4. Upper Limb Matrix

PA: Patient and Part Position

• Seated at end of table

• Palmar to IR, pronated

• Center hand/wrist to IR

PA: CR and SID

• CR perpendicular to IR at 3rd MCP joint

• SID: 40 Inches

PA: Structures Best Visualized

• Entire hand and wrist

• 1 inch of distal forearm

• Oblique Thumb

PA: Exposure Factors and Pathology

• kVp: 55-65

• Portrait

• Fractures, dislocations, foreign bodies

PA Oblique: Patient and Part Position

• Seated end of table

• Rotate hand and wrist 45 degrees so digits are parallel to IR

• Pronate hand

• Center and align long axis of hand with long axis of IR

PA Oblique: CR and SID

• CR perpendicular to IR at 3rd MCP joint

• SID: 40 Inches

PA Oblique: Structures Best Visualized

• Oblique view of hand and wrist

• 1 inch of distant forearm

PA Oblique: Exposure Factors and Pathology

• kVp: 55-65

• Portrait

• Fractures, dislocations, foreign bodies

Fan Lateral: Patient and Part Position

• Seated end of table

• Hand and wrist rotated 90 degrees

• Spread fingers into a fan

• Digits are parallel to IR

• No other rotation

Fan Lateral: CR and SID

• CR perpendicular to IR at 2nd MCP joint

• SID: 40 inches

Fan Lateral: Structures Best Visualized

• Entire hand and wrist

• 1 inch of distal forearm

Fan Lateral: Exposure Factors and Pathology

• kVp: 55-65

• Portrait

• Anterior/Posterior displaced fractures and dislocations of metacarpals

PA Wrist: Patient and Part Position

• Seated end of table

• Carpal centered to IR

• Soft fist shape

PA Wrist: CR and SID

• CR perpendicular to IR at midcarpal area

• SID: 40 inches

PA Wrist: Structures Best Visualized

• Midmetacarpals and proximal metacarpals, carpals, distal radius, ulna, joints, and soft tissues

PA Wrist: Exposure Factors and Pathology

• kVp: 55-65

• Portrait

• Fractures of distal radius and ulna

PA Oblique Wrist: Patient and Part Position

• Seated end of table

• Rotate wrist laterally 45 degrees

• Center wrist to IR

PA Oblique Wrist: CR and SID

• CR perpendicular to IR at midcarpal area

• SID: 40 inches

PA Oblique Wrist: Structures Best Visualized

• Distal radius, ulna, and carpals

• Trapezium and scaphoid

PA Oblique Wrist: Exposure Factors and Pathology

• kVp: 60-70

• Portrait

• Fractures of distal radius and ulna

Lateromedial Wrist: Patient and Part Position

• Seated end of table

• Rotate wrist true lateral

• Center wrist to long axis of IR

Lateromedial Wrist: CR and SID

• CR perpendicular to IR at midcarpal area

• SID: 40 inches

Lateromedial Wrist: Structures Best Visualized

• Distal radius, ulna, and carpals

Lateromedial Wrist: Exposure Factors and Pathology

• kVp: 60-70

• Portrait

• AP fragment displacement for Barton, Colles, and Smith fractures

• Osteroarthritis in 1st CMC