supinated Projection:Ap CR:MCP Joint **Must include the Trapezium |
| PA Oblique Thumb | Position:Hand pronated, Thumb abduct Projection:Pa Oblique CR:MCP Joint |
| Lateral Thumb | Position:Lateral Projection:Mediolateral CR:MCP Joint |
| PA Fingers 2-5 | Position:Prone Projection:PA CR:PIP Joint |
| PA Oblique Fingers 2-5 | Position:External Rotation Projection:PA Oblique CR:PIP Joint |
| Lateral Fingers 2-5 | Position:Lateral Projection:Mediolateral (2-3), Lateromedial (4-5) CR:PIP Joint |
| PA Fingers 2-5 Images | *Concavity of phalangeal shafts *Equal amount of soft tissue on both sides *Fingernail is centered over distal phalanx |
| Lateral Fingers 2-5 Images | *Concave anterior aspect of the phalangeal shaft *Open joints *No overlap of the other digits *Anatomy: head, body, & base |
| Why keep digits parallel to film? | 1.Keep joint spaces open 2.Prevent foreshortening |
| PA Hand | Position:Prone Projection:PA CR:3rd MCP Joint |
| PA Oblique Hand | Position:External Rotation Projection:PA Oblique CR:3rd MCP Joint |
| Fan Lateral Hand | Position:Fan Lateral Projection:Lateromedial CR:2nd MCP Joint |
| Fan Lateral Image | Superimposed metacarpals *See individual phalanges without superimposition |
| Lateral in Extension | Position:Lateral in Extension Projection:Lateromedial CR:2nd MCP Joint |
| Lateral in Extension Image | Superimposed digits, metacarpals, distal forearm *Thumb abducted |
| Why use a lateral in extension? | 1.To localized foreign body 2.Show soft tissue 3.Show metacarpal fx displacements |
| PA Wrist | Position:Prone Projection:Pa CR:Midcarpals |
| PA Oblique Wrist | Position:Lateral Rotation from prone Projection:PA Oblique CR:Midcarpals |
| Lateral Wrist | Position:Lateral Projection:Lateromedial CR:Wrist Joint |
| AP Oblique Wrist | Position:Medial Rotation from supine Projection:AP Oblique CR:Midcarpals |
| Why do a PA Oblique vs. AP Oblique Wrist? | PA Oblique demo scaphoid & trapezoid *carpals on lateral aspect AP Oblique shows the pisiform free from superimposition |
| Ulnar Deviation Wrist | Position:Prone with Ulnar deviation Projection:Pa CR:Scaphoid |
| Radial Deviation Wrist | Position:Prone with Radial deviation Projection:Pa CR:Midcarpals |
| Ulnar Deviation vs Radial Deviation | Ulnar Deviation: carpals on lateral aspect *shows scaphoid with no foreshortening & adjacent joints open Radial Deviation: carpals on medial aspect *Shows the pisiform |
| Stecher Method | Position:Stecher Method Projection:PA Axial CR:Perpendicular or angled 20 degrees toward elbow & enters scaphoid |
| Why the Stecher Method? | shows the scaphoid without foreshortening |
| Gaynor Hart Method | Position:Gaynor Hart Method Projection:Tangential CR:25-30 degrees to long axis of hand, 1" distal to base of 3rd MC |