Hand PA PROJECTION

Seat the patient

Hand

⁂ PA PROJECTION

• Position of patient

  • ______________ of the radiographic table.

Forearm

Hand

⁂ PA PROJECTION

• Position of patient

  • Adjust the patient's height so that the _________ is resting on the table

Rest the patient's forearm

Hand

⁂ PA PROJECTION

• Position of part:

  1. ____________ on the table, and place the hand with the palmar surface down on the IR.

Parallel

Hand

⁂ PA PROJECTION

• Position of part:

  2. Center the IR to the MCP joints, and adjust the long axis of the IR _________ with the long axis of the hand and forearm.

Spread the fingers slightly

Hand

⁂ PA PROJECTION

• Position of part:

  3. _____________

Adhesive tape or positioning sponges

Hand

⁂ PA PROJECTION

• Position of part:

  4. Ask the patient to relax the hand to avoid motion. Prevent involuntary movement with the use of _________ or ___________. A sandbag may be placed over the distal forearm

Gonads

Hand

⁂ PA PROJECTION

• Position of part:

  5. Shield _________

Third MCP joint

Hand

⁂ PA PROJECTION

• Central Ray:

  • Perpendicular to the _________.

• Carpals,

• Metacarpals,

• Phalanges (except the thumb),

• Interarticulations of the hand, and

• Distal radius and ulna

Hand

⁂ PA PROJECTION

• Structures shown:

  • PA projections of these are shown:

    • ________________

    • ________________

    • ________________

    • ________________

    • ________________

No rotation

Hand

⁂ PA PROJECTION

• Evaluation Criteria:

  The following should be clearly demonstrated:

  • ___________ of the hand

Equal concavity

Hand

⁂ PA PROJECTION

• Evaluation Criteria:

  The following should be clearly demonstrated:

  • No rotation of the hand:

    • ___________ of the metacarpal and phalangeal shafts on both sides

Equal amount

Hand

⁂ PA PROJECTION

• Evaluation Criteria:

  The following should be clearly demonstrated:

  • ____________ of soft tissue on both sides of the phalanges

Fingernails

Hand

⁂ PA PROJECTION

• Evaluation Criteria:

  The following should be clearly demonstrated:

  • __________, if visualized, in the center of each distal phalanx

Placed flat on the IR

Hand

⁂ PA PROJECTION

• Evaluation Criteria:

  The following should be clearly demonstrated:

  • Open MCP and interphalangeal joints, indicating that the hand is ______________

No soft tissue overlap

Hand

⁂ PA PROJECTION

• Evaluation Criteria:

  The following should be clearly demonstrated:

  • Slightly separate digits with ____________

Radius and ulna

Hand

⁂ PA PROJECTION

• Evaluation Criteria:

  The following should be clearly demonstrated:

  • All anatomy distal to the ______ and _________

Bony trabeculation

Hand

⁂ PA PROJECTION

• Evaluation Criteria:

  The following should be clearly demonstrated:

  • Soft tissue and ____________

AP projection

Hand

⁂ PA PROJECTION

• Evaluation Criteria:

  NOTE:

  • When the MCP joints are under examination and the patient cannot extend the hand enough to place its palmar surface in contact with the IR,

  • The position of the hand can be reversed for an ______________.

    • This position is also used for the metacarpals when the hand cannot be extended because of an injury, a pathologic condition, or the use of dressings.

Clements and Nakayama

Hand

⁂ PA PROJECTION

• Evaluation Criteria:

  Special Technique:

  • ______________ describe a special exposure technique for imaging early rheumatoid arthritis.