Hand - LateralThis is a featured page

Radiographic Positioning


Adult
Other related pages of interest

Name of projection Hand - Lateral
Area Covered Hand, wrist and 2.5cm of distal forearm
Pathology shown Displacement of fractures, location of foreign bodies.
Radiographic Anatomy Hand Radiographic Anatomy
IR Size & Orientation 18 x 24cm
Portrait
Film / Screen Combination Detail
(CR and DR as recommended by manufacturer)
Bucky / Grid No
Filter No
Exposure 54 kVp
3.2 mAs
FFD / SID 100cm
Central Ray Directed to the 2nd metacarpophalangeal joint
Perpendicular to the IR
Collimation Centre: 2nd metacarpophalangeal joint
Shutter A: Distal phalanges to 2.5cm of distal radius and ulna
Shutter B: To include soft tissues
Markers Distal and Lateral
Marker orientation AP
Shielding Gonadal (check your department's policy guidelines)
Respiration Not applicable
Positioning
  • Patient seated at end of table
  • Elbow flexed at 90°
  • Hand and forearm resting on table
  • Rotate hand and wrist into lateral position with thumb on up side
    • For the "Fan" lateral, digits are spread out
      • a step block may be used
    • For a "Flexion" lateral, digits 2 through to 5 are superimposed and held in extension with the thumb held clear
    • For an "Extension" lateral, digits 2 through to 5 are superimposed and held in flexion with the thumb held clear
Critique

 Positioning
  • The hand is in the lateral position, shown by
    • The metacarpal midshafts are superimposed
    • The ulna is slightly posterior to the radius
(Note: the wrist is not necessarily lateral when the hand is. In a lateral wrist the radius and ulna are superimposed)
  • The interphalangeal joints are open
  • Phalanges are not foreshortened

"Fan lateral"
  • 2nd through to 5th digits are separated with little superimposition of bony and soft tissue structures
  • 2nd through to 5th metacarpals are superimposed
  • Thumb has no superimposition
  • Thumb position varies from PA to slightly oblique

"Extension lateral"
  • 2nd through to 5th digits fully extended and superimposed

"Flexion lateral"
  • 2nd through to 5th digits are flexed and superimposed
Area Covered
  • Phalanges, metacarpals, carpals and 2.5cm of distal radius and ulna
Collimation
  • Include the distal phalanges to the distal forearm and soft tissue
Exposure
  • Bony trabecular patterns and cortical outlines are sharply defined
  • Soft tissues are visualised
Special Notes
  • The extension lateral is sometimes preffered in cases of suspected foreign bodies
  • Metacarpals are used in assessing how lateral the hand is
  • To identify metacarpals, the 2nd metacarpal is the longest and the 5th metacarpal is the shortest



AndyC
AndyC 		Latest page update: made by AndyC , Jun 17 2011, 2:27 PM EDT (about this update About This Update AndyC Edited by AndyC

1 word added
4 words deleted

view changes
- complete history)
Keyword tags: fan lateral flexion lateral hand hand lateral hand positioning lateral hand
More Info: links to this page

Threads for this page

There are no threads for this page.  Be the first to start a new thread.

Related Content

  (what's this?Related ContentThanks to keyword tags, links to related pages and threads are added to the bottom of your pages. Up to 15 links are shown, determined by matching tags and by how recently the content was updated; keeping the most current at the top. Share your feedback on Wetpaint Central.)
Hand - Bone Age Hand - Ballcatchers Hand - Oblique
Hand - PA Exposure - Hand Paediatric Hand
Hand Radiographic Anatomy Protocol - Hand Metacarpal Fractures
Hand - PA Oblique Hand - PA