PA Scaphoid - Hand Elevated and Ulnar Deviation - Wrist

What is the minimum SID for the modified stetcher method?

40 inches

What is the alternative method to part positioning of the modified stetcher method?

Have the patient clench the fist with ulnar deviation to obtain a similar position of the scaphoid

What IR size is used for the modified stetcher method?

8 x 10 or smallest IR and collimate to area of interest

How is no rotation evident for a modified stetcher method?

Appearance of distal radius and ulna with no or only minimal superimposition of distal radioulnar joint

When should the modified stecher method not be attempted?

Before a routine wrist series has been completed and evaluated to rule out possible fracture of distal forearm or wrist or both

What is the kV range for the modified stetcher method?

Digital - 60+-5; Analog - 60-70

What anatomy is demonstrated on the modified stetcher method?

Distal radius, ulna, carpals, and proximal metacarpals; adjacent interspaces of the carpals more open on the lateral side; scaphoid is shown without foreshortening or superimposition of adjoining carpals

How is the part positioned for the modified stetcher method?

Hand and wrist are palm down on IR with the hand elevated on a 20 degree sponge; wrist in direct contact with the IR; turn hand to the ulnar side unless there is severe injury

What is another term for the PA scaphoid projection of the wrist with an elevated hand and ulnar deviation?

Modified Stecher Method

What is the recommended collimation for the modified stetcher method?

On four sides to carpal region

How is ulnar deviation apparent on a modified stetcher method radiograph?

Only minimal, if any, superimposition of distal scaphoid

How is the patient positioned for the modified stetcher method?

Patient is seated at the end of the table with hand and forearm extended; shoulders are dropped so the shoulder, elbow, and wrist are on the same horizontal plane

Where is the CR centered for the modified stetcher method?

Perpendicular to IR and directed to scaphoid

What are the clinical indications for the modified stetcher method?

Possible fractures of the scaphoid

What is the modified stetcher method an alternative to?

The CR angle deviation wrist projection

Do you shield for the modified stetcher method?

Yes