Radiography Positioning: Upper Limb

Positioning Considerations

• Patient Position

• Technical (exposure factors)

• Projections

• Orientation

kVP

Low to mid range of 60-80 on digital systems

mAs

Varies depending on the system. Lookng for good trabecular bony detail and soft tissue margin visualization

SID

100-115cm

Orientation (includes)

• PA, Oblique, Lateral

Finger Projections (2nd-5th)

• PA finger

• PA 45 Oblique Finger

• Lateromedial or Mediolateral Finger

PA finger

PA 45 Oblique Finger

Lateromedial or Mediolateral - Finger

AP - Thumb

PA - Thumb

PA 45 Oblique Thumb

Lateral Thumb

PA Hand

PA (external) 45 Oblique Hand

Lateral (Fan) Hand - Lateromedial Projection

Bilateral AP Oblique Hands (Baseball hands)

PA Wrist

PA 45 Oblique Wrist

Lateral Wrist - Lateromedial Projection

PA Axial Scaphoid Ulnar Deviation

AP Forearm

Lateral Forearm - Lateromedial Projection

AP Elbow

Lateral Elbow

Medial Oblique (internal Rotation) (AP 45 Oblique Elbow)

Lateral Oblique (external Rotation)

Lateral Elbow - Radial head

1) Supinated (max external rotation)

2) Lateral

3) Pronated

4) Internal rotation

Axial Lateral Elbow - Radial head (coyle method)

Types of thumb projections

• AP (or PA)

• PA 45 Oblique thumb

• Lateral Thumb

Hand Projection (types)

• PA hand

• PA (external) 45 oblique

• Lateral (fan) Hand - lateromedial projection

• Bilayeral AP oblique hands

Wrist projection (Types)

• PA Wrist

• PA 45 Oblique Wrist

• Lateral Wrist - Lateromedial Projection

Scaphoid Projections

• PA Axial Scaphoid Ulnar Deviation

Forearm

• AP Forearm

• Lateral forearm - Lateromedial projection

• AP Elbow

• Lateral Elbow

• AP medial and lateral 45 oblique elbow

• Lateral elbow - Radial head (Supinated, lateral, Pronated, Internal rotation)

• Axial Lateral Elbow - Radial head

PACEMAN

• P: Position

• A: Anatomy

• C: Center ray or Collimation

• E: Exposure

• M: Marker

• A: Aesthetics

• N: Name