Special Projections of Digits, Hand, Wrist
Ballcatcher's Method
Indication: Rheumatoid Arthritis Projection: AP Oblique Bilateral Position: hands supinated, internally rotated 45°, fingers flexed In profile: pisiform
Norgaard Method
Indication: Rheumatoid Arthritis Projection: AP Oblique Bilateral Position: hands supinated, internally rotated 45°, fingers parallel to IR In profile: pisiform
Carpal Bridge
Indication: calcification of dorsal aspect of carpal bones Projection: Tangential AOI: dorsal aspect of carpal bones (scaphoid, lunate, triquetrum)
Gaynor-Hart Method
Indication: carpal tunnel syndrome, calcifications in carpal canal Projection: tangential, inferosuperior Position: wrist hyperextended, hand rotated 10° internally Tube angle: 25°-30° to the long axis of hand centering to 1" distal to base of third metacarpal AOI: hamulus, capitate, scaphoid
Radial Deviation
Indication: fractures of ulnar side of wrist (lunate, triquetrum, pisiform, hamate) Projection: PA Position: hand pronated, inverted
Modified Stetcher Method
Indication: scaphoid fractures Projection: PA Position: hand pronated, elevated 20° on angle sponge, everted Alternative: angle CR 10°-15° towards shoulder with hand everted or clench fist
Ulnar Deviation
Indication: scaphoid fractures (radial side of wrist) Projection: PA/PA Axial Position: hand pronated, everted Tube angle: 10°-15° proximally centering to scaphoid
Modified Robert's Method
Projection: AP Axial (1st digit) Indication: Bennett's Fracture (base of 1st metacarpal) Tube angle: 15° proximally entering at 1st CMC joint joint space open less distortion due to tube angle