FDR1 Radiographic positioning

Standard projections for a Hand:

Dorsi-Palmar, Dorsi-palmar Oblique

Centring point of DP hand:

Head of third metacarpal

Collimation for DP hand:

Distal Phlanges, Distal radius and ulna, skin borders

How to get hand into DP oblique position

Rotate 45 degrees externally onto little finger, keeping fingers in extension position

Should the heads of the metacarpals be superimposed in a DP oblique?

No

Centring point of DP oblique:

head of second metacarpal

how to get hand into lateral position

Rotate hand 90 degrees externally

Centring point for lateral hand

head of second metacarpal

Standard radiographic positions for fingers

PA and Lateral

centring point of finger

over metacarpo-phalangeal joint midway between affected and neighbouring finger

Collimation of finger

carpo-metacarpal joint proximally, distal phalanges distally, skin margins

Lateral finger positioning

Rotate finger 90 degrees internally or externally depending on the finger

Standard radiographic positioning of thumb

Antero-Posterior and Lateral

Postioning for AP thumb

arm is entended and medially rotated so dorsal aspect is in contact with image receptor

Centring point for AP thumb

First metacarpo-phalangeal joint

Collimation for thumb

Carpo-metacarpal joint proximally, distal phalanx distally and skin borders laterally

Positioning for lateral thumb

From DP hand apply ulnar deviation and raise lateral part of hand away from image receptor

Standard radiographic positions of Wrist

Postero-anterior and lateral

Postioning for PA wrist

Ensure that radial and ulnar styloid processes are equidistant to image receptor

Centring point of PA Wrist

midway between the radial and ulnar styloid processes

collimation of PA wrist

heads of metacarpals distally, distal third of ulna and radius, soft tissue margins

Positioning of lateral wrist

Medial side in contact with image receptor, over rotate slightly so that the styloid processes are superimposed

Centring point of lateral wrist

Radial styloid process

Standard radiographic positions for scaphoid

Postero-Anterior (with ulnar deviation), Lateral, Oblique, Postero-anterior with ulnar deviation and 30 degrees cranial angulation

PA with Ulnar deviation postioning

Adduct hand to achieve ulnar deviation (hold thumb and pull fingers away)

Centring point of PA with ulnar deviation

Midway between radial and ulnar styloid processes

Collimation of PA with ulnar deviation

Distal ends of radius and ulna, proximal ends of metacarpals

What is the poitioning of Lateral Scaphoid the same as?

Lateral Wrist

Oblique scaphoid positioning

hand and wrist roated 45 degrees onto little finger from PA position, keeping ulnar deviation

Postero-Anterior scaphoid with ulnar deviation and 30 degrees of cranial angulation positioning

Same as PA with ulnar deviation, Xray tube is angled 30 degrees cranially along the lond axis of scaphoid

Centring point for Postero-Anterior scaphoid with ulnar deviation and 30 degrees of cranial angulation

Anatomical snuff box

Collimation for Postero-Anterior scaphoid with ulnar deviation and 30 degrees of cranial angulation

Scaphoid only

Standard projections for radius and ulna

AP and Lateral

Positioning for AP radius and ulna

elbow fully extended, arm supinated, raise table so that elbow and shoulder are at same level

Epicondyles and styloid processes are equidistant from the image receptor

Centring point of AP radius and ulna

Midway between wrist and elbow joint to midline of forearm

AP ulna and radius collimation

Elbow joint, wrist joint and soft tissue margins

Forearm lateral positioning

elbow flexed to 90 degrees, styloid processes and epicondyles are superimposed

Elbow AP positioning

Elbow fully extended, shoulder and elbow at same level, medial and lateral epicondyles are equidistant to image receptor

Centring point of AP elbow

through joint space, 2.5cm distal to point midway between epicondyles

Collimation of AP elbow

distal third of humerus, proximal third of radius and ulna, lateral skin borders