Anatomy and Radiography Review: Digits, Hand, and Wrist

Vocabulary flashcards covering anatomy review and radiographic positioning procedures for digits, hand, and wrist.

Phalanges (Hand)

The 14 bones present in each hand, numbered 1 to 5 from lateral to medial and classified as long bones.

Metacarpals

The 5 long bones in each hand that compose the palm.

Carpals

The 8 wrist bones located in each hand, arranged in proximal and distal rows.

Proximal Carpal Row

The bottom row of carpals consisting of the scaphoid, lunate, triquetrum, and pisiform (remembered by 'Steve Left The Party').

Distal Carpal Row

The top row of carpals consisting of the trapezium, trapezoid, capitate, and hamate (remembered by 'To Take Carol Home').

Interphalangeal (IP) Joints

Freely movable hinge joints (synovial/diarthrotic) that form the articulations between phalanges.

Metacarpophalangeal (MCP) Joints

Articulations situated between the heads of the metacarpals and the proximal phalanges.

Carpometacarpal (CMC) Joints

Gliding type joints formed by the articulations between the bases of the metacarpals and the carpal bones.

Intercarpal Joints

Articulations located between individual carpal bones.

Radiocarpal Joint

The primary articulation joint between the radius and the carpal bones.

Source-to-Image Distance (SID) for Digits, Hand, and Wrist

A standard distance set to 40 inches for all X-rays of digits, hand, and wrist.

Lap Shielding

A mandatory radiation protection measure placed over the patient's lap during hand, digit, and wrist radiography.

PA View: Digits 2-5

Central Ray: Should be on PIP

Collimation: 1 inch on all sides of digit, including 1 inch beyond the MCP joint

Instruct patient to hold still w/ affected digit flat on IR

Lateral View: Digits 2-5

Flex MCP joints/hold other fingers out of anatomy of interest

Central Ray: Should be on PIP

Collimation: 1 inch on all sides of digit, including 1 inch beyond the MCP joint

PA Oblique View: Digits 2-5

Hand resting flat on IR/Sponge

Rotate digit of interest 45 degrees

Central Ray: Should be on PIP

Collimation: 1 inch on all sides of digit, including 1 inch beyond the MCP joint

PA Oblique Digits 2-5 Evaluation

Identified when a concave aspect is seen on one side of the finger, starting wide and dipping back in.

AP View: First Digit (Thumb)

Central Ray: Should be on MCP of thumb

Collimation: 1 inch on all sides of digit, including 1 inch beyond the CMC joint w/ thumb fully extended/flat on IR

Lateral View: First Digit (Thumb)

Thumb should be extended and resting on IR w/ other fingers out of the way

Central Ray: Should be on MCP of thumb

Collimation: 1 inch on all sides of digit, including 1 inch beyond the CMC joint

PA Oblique View: First Digit (Thumb)

Thumb should be resting on IR, w/ other fingers out of the way

Central Ray: Should be on MCP of thumb

Collimation: 1 inch on all sides of digit, including 1 inch beyond the CMC joint

45 degree rotation

PA View: Hand

Hand placed flat on IR,

Central Ray: Should be on the MCP of the third digit (middle finger)

Collimation: 1 inch on all sides of the hand, including 1 inch beyond the ulnar styloid w/ fingers extended and spread apart

PA Oblique View: Hand

Hand placed flat on IR/Sponge, MCP joints should be at a 45 degree angle to IR

Central Ray: Should be on the MCP of the third digit (middle finger)

Collimation: 1 inch on all sides of the hand, including 1 inch beyond the ulnar styloid w/ fingers extended and spread apart

True Lateral View (lateromedial): Hand

Hand should be positioned with ulnar side of hand/forearm resting on the IR, both styloids superimposed

Extend fingers and abduct the thumb

Central Ray: Should be on the MCP joint of the second digit (pointer finger)

Collimation: 1 inch on all sides of the shadow of the hand and thumb, including 1 inch beyond the ulnar styloid

Fan Lateral View: Hand

separate extended digits and rest hand on sponge. If no sponge, have the hand make the “ok” sign with first and second digits almost touching

Central Ray: Should be on the MCP joint of the second digit (pointer finger)

Collimation: 1 inch on all sides of the shadow of the hand and thumb, including 1 inch beyond the ulnar styloid

PA View: Wrist

fingers should be flexed/cupped under hand, wrist flat on the IR

Central Ray: Should be on the midcarpals

Collimation: 2.5 inches beyond the wrist joint both distal (mid-metacarpals) and proximal (past radius/ulna), and 1 inch on the sides

Lateral View: Wrist

wrist should be resting on ulnar surface on IR, radial/ulnar styloid should be superimposed, fingers extended and aligned with each other

Central Ray: Should be on the center of the wrist

Collimation: 2.5 inches beyond the wrist joint both distal (mid-metacarpals) and proximal (past radius/ulna), and 1 inch on the sides (sides = dorsal and palmar surfaces)

PA Oblique View: Wrist

wrist should be rotated 45 degrees externally, supported with a wedge sponge

Central Ray: Should be on the center of the wrist

Collimation: 2.5 inches beyond the wrist joint both distal (mid-metacarpals) and proximal (past radius/ulna), and 1 inch on the sides

PA Ulnar Deviation: Wrist

hand should be flat on IR, turned outward toward ulna

Central Ray: Should be on the scaphoid bone in the wrist to visualize it clearly

Collimation: 2.5 inches beyond the wrist joint both distal (mid-metacarpals) and proximal (past radius/ulna), and 1 inch on the sides

PA Axial Scaphoid Projection

Special PA wrist view with CR on the scaphoid that elongates the scaphoid bone.

Gaynor-Hart Method

Tangential carpal tunnel special projection performed with the wrist hyperextended and CR on the radial styloid.