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Radiology Positioning & X-ray Images 1

Includes hands, fingers, thumb and wrist
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Hand position- PA Projection
Elbow 90 deg., arm fully supported. Hand open, fingers extended with palmar face in contact with IR, fingers seperated. Center ray is perpendicular to the thrid metacarpel joint.
Hand Xray image- PA Projection
Xray image shows the ulna and raduis, wrist bones, 1-5 metacarpels, proximal phalanges, IP Joints, Middle phalanges and the distal phalanges
Hand position- PA Oblique projection, lateral rotation
Elbow 90 deg, arm fully supported. Hand is rotated laterally, then hand is rotated to a 45-degree angle with IR. Stair step sponge is used for support and to help maintain position. Central ray is perpendicular to the third metacarpel joint
Hand Xray image- PA Oblique projection, lateral rotation
carpels, 1-5 metacarpels, proximal phalanges, middle phalanges, and distal phalanges are visible in image.
Hand position- PA Oblique projection- Lateral roation "modified Teacup" position
Elbow is 90 deg, arm fully supported.Used when not using the stair step sponge, from the lateral position, the hand forms a 45 deg angle with the IR. Central ray is perpendicular with the 3rd metacarpel joint.
Hand Xray Image- PA Oblique projection
ulna, radius, carpels, metacarpels, proximal phalanges, middle phalanges, and distal phalanges are visible in image.
Hand Position-Lateral- Ulnar and Fanned Fingers
Elbow is 90 deg, arm fully supported. Ulnar portion on arm is in contact with IR. Hand is in lateral position with fingers extended or can be supported on sponge and fanned. Wrist will be slightly pronated. Central Ray is perpendicular to second metacarpel joint.
Hand Xray Image- Lateral Ulnar projection
Ulna, radius, carpels, 1-5 metacarpels, and phalanges are visible in image.
Hand Xray Image- Lateral projection, Fingers Fanned
Ulna, radius, carpels, 1-5 metacarpels, and phalanges are visible in image.
Thumb Position- AP Projection
seated at end of table, arm abducted 90 deg, w/ forearm rotated internally into exaggerateed deg of pronation. Dorsal surface of the thumb is in contact with IR, coronal plane of thumb is paralell to IR, plane of palm is perp to IR. Central Ray is perpendicular to 1st metacarpel joint.
Xray Image - Thumb AP Projection
Trapezium, 1st metacarpel, ip joint, proximal phalanx and distal phalanx are visible in image.
Thumb Position- PA Oblique Projection
elbow flexed 90 deg and arm fully supported. Palm of hand is in contact with IR. Coronal plane of thumb will be 45 deg (oblique) to the IR. Central Ray is perpendicular to the first metacarpel joint.
Xray Image- Thumb PA Oblique Projection
Trapezium, 1st metacarpel, proximal phalanx, and distal phalanx are visible in image.
Thumb Position- Lateral Projection
Elbow flexed 90 deg, and arm is fully supported. With hand positioned for PA oblique thumb, patient flexes MCP joints 2-5 w/ fingers extened "tenting" hand until thumb is in lateral position. Central Ray is perpendicular to the first metacarpel joint.
Xray Image- Thumb Lateral Projection
Trapezium, 1st metacarpel, proximal phalanx, and distal phalanx are visible in image.
Thumb Alternative PA Position
If AP position is too painful for patient, this position can be used. Ulnar aspect of hand is in contact w/ IR and the palm of hand is perpendicular to IR. Thumb is supported by circle sponge, with coronal plane parallel to IR. Center ray is perpendicular to 1st metacarpel.
Xray Image- Thumb alternative PA Position
xray not as clear as AP Projection, 1st metacarpel, proximal phalanx and distal phalanx are still visable.
Wrist position- PA Projection
elbow flexed 90 deg, forearm resting on table. Anterior surface of wrist is in contact w/ IR. Fingers are flexed to form a loose fist, placing wrist in firmer contact with IR and opening intercarpel joint. Centrl ray is perpendicular to metacarpel base area.
XRay Image- Wrist PA Projection
Ulna, Ulna Styloid, Lunate, Triquetrium, Capitate, Trapezium, Schapoid, Radial Styloid and Radius are all visible in image.
Wrist position- PA Oblique Projection- Lateral Rotation
Uses triangle sponge. Elbow flexed 90 deg, forearm resting on table. wrist formas a 45 deg angle against sponge. Central Ray in perpendicular to base metacarpel range.
XRay Image- PA Oblique Projection- Lateral Rotation
Ulna, Ulnar Styloid, Lunate, Triquetrium, Trapezium, Schapoid, Radial Styloid and Radius are visible in image.
Wrist position- Lateral Projection
Elbow is flexed 90 deg, forearm is resting on table. MEdial surface of wrist is in contact with IR. Coronal plane of wrist is perpendicual to IR, fingers are together and extended. Central Ray is perpendicular to Styloid process of radius.
XRay Image- Wrist Lateral Projection
from bottom to top: Ulna, Radius, Scaphoid, Trapezium, and 1st metacarpel are visible.
Wrist position- AP Oblique projection- -medial rotation
elbow flexed at 90 deg, forarm is resting on table. Using triangle sponge. Inner surface of wrist is facing upward resting in triangle at 45 deg angle with IR. Central Ray is perpendicular to midcarpal base. (opposite rotation than reg oblique).
XRay Image- Wrist AP Oblique projection- medial roation
Bottom to Top: Distal Radius, Distal Ulna, Lunate, Scaphoid, Pisiform, Hamate, 5th metacarpal
Wrist position- PA Projection-- ulnar deviation
Same fingers as PA psition, then hand is deviated in direction of ULNA.Central Ray isPerpedicular, centered to scaphoid (point slightly medial to first metacarpel base).
XRay Image- PA Projection-- Ulnar Deviation wrist
Ulna, Radius, Radial Styloid, Scaphoid, 1st metacarpal
Wrist position- PA Axial Projection
Arm is extended and parallel to long axis of table. Wrist is positioned with anterior aspect on IR, pinky slightly spread more than other fingers. CENTRAL RAY IS ANGLED 20 DEG. in direction of ELBOW and centered to schapoid
XRay Image- wrist PA Axial Projection
Radius, Radial Styloid, Ulna, Ulnar Styloid, Scaphoid