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The Thumb and Wrist

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

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The Thumb and Wrist

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  1. The Thumb and Wrist

  2. Things to know for the thumb • 3 views AP, lateral, Oblique • 8 x 10 divided 3 times • Shield • Marker • Hold still • Collimation

  3. 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

  4. Source Image Distance (SID) 40”

  5. Radiograph Critic • Distal and proximal phalanges • First metacarpal • Trapezium and joint • No rotation

  6. Oblique • Place hand palm side down • Long axis of thumb to long axis of cassette • Thumb in natural 45 angle

  7. SID 40Collimate

  8. What to look for • Distal and proximal phalanges • Joints open • Oblique thumb

  9. Lateral Thumb • Palm surface of hand on IR • Take and slightly arch fingers until thumb reaches a lateral position • Long axis with long axis

  10. CR is at First MP jointSID 40Collimate

  11. Radiograph Critic • Entire first digit • Trapezium is superimposed

  12. The Wrist • 4 views PA, Both Obliques, Lateral • 8x 10 divided in half crosswise • Mark • Shield • Hold still • Collimate

  13. 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.

  14. SID 40Collimate all 4 sides

  15. Seen on radiograph • All the metacarpals • Distal radius and Ulna

  16. Lateral • Turn wrist so the medial side is on IR (thumb Up) • Put wrist in true lateral position

  17. SID 40 Collimate

  18. Critic • All the carpals • Distal radius and ulna superimposed

  19. 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

  20. Critic • Materal- the trapezium and scaphoid are visualized • Medial- Pisiform

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