finger, thumb, and hand

• PA projection (finger)

  IR size: 8x10 screen LW

  patient position: seated, place the patients hand palm side down and spread the fingers slightly

  CR: perpendicular to the IR entering proximal interphalangeal joint space fo the affected digit (2-5)

  SID: 40 inches

  Technique:

  structures shown:
• PA oblique projection (finger)

  IR size: 8x10 screen LW

  patient position: seated, place the patients hand palm side down and spread the fingers slightly. Externally rotate the hand to form a 45 degree angle to the IR

  CR: perpendicular to the IR entering the proximal interphalangeal joint space of the affected digit (2-5)

  SID: 40 inches

  Technique:

  Structures shown:
• Lateral Projection (finger)

  IR size: 8x10 screen LW

  patient position: seated, place the medial border of the hand on th eIR for the 4th or 5th digit. Place the lateral border of the hand on th IR for the 2nd or 3rd digit. Ask the patient to make a fist and extend the affected digit

  CR: perpendicular to the IR entering proximal interphalangeal joint space of the affected digit (2-5)

  SID: 40 inches

  Technique

  structures show
• AP projection (thumb)

  IR size: 8x10 screen LW

  patient position: seated, place the patients hand in a position of extreme internal rotation. Have the patient extend the other digits

  CR: perpendicular to the IR entering the 1st metacarpophalangeal joint space

  SID: 40 inches

  technique:

  structures shown:
• PA oblique projection (thumb)

  IR size: 8x10 screen LW

  patient position: seated, place the patients hand palm side down and spread fingers slightly, placing the thumb in a 45 degree lateral oblique position

  CR: perpendicular to the IR entering the 1st metacarpophalangeal joint space

  SID: 40 inches

  technique:

  structures shown:
• lateral projection (thumb)

  IR size: 8x10 screen LW

  Patient position: seated, place the patients hand palm side down and spread fingers slightly. Internally rotate the hand to place the 1st digit in a lateral position

  CR: perpendicular to the IR entering the 1st metacarpophalangeal joint space.

  SID: 40 inches

  technique:

  structures shown
• PA projection (hand)

  IR size: 8x10 screen LW

  patient position: seated, place the patients hand palm side down and spread fingers slightly, forearm resting on the table in line with the wrist

  CR: perpendicular to the IR entering the 3rd metacarpophalnageal joint space.

  SID: 40 inches

  technique:

  structures shown
• PA oblique projection (hand)

  IR size: 8x10 screen LW

  patient position: seated, place the patients hand palm side down and spread the fingers slightly, with the forearm resting on the table. Externally rotate the hand to form a 45 degree angle to the IR

  CR: perpendicular to the IR entering the 3rd metacarpophalangeal joint space

  SID: 40 inches

  technique:

  structures shown
• lateral projection (hand)

  IR size: 8x10 screen LW

  patient position: seated, place the hand in a. lateral position with the medial border in contact with the IR and forearm resting on the table. The palmar surface should be perpendicular to the IR. Extend the 2nd-5th digits and place the 1st digit parallel to the IR (fan lateral alternate)

  begin with the hand in the lateral position, separate each digit so they are unsuperimposed

  CR: perpendicular to the IR entering the 2nd metacarpophalangeal joint space.

  SID: 40 inches

  technique
• hand

  A) distal phalanx

  B) middle phalanx

  C) proximal phalanx

  D) phalanges

  E) metacarpals

  F) carpals

  G) head

  H) body

  I) base

  J) head

  K) body

  L) base

  
• carpals

  A) trapezium

  B) trapezoid

  C) capitate

  D) hamate

  E) scaphoid

  F) lunate

  G) triquetrum

  H) pisiform

  
• hand joints

  A) interphalangeal joint

  B) 1st metacarpophalangeal joint

  C) trapezoid

  D) trapezium

  E) capitate

  F) hamate

  G) 5th carpometacarpal joint

  H) 5th metacarpophalangeal joint

  I) proximal interphalangeal joint

  J) distal interphalangeal joint

  
• what is the SID for all projections of the hand, fingers, and thumb

  40"
• what are the IR sizes and orientation for all of the projections for the hand, fingers, and thumb

  8x10 LW
• CR for PA finger

  perpendicular to the IR entering proximal interphalangeal joint space fo the affected digit
• CR for PA oblique finger

  perpendicular to the IR entering proximal interphalangeal joint space of the affected digit
• CR for lateral finger

  perpendicular to the IR entering the proximal interphalangeal joint space of the affected digit
• CR for AP thumb

  perpendicular to the IR entering the 1st metacarpophalangeal joint space
• CR for PA oblique thumb

  perpendicular to the IR entering the 1st metacarpophalangeal joint space
• CR for lateral thumb

  perpendicular to the IR entering the 1st metacarpophalangeal joint space
• CR for PA hand

  perpendicular to the IR entering the 3rd metacarpophalangeal joint space
• CR for PA oblique hand

  perpendicular to the IR entering the 3rd metacarpophalangeal joint space
• CR for lateral hand

  perpendicular to the IR entering the 2nd metacarpophalangeal joint space
• patient prep for all UE

  take off jewelry

  move the mrn band up the arm

  get sleeves out of the way

  bandages will show
• radiation protection

  collimate to area of interest

  seated next to table instead of under

  all soft tissue
• pediatric considerations for UE

  restraining devices (Plexi)

  parents can help

  model the positions

  praise age appropriately

  give kids a job to distract them
• Geriatric considerations for UE

  provide complete and clear instructions

  time management

  often less flexible
• indications for hand, finger, or thumb

  trauma

  fracture

  pain

  osteomyelitis (inflammation of the bone and bone marrow)

  foreign body

  ORIF (open reduction internal fixation)

  osteoporosis (loss of cancellous bone)

  osteoarthritis (joints and bones)

  rheumatoid arthritis (autoimmune disease for joints)