| Question | Answer |
| PA OBLIQUE PROJECTION—MEDIAL ROTATION: THUMB
CR | CR perpendicular to IR, directed to first MCp joint |
| PA OBLIQUE PROJECTION—MEDIAL OR LATERAL ROTATION: FINGERS
Anatomy Demonstrated | 45° oblique view of distal, middle, and proximal phalanges; distal metacarpal; and associated joints. |
| Located laterally on proximal humerus in a true AP projection. | greater tubercle |
| TRANSTHORACIC LATERAL PROJECTION: HUMERUS
CR | Center mid-diaphysis of affected humerus and center of IR to CR as projected through thorax.
CR perpendicular to IR, directed through thorax to mid-diaphysis |
| AP OBLIQUE PROJECTION—LATERAL (EXTERNAL) ROTATION: ELBOW
Best visualizes? | Lateral (external rotation) oblique Best visualizes radial head and neck of the radius and capitulum of humerus
(supinated hand) |
| AP PROJECTION: ELBOW
Anatomy Demonstrated | Distal humerus, elbow joint space, and proximal radius and ulna are visible. |
| LATERAL PROJECTION: WRIST
Anatomy Demonstrated | Distal radius and ulna, carpals, and at least the midmetacarpal area are visible. |
| “FAN” LATERAL—LATEROMEDIAL PROJECTION: HAND
Anatomy Demonstrated | Entire hand and wrist and about 2.5 cm (1 inch) of distal forearm are visible. |
| INFEROSUPERIOR AXIAL PROJECTION: SHOULDER -LAWRENCE METHOD
Patient Position | Position patient supine with shoulder raised about 2 inches (5 cm) from tabletop by placing support under arm and shoulder to place body part near center of IR. |
| TRANSTHORACIC LATERAL PROJECTION: HUMERUS
Minimum SID —
IR size —
KV | Minimum SID—40 inches (102 cm) •
IR size—35 × 43 cm (14 × 17 inches),lengthwise
80-90 KV |
| INFEROSUPERIOR AXIAL PROJECTION: SHOULDER -LAWRENCE METHOD
Anatomy Demonstrated
Respiration Suspend respiration during exposure. | Lateral view of proximal humerus in relationship to scapulohumeral cavity is shown. • Coracoid process of scapula and lesser tubercle of humerus are seen in profile. • The spine of the scapula is seen on edge below scapulohumeral joint |
| LATERAL POSITION: THUMB
Anatomy Demonstrated | Distal and proximal phalanges, first metacarpal, trapezium (superimposed), and associated joints are visualized in the lateral position. |
| AP PROJECTION: ELBOW
Minimum SID —
IR size —
KV | Minimum SID—40 inches (102 cm)
IR size—24 × 30 cm (10 × 12 inches)
—70 to 75 kV range |
| PA PROJECTION: FINGERS
how can you tell if there is no rotation in a pa finger projection? | No rotation of fingers is evidenced by symmetric appearance of both sides or
concavities of the shafts of the phalanges and distal metacarpals. |
| PA PROJECTION: WRIST
Minimum SID —
IR size —
KV | Minimum SID—40 inches (102 cm) •
IR size—24 × 30 cm (10 × 12 inches),lengthwise
65 TO 70 kV range |
| LATERAL PROJECTION: ELBOW
Anatomy Demonstrated | Lateral projection of distal humerus and proximal forearm, olecranon process, and soft tissues and fat pads of the elbow joint are visibl |
| LATERAL PROJECTION: ELBOW
Part Position | Center elbow joint to CR and to center of IR. Drop shoulder so that humerus and forearm are on same horizontal plane. Rotate hand and wrist into true lateral position, thumb side up. |
| POSTERIOR OBLIQUE POSITION—GLENOID CAVITY: SHOULDER ---GRASHEY METHOD
Anatomy Demonstrated | Glenoid cavity should be seen in profile without superimposition of humeral head. |
| PA OBLIQUE PROJECTION—MEDIAL ROTATION: THUMB
Anatomy Demonstrated | Distal and proximal phalanges, first metacarpal, trapezium, and associated joints are visualized in a 45° oblique position |
| How many bones does a hand have? | The 27 bones on each hand and wrist are divided into the following three groups:
Total 27
Phalanges (fingers and thumb) 14 Metacarpals (palm) 5
Carpals (wrist) 8 |
| AP PROJECTION: AC JOINTS
Part Position | Position patient to direct CR to midway between AC joints. • Center midline of IR to CR (top of IR should be approximately
2 inches [5 cm] above shoulders). |
| AP PROJECTION—INTERNAL ROTATION: SHOULDER
Anatomy Demonstrated | Lateral view of proximal humerus and lateral two-thirds of clavicle and upper scapula is demonstrated, including the relationship of the humeral head to the glenoid cavity. |
| Explain the Neer Method | Same as SCAPULAR Y SHOULDER except that the angle of the CR is 10°-15° caudal,centered posteriorly to pass through superior margin of humeral head. This puts the Proximal humerus superimposed over thin body of the scapula, seen on end without ribs |
| The expanded distal end of the spine of the scapula that extends superiorly and posteriorly to the glenoid cavity (fossa). | acromion |
| AP PROJECTION: HUMERUS
CR | CR perpendicular to IR, directed to midpoint of humerus |
| AP PROJECTION: FOREARM
Anatomy Demonstrated | AP projection of the entire radius and ulna is shown, with a minimum of proximal row carpals and distal humerus and pertinent soft tissues, such as fat pads and stripes of the wrist and elbow joints. |
| PA PROJECTION: FINGERS
Minimum SID —
IR size —
kV range - | Minimum SID— 40 inches (102 cm)
IR size— 18 × 24 cm (8 × 10 inches), crosswise (multiple exposures) or lengthwise (single exposure)
Digital systems—55 to 60 kV range |
| PA OBLIQUE PROJECTION—MEDIAL ROTATION: THUMB
Part Position | Abduct thumb slightly with palmar surface of hand in contact with IR. (This action naturally places thumb in a 45° oblique position.) |
| LATERAL PROJECTION: WRIST
Part Position | Adjust hand and wrist into a true lateral position, with fingers comfortably flexed; if support is needed to prevent motion, use a radiolucent support block and sandbag, and place block against extended hand and fingers |
| AP PROJECTION: HUMERUS
Anatomy Demonstrated | AP projection shows the entire humerus, including the shoulder and elbow joints |
| Name the distal row of the carpals: | (1) Trapezium
(2) Trapezoid
(3) Capitate
(4) Hamate |
| AP PROJECTION: FOREARM
Minimum SID —
IR size —
KV | Minimum SID—40 inches (102 cm)
IR size—30 × 35 cm (11 × 14 inches), for smaller patients; 35 × 43 cm (14 × 17 in), for long forearms, lengthwise
70-75 KV |
| POSTERIOR OBLIQUE POSITION—GLENOID CAVITY: SHOULDER ---GRASHEY METHOD
Minimum SID —
IR size —
KV | Minimum SID—40 inches (102 cm).
IR size—18 × 24 cm (8 × 10 inches), crosswise
75-85 KV |
| AP AND AP AXIAL PROJECTIONS: CLAVICLE
Patient Position | Perform radiograph with patient in erect or supine position with arms at sides, chin raised, and looking straight ahead. Posterior shoulder should be in contact with IR or tabletop, without rotation of body. |
| LATERAL PROJECTIONS: FINGERS
Part Position | Place hand in lateral position (thumb side up) with finger to be examined fully extended and centered to portion of IR being |
| CAST CONVERSiON
Fiberglass cast | Increase 3 kV to 4 kV |
| SCAPULAR Y LATERAL—ANTERIOR OBLIQUE POSITION: SHOULDER
Part Position | Rotate into an anterior oblique position (45°-60°)as for a lateral scapula with patient facing IR. Palpate the superior angle of the scapula and aC joint articulation. Rotate the patient until an imaginary line between those two points are perp. to IR. |
| AP AXIAL PROJECTION (MODIFIED ROBERT’S METHOD)*: THUMB | Base of first metacarpal is demonstrated for ruling out bennett’s fX - CR directed 15° proximally(toward wrist)entering at the first CMC joint. trapezium should be well visualized. |
| PA PROJECTION: WRIST
Patient Position | Seat patient at end of table with elbow flexed about 90° and hand and wrist resting on IR, palm down. Drop shoulder so that shoulder, elbow, and wrist are on same horizontal plane |
| “FAN” LATERAL—LATEROMEDIAL PROJECTION: HAND
Part Position | Rotate into lateral position with thumb side up. Spread fingers and thumb into a fan Position, &support each digit on Radiolucent block.Ensure that ALL are separated and parallel to iR and that the mCs are not rotated but remain in a true lateralposition. |
| LATERAL POSITION: THUMB
Patient Position | Seat patient at end of table, with elbow flexed
about 90° with hand resting on IR. |
| PA OBLIQUE PROJECTION: HAND
CR | CR perpendicular to IR, directed to third MCp joint |
| AP PROJECTION—EXTERNAL ROTATION: SHOULDER
Anatomy Demonstrated | AP projection of proximal humerus and lateral two-thirds of clavicle and upper scapula, including relationship of the humeral head to the glenoid cavity. |
| A good criterion by which to evaluate a true lateral position of the elbow when it is flexed 90° is the appearance of the three concentric arcs. What are they? | 1 & smallest arc is the trochlear sulcus. 2nd & intermediate arc appears double-lined as the outer ridges or rounded edges of the capitulum and trochlea. The trochlear notch of the ulna appears as a 3rd arc of a true lateral elbow. |
| AP PROJECTION: ELBOW
CR | CR perpendicular to IR, directed to mid-elbow joint, which is approximately 2 cm (3/4 inch) distal to midpoint of a line between epicondyles |
| AP PROJECTION: THUMB
Patient Position | Seat patient facing table, arms extended in front, with hand rotated internally to supinate thumb for AP projection |
| AP PROJECTION—EXTERNAL ROTATION: SHOULDER
Part Position | Position patient to center scapulohumeral joint to center of IR. • Abduct extended arm slightly; externally rotate arm (supinate hand) until epicondyles of distal humerus are parallel to IR. |
| AP PROJECTION—EXTERNAL ROTATION: SHOULDER
Patient Position
SAME - AP PROJECTION—INTERNAL ROTATION: SHOULDER | Perform radiograph with the patient in an erect or supine position. (The erect position is usually less painful for patient, if condition allows.) Rotate body slightly toward affected side if necessary to place shoulder in contact with IR or tabletop |
| PA PROJECTION: FINGERS
Patient Position | Seat patient at end of table, with elbow flexed about 90° and with hand and forearm resting on the table. |
| PA PROJECTION: HAND
Anatomy Demonstrated | PA projection of entire hand and wrist and about 2.5 cm (1 inch) of distal forearm are visible. • PA projection of hand demonstrates oblique view of the thumb. |
| LATERAL PROJECTION: WRIST
Minimum SID —
IR size —
KV | Minimum SID—40 inches (102 cm) •
IR size—24 × 30 cm (10 × 12 inches),lengthwise
65 TO 70 kV range |
| AP PROJECTION: AC JOINTS
CR | CR perpendicular to midpoint between aC joints, 1 inch
(2.5 cm) above jugular notch |
| LATERAL PROJECTIONS: FINGERS
Anatomy Demonstrated | Lateral views of distal, middle, and proximal phalanges; distal metacarpal; and associated joints are visible. |
| AP PROJECTION: THUMB
Part Position | Demonstrate this awkward position on yourself, so the patient can see how it is done & better understand what is expected. Internally rotate hand with fingers extended until posterior surface of thumb is in contact with IR. |
| PA PROJECTION: FINGERS
Part Position | Pronate hand with fingers extended.
Center and align long axis of affected finger with long axis of IR.
Separate adjoining fingers from affected finger. |
| LATERAL PROJECTION: ELBOW
CR | CR perpendicular to IR, directed to mid-elbow joint (a point approximately 4 cm [1-1/2 inches] medial to easily palpated posterior surface of olecranon process) |
| Name the proximal row of carpals: | (1) Scaphoid
(2) Lunate
(3) Triquetrum
(4) Pisiform |
| AP PROJECTION: AC JOINTS
Weights | 1st exposure is made w/o weights, for large adult patients, strap 8-10 lbs min weights to each wrist, w/shoulders relaxed, let weights hang from wrists while pulling down on each arm and shoulder. The same weight must be used on each wrist. |
| SCAPULAR Y LATERAL—ANTERIOR OBLIQUE POSITION: SHOULDER
CR | CR perpendicular to IR, directed to scapulohumeral joint (2 or 2-1/2 inches [5 or 6 cm] below top of shoulder) |
| AP PROJECTION: AC JOINTS
Patient Position | Patient in erect position, shoulders against IR w/ equal weight on both feet; arms at side; no rotation of shoulders or pelvis; &looking straight ahead. 2 sets of bilateral AC joints are taken in the same position, 1 w/o weights & 1 stress view w/weights. |
| PA OBLIQUE PROJECTION—MEDIAL OR LATERAL ROTATION: FINGERS
Part Position | Fingers extended against 45° foam wedge, place hand in a 45° lateral oblique(thumb side up) or put hand on cassette so that the long axis of the finger is aligned with the long axis of the IR. in a 45°oblique and parallel to iR. |
| AP PROJECTION: FOREARM
CR | CR perpendicular to IR, directed to mid-forearm |
| LATERAL PROJECTION: WRIST
Patient Position | Seat patient at end of table, with arm and forearm resting on the table and elbow flexed about 90°. Place wrist and hand on IR in thumb-up lateral position. Shoulder, elbow, and wrist should be on same horizontal plane. |
| PA OBLIQUE PROJECTION—MEDIAL OR LATERAL ROTATION: FINGERS
CR | CR perpendicular to IR, directed to pip joint |
| In this rotation position, the epicondyles of the distal humerus are perpendicular to the iR, placing the humerus in a true lateral position. The hand must be pronated and the elbow adjusted to place the epicondyles perpendicular to the iR | Internal rotation |
| AP AND AP AXIAL PROJECTIONS: CLAVICLE
CR --AP AND AP AXIAL | AP
CR perpendicular to midclavicle
AP Axial
CR 15° to 30° cephalad to midclavicle |
| Radial deviation - why is it used? | A less frequent PA wrist projection involves the radial deviation movement that opens and best demonstrates the carpals on the opposite, or ulnar, side of the wrist—the hamate, pisiform, triquetrum, and lunate. |
| INFEROSUPERIOR AXIAL PROJECTION: SHOULDER -LAWRENCE METHOD
Part Position | Move patient toward the front edge of tabletop Place vertical cassette on table as close to neck as possible, and support w/ sandbags. Abduct arm 90° from body if possible;keep in ext rotation, palm up, with support under arm& hand. |
| AP PROJECTION: ELBOW
Patient Position | Seat patient at end of table, with elbow fully extended, if possible. |
| LATERAL PROJECTION: FOREARM
Anatomy Demonstrated | Lateral projection of entire radius and ulna, proximal row of carpal bones, elbow, and distal end of the humerus are visible as well as pertinent soft tissue, such as fat pads and stripes of the wrist and elbow joints. |
| AP PROJECTION: AC JOINTS
Minimum SID —
IR size —
KV | Minimum SID—72 inches (183 cm) •
IR size—35 × 43 cm (14 × 17 inches), crosswise, or (10 × 12 inches) crosswise for unilateral exposures
Digital systems—70 to 80 kV range |
| INFEROSUPERIOR AXIAL PROJECTION: SHOULDER -LAWRENCE METHOD
CR | Direct CR medially 25° to 30°, centered horizontally to axilla and humeral head. If abduction of arm is less than 90°, the CR medial angle also should be decreased to 15° to 20° if possible. |
| LATERAL PROJECTION: ELBOW
Patient Position | Seat patient at end of table, with elbow flexed
90° |
| Located anteriorly on proximal humerus in a true AP projection. | lesser tubercle |
| CAST CONVERSiON
Small to medium plaster cast | Increase 5 kV to 7 kV |
| PA OBLIQUE PROJECTION—MEDIAL OR LATERAL ROTATION: FINGERS
Patient Position | Seat patient at end of table, with elbow flexed
about 90° with hand and wrist resting on IR and fingers extended. |
| AP PROJECTION: FOREARM
Part Position | Drop shoulder to place entire upper limb on same horizontal plane. Place entire wrist, forearm, and elbow in as near a true frontal position as possible. Epicondyles same distance from IR. |
| SCAPULAR Y LATERAL—ANTERIOR OBLIQUE POSITION: SHOULDER
Anatomy Demonstrated | True lateral view of the scapula, proximal humerus, and scapulohumeral joint. |
| PA OBLIQUE PROJECTION: WRIST
Part Position | Center to IR. From pronated position, rotate wrist and hand laterally 45°. For stability, place a 45° block under thumb side of hand to support hand and wrist in a 45° oblique position or partially flex fingers to arch hand so that tips rest lightly on IR |
| LATERAL PROJECTION: FOREARM
Part Position | Drop shoulder to place entire upper limb on same horizontal plane.
Rotate hand and wrist into true lateral position, and support hand to prevent motion, if needed. (Ensure that distal radius and ulna are superimposed directly) |
| AP OBLIQUE PROJECTION—MEDIAL (INTERNAL) ROTATION: ELBOW
Best visualizes? | Medial (internal rotation) oblique Best visualizes coronoid process of ulna and trochlea in profile
(pronated hand) |
| Ulnar deviation - why is it used? | The ulnar deviation movement of the wrist “opens up” and best demonstrates the carpals on the opposite side (the radial or lateral side) of the wrist— the scaphoid, trapezium, and trapezoid. Because the scaphoid is the most frequently fx carpal bone... |
| TRANSTHORACIC LATERAL PROJECTION: HUMERUS
Anatomy Demonstrated | Lateral view of entire humerus and glenohumeral joint should be visualized through the thorax without superimposition of the opposite humerus. |
| PA OBLIQUE PROJECTION: WRIST
Minimum SID —
IR size —
KV | Minimum SID—40 inches (102 cm) •
IR size—24 × 30 cm (10 × 12 inches),lengthwise
65 TO 70 kV range |
| “FAN” LATERAL—LATEROMEDIAL PROJECTION: HAND
CR | CR perpendicular to IR, directed to second MCp joint |
| TRANSTHORACIC LATERAL PROJECTION: HUMERUS
Patient Position | Place patient in an erect or supine position. Place patient in lateral position with side of interest closest to IR. With patient supine, place portable grid lines horizontally and center CR to centerline to prevent grid cutoff |
| AP PROJECTION—INTERNAL ROTATION: SHOULDER
Part Position | Position patient to center scapulohumeral joint to center of IR. • Abduct extended arm slightly; internally rotate arm (pronate hand) until epicondyles of distal humerus are perpendicular
to IR. |
| AP PROJECTION: FOREARM
Patient Position | Seat patient at end of table, with hand and arm
fully extended and palm up (supinated). |
| AP projections of the elbow a medial rotation | superimposes the radius and ulna |
| LATERAL PROJECTION: FOREARM
Minimum SID —
IR size —
KV | Minimum SID—40 inches (102 cm)
IR size—30 × 35 cm (11 × 14 inches), for smaller patients; 35 × 43 cm (14 × 17 in), for long forearms, lengthwise
70-75 KV |
| AP AND AP AXIAL PROJECTIONS: CLAVICLE
Minimum SID —
IR size —
KV | Minimum SID—40 inches (102 cm). •
IR size—24 × 30 cm (10 × 12 inches),lengthwise
—75 to 85 kV range |
| POSTERIOR OBLIQUE POSITION—GLENOID CAVITY: SHOULDER ---GRASHEY METHOD
Patient Position | Perform radiograph with patient in an erect or supine position. (The erect position is usually less painful for patient, if condition allows.) |
| PA PROJECTION: FINGERS
CR | at the PIP joint |
| LATERAL POSITION: THUMB
Minimum SID —
IR size —
KV - | Minimum SID— 40 inches (102 cm)
IR size— 18 × 24 cm (8 × 10 inches), crosswise (multiple exposures) or lengthwise (single exposure)
Digital systems—55 to 60 kV range |
| This rotation position represents a true aP projection of the humerus in the anatomic position | External rotation |
| LATERAL PROJECTION: ELBOW
Minimum SID —
IR size —
KV | Minimum SID—40 inches (102 cm)
IR size—24 × 30 cm (10 × 12 inches)
—70 to 75 kV range |
| PA OBLIQUE PROJECTION—MEDIAL ROTATION: THUMB
Patient Position | Seat patient at end of table, with elbow flexed
about 90° with hand resting on IR. |
| PA OBLIQUE PROJECTION: HAND
Part Position | Pronate hand on IR; center and align long axis of hand with long axis of IR.
• Rotate entire hand and wrist laterally 45° and support with radiolucent wedge or step block, as shown, so that all digits are separated and parallel to iR |
| The height of the tabletop should be: | near shoulder height so that the arm can be fully supported |
| AP PROJECTION: HUMERUS
Patient Position | Position patient erect or supine. Adjust the height of the cassette so that shoulder and elbow joints are equidistant from ends of IR |
| CAST CONVERSiON
Large plaster cast | Increase 8 kV to 10 kV |
| AP PROJECTION: ELBOW
Part Position | Extend elbow, supinate hand, and align arm and forearm with long axis of IR.
Center elbow joint to center of IR. • Ask patient to lean laterally as necessary for true Ap projection.
(Palpate humeral epicondyles to ensure that they are parallel to
IR.) |
| PA PROJECTION: HAND
CR | CR perpendicular to IR, directed to third MCp joint |
| PA OBLIQUE PROJECTION—MEDIAL ROTATION: THUMB
Minimum SID —
IR size —
KV - | Minimum SID— 40 inches (102 cm)
IR size— 18 × 24 cm (8 × 10 inches), crosswise (multiple exposures) or lengthwise (single exposure)
Digital systems—55 to 60 kV range |
| AP PROJECTION: THUMB
CR | Center first MCp joint to CR and to center of IR. Immobilize other fingers with tape to isolate thumb if necessary. |
| LATERAL PROJECTIONS: FINGERS
CR | CR perpendicular to IR, directed to pip joint |
| AP PROJECTION—EXTERNAL ROTATION: SHOULDER
Minimum SID —
IR size —
KV
SAME AP PROJECTION—INTERNAL ROTATION: SHOULDER | •Minimum SID—40 inches
IR size— 10 × 12 inches, crosswise
78-85 KV |
| PA OBLIQUE PROJECTION: WRIST
Anatomy Demonstrated | Distal radius, ulna, carpals, and at least to midmetacarpal area are visible. • Trapezium and scaphoid should be well visualized, with only slight superimposition of other carpals on their medial aspects. |
| PA PROJECTION: FINGERS
Anatomy Demonstrated | Distal, middle, and proximal phalanges; distal metacarpal; and associated joints. |
| CARPAL CANAL (TUNNEL)—TANGENTIAL, INFEROSUPERIOR PROJECTION: WRIST
CR | Angle CR 25° to 30° to the long axis of the hand. (The total CR angle in relationship to the IR must be increased if patient cannot hyperextend wrist as far as indicated.)
•Direct CR to a point 1inch distal to the base of third metacarpal |
| AP PROJECTION: HUMERUS
Part Position | Rotate body toward affected side as needed to bring shoulder and proximal humerus in contact with cassette. Abduct arm slightly and gently supinate hand so that epicondyles of elbow are parallel and equidistant from IR. |
| TRANSTHORACIC LATERAL PROJECTION: HUMERUS
Part Position | Place affected arm in neutral rotation; drop shoulder if possible. Raise opposite arm and place hand over top of head; elevate shoulder as much as possible to prevent superimposition of affected shoulder. Ensure that thorax is in a true lateral position |
| LATERAL PROJECTION: FOREARM
Patient Position | Seat patient at end of table, with elbow flexed 90° |
| AP projections of the elbow a lateral rotation: | separates the radius and ulna |
| PA PROJECTION: WRIST
CR | CR perpendicular to IR, directed to midcarpal area |
| AP PROJECTION—EXTERNAL ROTATION: SHOULDER
CR
SAME - AP PROJECTION—INTERNAL ROTATION: SHOULDER | CR perpendicular to IR, directed to 1 inch (2.5 cm) inferior to coracoid process |
| LATERAL PROJECTION: WRIST
CR | CR perpendicular to IR, directed to midcarpal area |
| AP AND AP AXIAL PROJECTIONS: CLAVICLE
Part Position | Center clavicle and IR to CR. (Clavicle can be readily palpated with medial aspect at jugular notch and lateral portion at AC joint above shoulder.) |
| POSTERIOR OBLIQUE POSITION—GLENOID CAVITY: SHOULDER ---GRASHEY METHOD
Part Position | Rotate body 35°-45° toward affected side. Center midscap-humral joint to center of IR. Adjust cassette so that top of IR is about 2" above shoulder and side of IR is about 2" from lateral border of humerus. Abduct arm slightly w/arm in neutral rotation. |
| SCAPULAR Y LATERAL—ANTERIOR OBLIQUE POSITION: SHOULDER
Minimum SID —
IR size —
KV | Minimum SID—40 inches (102 cm). •
IR size—24 × 30 cm (10 × 12 inches),lengthwise
—75 to 85 kV range |
| PA OBLIQUE PROJECTION: WRIST
CR | CR perpendicular to IR, directed to midcarpal area |
| LATERAL PROJECTIONS: FINGERS
Minimum SID —
IR size —
kV range - | Minimum SID— 40 inches (102 cm)
IR size— 18 × 24 cm (8 × 10 inches), crosswise (multiple exposures) or lengthwise (single exposure)
Digital systems—55 to 60 kV range |
| PA OBLIQUE PROJECTION: WRIST
Patient Position | Seat patient at end of table, with elbow flexed
about 90° and hand and wrist resting on IR, palm down. |
| AP AND AP AXIAL PROJECTIONS: CLAVICLE
Anatomy Demonstrated --AP AND AP AXIAL | aP 0°
Anatomy Demonstrated:
• Entire clavicle visualized, including both AC and sternoclavicular joints and acromion.
aP axial
Anatomy Demonstrated:
• Entire clavicle visualized, including both AC and sternoclavicular joints and acromion |
| POSTERIOR OBLIQUE POSITION—GLENOID CAVITY: SHOULDER ---GRASHEY METHOD
CR | CR perpendicular to IR, centered to scapulohumeral joint, which is approximately 2 inches (5 cm) inferior and medial from the superolateral border of shoulder |
| PA OBLIQUE PROJECTION: HAND
Anatomy Demonstrated | Oblique projection of the entire hand and wrist and about 2.4 cm (1 inch) of distal forearm are visible. |
| PA OBLIQUE PROJECTION—MEDIAL OR LATERAL ROTATION: FINGERS
Minimum SID —
IR size —
kV range - | Minimum SID— 40 inches (102 cm)
IR size— 18 × 24 cm (8 × 10 inches), crosswise (multiple exposures) or lengthwise (single exposure)
Digital systems—55 to 60 kV range |
| AP PROJECTION: HUMERUS
Minimum SID —
IR size —
KV | Minimum SID—40 inches
IR size—lengthwise (large enough to include entire humerus) For larger patient, 14 × 17 inches) may be needed to place cassette diagonally to include both joints •For smaller patient, 11 × 14 inches)
- 75-85 KV |
| PA PROJECTION: HAND
Patient Position | Seat patient at end of table, with elbow flexed
about 90° with hand resting on IR. |
| SCAPULAR Y LATERAL—ANTERIOR OBLIQUE POSITION: SHOULDER
Patient Position | Perform radiograph with patient in erect or recumbent position |
| PA PROJECTION: WRIST
Part Position | Align and center long axis of hand and wrist to IR, with carpal area centered to CR.
• With hand pronated, arch hand slightly to place wrist and carpal area in close contact with iR. |
| PA PROJECTION: HAND
Part Position | Pronate hand with palmar surface in contact with IR; spread fingers slightly.
•Align long axis of hand and forearm with long axis of IR.
•Center hand and wrist to IR. |
| AP PROJECTION: THUMB
Minimum SID —
IR size —
KV
kV range - | Minimum SID— 40 inches (102 cm)
IR size— 18 × 24 cm (8 × 10 inches), crosswise (multiple exposures) or lengthwise (single exposure)
Digital systems—55 to 60 kV range |
| “FAN” LATERAL—LATEROMEDIAL PROJECTION: HAND
Minimum SID —
IR size —
KV - | Minimum SID—40 inches (102 cm) •
IR size—24 × 30 cm (10 × 12 inches),lengthwise
65 to 70 kV range |
| PA PROJECTION: HAND
Minimum SID —
IR size —
KV -
SAME ON PA OBLIQUE PROJECTION: HAND | Minimum SID—40 inches (102 cm) •
IR size—24 × 30 cm (10 × 12 inches),lengthwise
55 to 60 kV range |
| PA PROJECTION: WRIST
Anatomy Demonstrated | Midmetacarpals and proximal metacarpals; carpals; distal radius, ulna, and joints; and soft tissues of the wrist joint, such as fat pads and fat stripes, are visible |
| PA AND PA AXIAL SCAPHOID—WITH ULNAR DEVIATION: WRIST
CR | Angle CR 10° to 15° proximally, along long axis of forearm and toward elbow. (CR angle should be perpendicular to long axis of scaphoid.)
• Center CR to scaphoid. (Locate scaphoid at a point 2 cm [34 inch] distal and medial to radial styloid process.) |
| LATERAL POSITION: THUMB
Part Position | Start with hand pronated and thumb abducted, with fingers and hand slightly arched; then rotate hand slightly medial until thumb is in true lateral position. (You may need to provide a sponge or other support under lateral portion of hand.) |
| INFEROSUPERIOR AXIAL PROJECTION: SHOULDER -LAWRENCE METHOD
Minimum SID —
IR size —
KV | Minimum SID—40 inches (102 cm). •
IR size—18 × 24 cm (8 × 10 inches)
75-85 KV |
| The principal exposure factors for radiography of the upper limbs are as follows: | Lower to medium kV (55 to 80—digital)
Short exposure time
Small focal spot
Adequate mAs for sufficient density (brightness) |
| LATERAL POSITION: THUMB
CR | CR perpendicular to IR, directed to first MCp joint |
| AP PROJECTION: AC JOINTS
Anatomy Demonstrated | Anatomy Demonstrated: • Both AC joints, entire clavicles, and SC joints are demonstrated. |
| LATERAL PROJECTION: FOREARM
CR | CR perpendicular to IR, directed to mid-forearm |
| AP PROJECTION: THUMB
Anatomy Demonstrated | Distal and proximal phalanges, first metacarpal, trapezium, and associated joints are visible. • Interphalangeal and metacarpophalangeal joints should appear open. |
