Image Evaluation of the Hand, Wrist, Digit, and Thumb

These flashcards cover the concepts, techniques, and critical evaluations necessary for effective imaging of the hand and wrist.

What does PA stand for in hand imaging?

Posteroanterior.

What should be visualized in a PA Hand image?

Entire hand distal to the radius and ulna.

How should the hand be aligned when taking a PA Hand image?

Hand down the long axis of the IR.

What indicates no rotation in a PA Hand image?

Equal concavity of the metacarpal and phalangeal shafts.

Why is it important that the fingernails are seen in the center of each distal phalanx?

It indicates proper alignment and no rotation.

What should be the state of the joint spaces in a PA Hand?

Open joint spaces.

What avoids soft tissue overlap in a PA Hand image?

Digits slightly separated.

What is a sign of poor collimation?

Visible anatomy that extends beyond the area of interest.

In a PA Hand, what is meant by proper alignment?

The hand should be straight along the longitudinal axis.

What creates excessive soft tissue overlap in an image?

Digits that are not separated.

How should the palmar surface be positioned for open joint spaces?

Flat against the IR.

What is the purpose of evaluating the oblique hand?

To ensure the hand is correctly positioned and anatomical details are visible.

What indicates that the hand is properly obliqued?

Slight overlap of the 3rd – 5th shafts of the metacarpals.

What should be seen between the 2nd and 3rd metacarpals in an oblique hand?

Separation.

In a Lateral Hand image, what should be superimposed?

Metacarpals.

Why should phalanges be free from superimposition in a lateral view?

To allow clear visualization of each digit.

What is a consequence of inadequate digit separation in lateral views?

Loss of clear detail and assessment of the phalanges.

What angle is recommended for a properly rotated oblique hand image?

45 degrees.

What is a key visual indicator for a lateral wrist?

Superimposed radius and ulna.

What indicates a poor top-to-bottom collimation in wrist images?

Cut-off of the distal phalanx.

What must be maintained for proper imaging of the wrist?

The wrist should be down the long axis of the IR.

How can excessive overlap of the radius and ulna be avoided?

Proper positioning of the wrist.

What does a true lateral wrist show?

Superimposed metacarpals and carpals.

What should be demonstrated in a PA wrist image?

Open radioulnar joint space.

What visual confirmation indicates that the hand is not in true lateral?

Radius and ulna not superimposed.

What aspect of positioning affects the PA wrist image?

Digits need to be only slightly flexed.

What is the significance of centering in wrist imaging?

Ensures the area of interest is accurately represented.

What is indicated by the phrase 'entire wrist visualized'?

Includes proximal half of the metacarpals and radius and ulna.

What is essential for Open IP and MCP joints in an oblique hand?

Slightly separated digits with no soft tissue overlap.

Is side-to-side collimation acceptable in a lateral hand image?

Yes, as long as other factors are maintained.

What does poor positioning of the first two digits in Fan Lateral indicate?

Improper positioning leading to inadequate evaluation.

What should be evaluated in the daily question regarding fan lateral hand radiographs?

Positioning, centering, and collimation adjustments.

What is the proper center for the hand in an image?

Centered to the second MP joint.