special views wrist and elbow

• PA wrist radial deviation

  IR size: 8x10 screen LW or CW

  Patient position: seated, hand is pronated, forearm and arm resting on table, cup one hand over the wrist joint to hold it in position. Move the elbow towards the patients body and turn the hand medially until the wrist is in extreme radial deviation

  CR: perp to IR entering midcarpal area

  SID: 40"

  Tech: kVp 60 mAs 2.5
• PA wrist ulnar deviation

  IR Size: 8x10 screen LW or CW

  Patient Position: seated, hand is pronated on IR, arm and forearm on the table. cup one hand over the patients wrist and move the elbow away from the body as well as move the hand laterally until the wrist is in extreme ulnar deviation

  CR: perp to IR entering the scaphoid

  SID: 40"

  Tech: kVp 60 mAs 2.5
• PA axial stretcher method oblique sponge (scaphoid)

  IR size: 8x10 screen LW

  Patient position: seated, wrist and hand on the IR with hand pronated. shoulder, elbow, and wrist on same horizontal plane. IR can either be on top or under an angle sponge

  CR: perp to IR entering the scaphoid

  SID: 40"

  Tech:

  Structures shown: scaphoid, distal radius and ulna, carpals, and proximal metacarpals
• PA axial stretcher scaphoid

  IR size: 8x10 screen LW

  Patient position: seated, hand and forearm are extended. drop the shoulder so that the shoulder, wrist, and elbow are all on the same horizontal plane

  CR: angled 30 degrees towards the elbow joint entering the scaphoid

  SID: 40"

  tech:

  Structures: scaphoid, distal radius and ulna, and proximal metacarpals are visible
• PA stretcher with ulnar deviation

  IR size: 8x10 screen LW

  Patient position: seated with arm and forearm resting on the table, without moving the forearm, turn the hand outward until the wrist is in extreme ulnar deviation

  CR: angled 20 degrees towards the elbow and entering the scaphoid

  SID: 40"

  Tech:

  Structures: scaphoid, distal radius and ulna, carpals, proximal metacarpals
• tangential Gaynor-Hart method inferosuperior

  IR size: 8x10 screen LW

  Patient position: seated, wrist and hand on the IR with forearm resting on the table and hand is pronated, hyperextend their wrist until the long axis of the metacarpals are as near vertical ensuring the wrist does not lift off the IR. Internally rotate the hand and wrist medially 10 degrees

  CR: angled 25-30 degrees, to the long axis of the hand entering 1" distal to the base of the third metacarpal

  SID: 40"

  Tech: 50-60 kVp 3-5 mAs

  Structures: carpals and metacarpals
• tangential Gaynor-Hart method superoinferior

  IR size: 8x10 screen LW

  Patient position: seated. Patient dorsiflex wrist as much as possible and lean forward

  Alternate: use a 45 degree sponge under the palmar surface of the hand to slightly elevate the wrist

  CR: angled 20-35 degrees from being parallel with the long axis of the forearm entering the midpoint of the wrist

  SID: 40"

  Tech: 50-60 kVp 3-5 mAs

  Structures: carpals and metacarpals
• tangential carpal bridge

  IR size: 8x10 screen LW

  patient position: standing or sitting. IR is flat on table, patient lean over and place dorsal surface of hand on IR. Center dorsal aspect of the carpals to IR with fingers facing toward patient. Gently flex wrist as far as possible or until 90 degrees

  CR: angle 45 degrees distally, to the long axis of the forearm and entering as=t the midpoint of the distal forearm about 1.5" proximally to wrist joint

  SID: 40"
• tangential carpal bridge modified

  IR size: 8x10 screen LW

  Patient position: seated or standing. Elevate the forearm with support. pateint gently flex wrist as far as possible or until 90 degree angle between hand and forearm. IR is placed against the distal aspect of the hand

  CR: angled 45 degrees distally, to the long axis of the forearm and entering at the midpoint of the distal forearm about 1.5" proximal to the wrist joint

  SID: 40"
• axial lateromedial projection elbow coyle radial head seated

  IR size: 10x12 screen LW

  Patient position: seated, elbow flexed 90 degrees. hand pronated on table

  CR: centered at the mid-elbow joint, angled 45 degrees toward the shoulder

  SID: 40"

  Tech: kVp 70-80 mAs 3.2
• axial lateromedial elbow coyle radial head supine

  IR size: 10x12 screen LW

  Patient position: supine with the elbow flexed 90 degrees. IR should be placed upright and positioned between the patients elbow and torso/abdomen with hand rotated parallel to the IR

  CR: horizontal to IR centered at the mid-elbow joint, angled 45 degrees toward the shoulder

  SID: 40"

  Tech: kVp 70-80 mAs 3.2
• axial mediolateral elbow coyle coronoid seated

  IR size: 10x12 screen LW

  Patient position: seated elbow flexed 80 degrees. patient hand is pronated

  CR: centered at mid-elbow joint, angled 45 degrees away from the shoulder

  SID: 40"

  Tech: kVp 70-80 mAs 3.2
• axial mediolateral elbow coyle coronoid supine

  IR size: 10x12 screen LW

  Patient position: supine with elbow flexed 80 degrees, IR should be placed upright and positioned between the patients elbow and torso/abdomen, with the patients hand rotated parallel to the IR

  CR: horizontal to the IR centered at the mid-elbow joint, angled 45 degrees away from the shoulder

  SID: 40"

  Tech: kVp 70-80 mAs 3.2