| 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 degrees 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
- 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
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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 (1 inch) 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
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| 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
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