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Position

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