finger/thumb imaging protocol

What are the charges for a Finger (2nd-5th) and Thumb?

XR FINGER LT 2 VWS OR MORE

XR FINGER RT 2 VWS OR MORE

Which views are obtained for a Finger (2nd-5th)?

PA, Oblique, Lateral

Which views are obtained for a Thumb?

AP, Oblique, Lateral

For fingers 2nd-5th + thumb, what is the technique (kVp, mAs) used?

63 kVp, 0.6 mAs

For fingers 2nd-5th and thumb, what is the SID?

40 inches

How is the patient positioned for a PA finger 2nd-5th?

Pt seated, hand on IR, palm down. Separate digits slightly and center to digits of interest

How is the central ray for a PA Finger?

Perpendicular to the proximal interphalangeal joint (PIP)

For a PA Oblique (Lateral Rotation) in fingers 2-5, how is the patient positioned?

Pt seated with hand placed on image receptor, palm down. Rotate the hand and finger(s) laterally until they reach 45 degrees. Place a 45 degree angle sponge to support the pt; separate fingers and ensure parallel to IR

For a PA Oblique (Lateral Rotation) in fingers 2-5, where is the central ray located?

Proximal interphalangeal PIP joint

For a Lateral Finger, how is the patient positioned?

Seated with digit of interest extended and the rest flexed in a fist

For a Lateral 2nd digit, how should the patient be positioned?

Rest the hand on the lateral/radial surface; support the elbow with a sponge. long axis of the finger is parallel to the IR; adjust anterior or posterior rotation of the hand to obtain a true lateral

For a Lateral 3rd-5th digit, how should the patient be positioned?

Hand should rest on medial/ulnar surface; adjust anterior or posterior rotation of the hand to obtain a lateral position; 2+5 directly on IR, 3+4 elevated, use spongeW

Where is the Lateral Finger central ray located?

Proximal interphalangeal joint

For an Oblique (PA) Thumb, how should the patient be positioned?

Pt seated with thumb abducted, place palmar surface in contact with IR; ulnar deviate hand slightly; naturally positions thumb in 45 degree oblique position

For an Oblique (PA) Thumb, where should the Central Ray be?

First metacarpophalangeal joint

For a Lateral Thumb, how should the patient be positiioned?

Pt seated at end of radiographic table; place hand in a natural arched position with the palm down and fingers flexed or resting on sponge; rotate hand until thumb is in a true lateral position

For a Lateral Thumb, where should the Central Ray be?

First metacarpophalangeal joint

For an AP Thumb, how should the patient be positioned?

Seated with hand turned into extreme medial rotation so that thumb is in true AP position; hold extended digits back with opposite hand; aline thumb with the long axis of the IR

For an AP Thumb, where should the Central Ray be?

First metacarpophalangeal joint