Upper Limb Positions

AP- Thumb

SID-40 in. 63 kVp @ 1.6 mAs; hand rotated internally to supinate thumb for AP projection. Posterior surface of thumb should be touching the IR. CR centered on 1st MCP joint.

PA Oblique- Thumb

SID-40 in.; 63 kVp @ 1.6 mAs; hand in PA position will naturally put the thumb in PA oblique. CR centered on 1st MCP joint

Lateral- Finger

SID-40 in.; 63 kVp @ 1.6 mAs; seat patient at end of table, with elbow flexed about 90 degrees and with hand and wrist resting on IR and fingers extended. Finger parallel to IR, use sponge if needed. CR directed to PIP joint

PA with Ulnar Deviation- Wrist

SID-40 in; 60-65 kV; hand and wrist in PA position, then move hand laterally (ulnar side). Angle CR 10-15 degrees and CR centered at scaphoid.

PA with Radial Deviation-Wrist

SID-40 in; 60-65 kV; hand and wrist in PA, then move hand toward radius(thumb side). CR centered at midcarpal area.

Lateral Extension- Hand

SID-40 in; 60-65 kVp; hand in lateral position with thumb up, extend fingers. CR centered on 2nd-5th MCP joints

AP- Elbow when elbow cannot be fully extended

SID-40 in; 60-70 kV; 2 projections- one with forearm parallel to IR and one with humerus parallel to IR. CR centered at mid-elbow joint

AP Oblique internal rotation- Elbow

SID-40 in; 60-70 kV; pronate hand, palm side down on IR, rotate arm 45 degrees. CR centered at mid-elbow joint

AP Oblique external rotation- Elbow

SID-40 in; 60-70 kV; supinate hand and rotate laterally arm so that lateral side is 45 degrees. CR centered at mid-elbow joint

Lateral- Thumb

SID-40 in; 63 kVp @ 1.6 mAs; thumb lateral on IR; CR centered on 1st MCP joint

PA(AP)- Wrist

SID-40 in; 66 kVp @ 2 mAs; drop shoulder so that shoudler, elbow and wrist are in the same plane. If PA, loose fist. CR centered on midcarpal area

PA Oblique- Wrist

SID-40 in; 66 kVp @ 2 mAs; rotate wrist 45 degrees (use sponge if needed) thumb up. CR centered at midcarpal area

Lateral-Forearm

SID-40 in; 70 kVp @ 2.2 mAs; drop shoulder or raise table to have shoulder and arm in the same plane, have elbow flexed at 90 degrees, arm and wrist in lateral position, thumb up. CR centered at mid forearm.

AP-Forearm

SID-40 in; 70 kVp @ 2.2 mAs; posterior surface of forearm should touch the IR, drop the shoulder or raise table to have shoulder and arm in the same plane. CR centered on midforearm.

AP-Elbow

SID-40 in; 70 kVp @ 2.5 mAs; extend elbow, supinate hand. CR centered at mid-elbow joint (palpate epicondyles if needed)

"Fan" Lateral- Hand

SID-40 in; 70 kVp @ 2.5 mAs; rotate hand and wirst in lateral position, thumb up, spread fingers in fan position; digits should be separated and parallel to IR. CR centered on 2nd MCP joint

Lateral-Wrist

SID-40 in; 70 kVp @ 2.5 mAs; wrist in lateral position. CR centered at midcarpal area.

PA- Finger

SID-40 inches; 63 kVp @ 1.6 mAs; seat patient at end of table, with elbow flexed about 90 degrees and with hand and forearm resting on the table. CR directed to PIP joint

PA Oblique Projection- Finger

SID-40 inches; 63 kVp @ 1.6 mAs; seat patient at end of table, with elbow flexed about 90 degrees and with hand and wrist resting on IR and fingers extended. CR directed to PIP joint. Hand or finger at 45 degree angle, or placed on a wedged sponge (thumb side up)

PA- Hand

SID-40in; 66 kVp @ 1.6 mAs; pronate hand with palmar surface in contact with IR; spread fingers slightly. CR centered on 3rd MCP joint

PA Oblique- Hand

SID-40in; 66 kVp @ 2 mAs; pronate hand on IR; rotate hand and wrist laterally 45 degrees (use wedge if necessary), digits separated and parallel to IR. CR centered on 3rd MCP joint

Lateral- Elbow

SID-40in; 70 kVp @ 2.5 mAs; drop shoulder or raise table so that shoulder and arm are in the same plane, have elbow and forearm in lateral position, elbow at 90 degrees. CR centered at mid-elbow joint.