The Thumb and Wrist

Things to know for the thumb

3 views AP, lateral, Oblique 8 x 10 divided 3 times Shield Marker Hold still Collimation

AP Positioning for thumb

Take the 1/3 of 8x10 Internally rotate the hand until the

posterior surface of hand is in contact with Image Receptor(IR)/Cassette

Align long axis of thumb with long axis of IR

Patient holds finger out of way with other hand

Source Image Distance (SID) 40”

Radiograph Critic

Distal and proximal phalanges First metacarpal Trapezium and joint No rotation

Oblique

Place hand palm side down Long axis of thumb to long axis of

cassette Thumb in natural 45 angle

SID 40Collimate

What to look for

Distal and proximal phalanges Joints open Oblique thumb

Lateral Thumb

Palm surface of hand on IR Take and slightly arch fingers until

thumb reaches a lateral position Long axis with long axis

CR is at First MP jointSID 40

Collimate

Radiograph Critic

Entire first digit Trapezium is superimposed

The Wrist

4 views PA, Both Obliques, Lateral 8x 10 divided in half crosswise Mark Shield Hold still Collimate

PA

Place Wrist and hand palm side down on IR

Center wrist to middle of divided cassette

Curl fingers slightly to bring wrist in contact with IR.

SID 40Collimate all 4 sides

Seen on radiograph

All the metacarpals Distal radius and Ulna

Lateral

Turn wrist so the medial side is on IR (thumb Up)

Put wrist in true lateral position

SID 40 Collimate

Critic

All the carpals Distal radius and ulna superimposed

Obliques

Lateral rotation-Lay wrist palm side down and rotate wrist up to a 45 degrees angle laterally

Medial rotation- from lateral position turn hand 45 degrees laterally

Critic

Materal- the trapezium and scaphoid are visualized

Medial- Pisiform