Fingers, Hand, Wrist, Forearm, Elbow, Humerus, and Shoulder

A patient arrives in radiology with a metal foreign body in the palm of the hand. Which of the following hand routines should be performed on this patient to confirm the location of the foreign body?

PA and lateral in extension projections

Where is the central ray (CR) placed for a PA projection of the third digit?

At the proximal interpharangeal joint

Which projection of the thumb results in a more magnified image because of the increase in OID?

PA

What is the name of the most common type of arthritis?

Osteoarthritis

When radiographing the fingers, what anatomy should be included?

The distal portions of the metacarpal and all of the phalanges

What is the name of the joint found between the proximal and distal phalanges of the first digit?

Interpharangeal

What is the name of the bones that comprise the digits of the hands?

Phalanges

Where is the CR centered for a PA projection of the hand?

At the third metacarpophalangeal joint

Which one of the following is the most common primary malignant bone tumor?

Multiple myeloma

The first carpometacarpal joint is classified as a ? Joint.

Sellar

What is the position of the thumb on a PA projection of the hand?

Oblique

The bones that are located in the palm of the hand are called:

Metacarpals

From a pronated position, which of the following is required for a PA oblique projection of the 4th digit of the hand?

45 degree lateral rotation

A ginglymus joint can also be referred to as a ? Joint

Hinge

Which of the following positioning strategies helps demonstrate the interphalangeal joints on the PA oblique projection of the hand?

Use of a stair-step sponge to support the fingers

How many bones are normally found in digits 2 to 5?

3

Which surface of the hand should be in contact with the IR for the lateral projeciton of the 5th (pinky) digit?

The medial surface

The second most common type of primary cancerous bone tumor is:

Osteogenic sarcoma

Which projection best demonstrates pathology involving the first carpometacarpal joint?

Anteroposterior (AP) thumb, modified Robert's method

What is the center point of the CR for the PA projection of the hand?

3rd MCP joint

What CR angle is required with the modified Robert's method?

15 degrees proximally (toward the wrist)

The interphalangeal joints have a(n) ? Type of joint movement

Ginglymus

The first metacarpophalangeal joint has a(n) ? Type of joint movement.

Ellipsoidal

Where is the CR center point for the AP projection of the thumb?

MCP joint

What term is used to denote inflammation of the bone, especially in the marrow, caused by a pathogenic organism?

Osteomyelitis

The joint found between the base of the 3rd metacarpal and carpal bone is the:

Carpometacarpal

A general positioning rule his to place the long axis of the part ? To the long axis of the image receptor.

Parallel

Which specific anatomy is better visualized with a fan lateral as compared with the other lateral projections of the hand?

Phalanges

Where is the CR center point for the PA projection of the second digit?

Proximal interphalangeal joint

Why is it important to keep the phalanges parallel to the IR for a PA oblique projection of the hand?

Prevents foreshortening of phalanges and obscuring of interphalangeal joints

Why is it recommended that the medial oblique projection be performed rather than the lateral oblique for the second digit of the hand?

To improve radiographic contrast

Which surface of the hand is in contact with the IR for the lateral projection of the hand?

Medial

The CR placement for an AP projection (modified Robert's method) of the thumb is at the:

First carpometacarpal joint

To demonstrate the interphalangeal joint spaces, how must the finger be positioned for the PA oblique and lateral projections?

Parallel to the IR

Which carpal bone articulates with the first metacarpal?

Trapezium

How many carpal bones are found in the wrist?

8

A radiograph of a tangential, inferosuperior projection of the carpal canal reveals that the hamate is superimposed over the pisiform. Which of the following measures will correct this problem?

Rotate the wrist and hand 10 degrees internally

Which of the carpal bones is considered to be the largest?

Capitate

Which of the following projections of the wrist will best demonstrate the wrist joint and intercarpal spaces if the patient can assume this position?

AP

The bending or forcing of the hand laterally with the hand pronated in a posteroanterior (PA) projection is known as:

Ulnar deviation

A patient enters the emergency dept (ED) with a Smith fracture. Which region of the upper limb must be radiographer to demonstrate this injury?

Wrist and forearm

Carpal tunnel syndrome is more common in middle aged women than in middle-aged men.

True

Which carpal bone is located in the proximal row on the lateral side?

Scaphoid

A radiograph of the PA scaphoid projection reveals extensive superimposition of the scaphoid and adjacent carpals. Which of the following factors can lead to this problem?

Insufficient ulnar deviation

The radiocarpal (wrist) joint possesses a(n) ? Type of joint movement

Ellipsoidal

Which carpal bone has a characteristic hooklike process on its anterior surface?

Hamate

Which of the following is located at the distal end of the radius?

Styloid process

Which positioning strategy places the wrist in closer contact with the IR for the PA projection of the wrist?

Flexing the fingers into a loose fist

Which special projection of the wrist is ideal for demonstrating possible calcification in the dorsal aspect of the carpals?

Carpal bridge

Which surface of the wrist is in contact with the IR for the PA projection of the wrist?

Anterior

Which carpal bone, if fractured, can have serious complications?

Scaphoid

Which carpal bone is located in the distal row on the medial side?

Hamate

A ginglymus joint can also be referred to as a ? Joint

Hinge

How much CR angulation to the long axis of the hand is require for the tangential, inferosuperior projection to demonstrate the Carpal sulcus (canal)?

25 to 30 degrees

Which special projection of the wrist will open up the inter spaces on the ulnar side of the wrist?

Radial deviation

A patient with a history of carpal tunnel syndrome comes to radiology. The physician wants to rule out abnormal calcification symptoms in the carpal sulcus. Which of the following projections would best demonstrate this region?

Coyle method

Which of the following carpals articulates with the radius?

Scaphoid

The two fat stripes of the wrist demonstrated radiographically are known as the scaphoid fat stripe and the ? Fat stripe

Pronator

Which carpal articulates with both the fourth and fifth metacarpals?

Hamate

Which of the following special projections can be sued to demonstrate the scaphoid carpal bone?

PA projection (ulnar deviation position), PA axial projection (Stecher method)

The first carpometacarpal joint is classified as a ? Joint.

Sellar

Which carpal bone is the smallest?

Pisiform

The joint found between the base of the third metacarpal and carpal bone is the:

Carpometacarpal

What is the proper position of the wrist for the lateral projection?

Medial surface of the wrist on the IR with the coronal plane perpendicular to the IR

Which is the most commonly fractured carpal bone?

Scaphoid

What is the position of the wrist for the PA oblique projection with lateral rotation?

Coronal plane of the wrist at a 45 degree angle to the IR with the anteromedial surface on the IR

A patient enters the ED with a possible scaphoid fracture. The patient is unable to assume the ulnar deviation position. Which of the following positions should be performed to confirm the diagnosis?

Modified Stecher

Which bone of the forearm is located on the medial side?

Ulna

Where is the radial tuberosity located?

At the proximal end, distal to the head of the radius

Which of the following bony structures is found on the distal aspect of the ulna?

Head

The forearm consists of which of the following bones?

Ulna and radius

A patient with a fractured forearm had the fracture reduced and a fiberglass cast placed on the extremity. The orthopedic surgeon orders a postreduction study. The original kV was 60 kV. Which one of the following kV factors should be selected for the postreduction study?

63 kV

For the lateral projection of the forearm, the elbow should be flexed:

90 degrees

Which of the following joints should be clearly demonstrated on the AP projection of the forearm?

Wrist and elbow

The bones of the forearm are the:

Radius and ulna

Which of the following bony structures is found on the distal aspect of the ulna?

Head

Which of the following actions will lead to the proximal radius crossing over the ulna?

Pronation of the hand

Which two structures form the distal radioulnar joint?

Ulnar notch and head of ulna

Which of the following is located the distal end of the radius?

Styloid process

How many degrees is the central ray angled for the AP forearm?

0

Which of the following actions will lead to the proximal radius crossing over the ulna?

Pronation of the hand

Which one fo the following structures is not part of the ulna?

Ulnar notch

In radiography of the forearm, it is important to:

Include both bones in their entirety and their articulations

The lateral projection of the forearm should clearly demonstrate which of the following?

Elbow joint, radius and ulna, proximal row of carpal bones

Which of the following general procedures should be observed when performing x-ray examinations of the upper limb?

Remove rings and watches, use an R or L marker on each image

For the AP projection of the forearm, the hand is:

Supinated

How many degrees should the elbow be angled for an PA oblique projection in lateral rotation?

45 degrees

Which of the following would be projected free of superimposition for an AP oblique projection of the elbow with medial rotation?

Coronoid process

The head of the radius articulates on the medial side with the:

Radial notch

For the lateral projection of the elbow, the elbow joint should be e flexed:

90 degrees

A radiograph of an AP projection of the elbow reveals that there is complete separation of the proximal radius and ulna. What positioning error has been committed?

Excessive lateral rotation

A radiograph of an AP oblique elbow with medial rotation reveals that the radial head is superimposed over part of the coronoid process. What positioning error has been committed?

Excessive medial rotation

Which routine projection of the elbow best demonstrates the radial head and tuberosity free of superimposition?

AP oblique with lateral rotation

Which of the following should b eon the same plane for a lateral projection of the elbow?

Wrist, elbow and shoulder joint

Which two structures primarily form the hinge-like structure and movement of the elbow joint?

Trochlea and olecranon process

The head of the radius fits into a depression on the lateral aspect of the coronoid process of the ulna. This depression is called the:

Radial notch

Which of the following projections of the elbow will demonstrate the radial head and neck free of superimposition?

AP oblique projection, lateral rotation

How many degrees should the elbow be angled for an AP oblique projection in medial rotation?

45 degrees

What is the central-ray angulation for the AP elbow when the forearm is partially flexed?

0 degrees

A lateral elbow radiograph demonstrates about half of the radial head superimposed by the coronoid process of the ulna. Which of the following occurred?

No positioning errors occurred