Positioning for hand x-rays

Standard projections for hands are dorsipalmar projections, oblique rotated to 45 degrees or sometimes lateral rotated 90 degrees.

• Centring point perpendicular to detector over the head of the third metacarpal

• Collimation from top of the fingers to the wrist (includes carpal bones)

• 60 kV and 2.0 mAs

Standard projections for fingers require the area of interest as close to the detector as possible, and lateral rotated 90 degrees. (Two views at right angles to each other.)

No oblique projections are necessary because bones can be easily separated unlike metacarpals.

• Centring point perpendicular to the detector

• Collimation of whole finger to metacarpal with neighbouring finger for reference (in dorsipalmar projection)

• 60 kV and 1.0 mAs

Standard projections for thumb are AP to get thumb closer to the detector, but PA can be used for the patients comfort, and lateral rotated 90 degrees.

• Centring point perpendicular to the detector

• Collimation of top of distal phalanx and first metacarpal

• 60 kV and 1.0 mAs