Labeled X-Ray Images
Waters
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PA Wrist
Central ray: Midcarpals Positioning: place patient 90 degrees to table, place hand pronated on IR with fingers rolled in Collimation: 2 1/2 inches beyond the wrist Breathing instructions: normal respiration Shielding: recommended Structures seen: PA projection of carpal bones, proximal metacarpals, distal ulna and radius
PA Hand
CR: 3rd metacarpophalangeal joint (MCP) Positioning: place patient 90 degrees to table, place hand pronated on IR with fingers extended Collimation: to include distal wrist Breathing: normal respiration Shielding: recommended Structures seen: PA projection of 2nd through 5th digit, oblique view of the first digit
PA Oblique Hand
CR: 3rd metacarpophalangeal joint (MCP) Positioning: place patient 90 degrees to table, rotate hand 45 degrees lateral, place all fingers on IR Collimation: to include distal wrist Breathing: normal respiration Shielding: recommended Structures seen: PA oblique projection of the hand
Lateral Hand
CR: metacarpophalangeal joint (MCP) Positioning: place patient 90 degrees to table, place hand in lateral position (finders extended or in fan position) Collimation: to include distal wrist Breathing: normal respiration Shielding: recommended Structures seen: Superimposed carpals, metacarpals, phalanges (phalanges without superimposition when fanned).
PA Oblique Wrist
Upper limb positioned as described for previous wrist projections. Slight overlap of the distal radius and ulna. Well-demonstrated scaphoid and trapezium. Anatomy demonstrated: distal radius and ulna, carpals, and proximal half of metacarpals.