Lecture 5 Radiography of the Upper limbs 1

Lecture (5)

Radiography of the Upper limbs 1 - Radiography of the hand • Basic Projection’s 1 -Posteroanterior (PA) 2 -Lateral (Lat) 3 -Oblique

1 -PA Hand • Exposure Factor Kv 55 m. As FFD (cm) 5 100 Patient position Seated at end of radiographhic table Apply lead shielding for Radiation safety Part position Forearm resting on table top Palmar surface against cassette Separate fingers slightly Grid No Focus Cassette Fine 24 x 30 cm

• Central Ray Perpendicular • Center Point To third metacarpophalangeal joint • Structures shown Carpals , Metacarpals & Phalanges

• 2/ Lateral Hand Exposure Factors Kv m. As FFD (cm) Grid Focus Cassette 55 7 100 No Fine 24 x 30 cm Patient position Seated at end of radiographic table Apply lead shielding for Radiation safety Part position Rest ulnar surface on table Hand in true lateral position Extend fingers with thum to palm of hand

• Central Ray Perpendicular • Center Point To second metacarpophalangeal joint • Structures shown Carpals , Metacarpals & Phalanges superimposed Note: Lateral hand is essential in suspected : • • • Fracture to demonstrate the bone Displacement and for a suspected foreign Body to detect its depth

3 -Oblique Hand Exposure Factors Kv m. As FFD (cm) Grid Focus Cassette 57 5 100 No Fine 24 x 30 cm Patient position Seated at end of radiographic table Apply lead shielding for Radiation safety Part position Forearm resting on table top Hand on cassette in lateral position Separate fingers slightly Rotate hand medially 45 degrees

• Central Ray Perpendicular • Center Point To third metacarpophalangeal joint • Structures shown Carpals, Metacarpals & Phalanges in oblique view • Note: AP oblique( Ball catcher position) for both hands is recommended for comparison purposes

Oblique Hand