Hand Positioning and Projection Protocols Quiz

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Questions and Answers

Which joint should be closed for correct positioning in the PA Oblique Hand view?

Interphalangeal (IP) joint

Wrist joint

Metacarpophalangeal (MCP) joint (correct)

Elbow joint

What is the optimal positioning of the fingers in the PA Oblique Hand view?

Foreshortened

Overlapping

Parallel to the IR (correct)

Separated with slight overlap of metacarpal shafts

In the Fan Lateral (lateromedial) Hand view, which part of the hand should be in contact with the IR?

Medial side (correct)

Dorsal side

Lateral side

Palmar side

What should be the position of the metacarpals in the Fan Lateral (lateromedial) Hand view for correct positioning?

Parallel to the IR Signup and view all the answers

Where should the CR enter for the Fan Lateral Hand view?

At the 2nd MCP joint Signup and view all the answers

What should be the positioning of the digits in the Fan Lateral Hand view for correct positioning?

"Okay sign" Signup and view all the answers

What is a common error in positioning for the PA Oblique Hand view?

Digits not parallel to the IR Signup and view all the answers

Which joint should be open in the PA Oblique Hand view for correct positioning?

Interphalangeal (IP) joint Signup and view all the answers

What should be used to support the digits in the Fan Lateral Hand view when available?

Sponge Signup and view all the answers

What is the recommended positioning error for the digits in the Fan Lateral Hand projection?

Digits should be fully extended and parallel to the IR Signup and view all the answers

In the Extension Lateral Hand evaluation criteria, what is the recommended positioning for the fingers?

Fingers should be separated with no superimposition Signup and view all the answers

What is the correct CR positioning for the Extension Lateral Hand projection?

Enters at the 2nd-5th MCP joint Signup and view all the answers

In the AP Oblique Bilateral Hand projection, how should the hands be positioned?

Hands should be supinated Signup and view all the answers

What is the recommended hand position for creating a Fan Lateral Hand projection?

Supinate hands Signup and view all the answers

Which structure should be superimposed in the Extension Lateral Hand projection?

Radial and ulnar styloid Signup and view all the answers

What is the optimal density and contrast requirement for the Fan Lateral Hand projection?

Optimal density and contrast Signup and view all the answers

How should the forearm be positioned in the Extension Lateral Hand projection?

Resting on the table Signup and view all the answers

Which of these is an error in positioning for the Fan Lateral Hand projection?

Digits partially extended and not parallel to IR Signup and view all the answers

What is the recommended digit positioning in an AP Oblique Bilateral Hand projection?

Digits extended, relaxed, and separated parallel to IR Signup and view all the answers

What is the recommended patient position for hand X-rays?

Seated at the end of the table, facing the right side Signup and view all the answers

Where should the marker be placed for a PA hand X-ray?

At the most narrow part of the anatomy Signup and view all the answers

What is the recommended CR positioning for a PA hand X-ray?

Enters at 3rd MCP joint Signup and view all the answers

What should be included in the collimation for a hand X-ray?

4-sided to include anatomy of interest Signup and view all the answers

In which projection is the hand and wrist rotated 45 degrees laterally?

PA Oblique Hand Signup and view all the answers

What is the recommended part position for a PA Oblique Hand projection?

Pronate hand, fingers extended, and separated Signup and view all the answers

What should be evaluated in a PA Hand X-ray for optimal results?

Equal concavity of digits Signup and view all the answers

What is the general projection routine protocol for hand X-rays?

$4 view$ Lateral, Lateral Oblique, PA, and PA Oblique Signup and view all the answers

What are some clinical indications for hand X-rays?

$Fractures$, Dislocations, Osteoporosis, Osteoarthritis Signup and view all the answers

Study Notes

PA Oblique Hand View

Close the second metacarpophalangeal joint for correct positioning.
Fingers should be positioned so that they are extended and separated, with the thumb slightly abducted.
Open the proximal interphalangeal joint for optimal visualization.

Fan Lateral (Lateromedial) Hand View

The palm of the hand should be in contact with the image receptor (IR).
Metacarpals should be positioned parallel to the IR for accurate representation.
Central Ray (CR) should enter at the level of the second metacarpophalangeal joint.
Digits should be extended and separated, with the long axis of the fingers aligned parallel to the long axis of the forearm.

Positioning Errors

Common error in PA Oblique view includes excessive rotation, which can obscure joint spaces.
In Fan Lateral projection, common error is incorrect alignment of the fingers or metacarpals, potentially leading to foreshortening.

Extension Lateral Hand View

Position fingers in a straight alignment, making sure they are parallel and not overlapping.
CR should be positioned at the level of the second metacarpophalangeal joint, aligned with the midpoint of the hand.
The proper alignment results in the superimposition of the metacarpals.

AP Oblique Bilateral Hand Projection

Hands should be positioned with palms facing each other and externally rotated 45 degrees for optimal visualization.
The recommended hand position for Fan Lateral projection involves alignment to ensure clear depiction of all digits.

General Guidelines for Hand X-rays

Optimal density and contrast are required for proper visualization in Fan Lateral projection.
The forearm should be placed parallel to the imaging plate in the Extension Lateral view.
The patient should be seated with hands placed correctly, ensuring stability during imaging.

Markers and Collimation

Place the marker on the lateral side of the hand for PA hand X-rays.
Correct CR positioning for PA hand X-ray is at the third metacarpophalangeal joint.
Include collimation to limit exposure and focus on the area of interest.

Projection Routine and Clinical Indications

Hand and wrist are rotated 45 degrees laterally in the PA Oblique Hand projection.
Evaluate positioning in PA Hand X-ray by ensuring all bony structures are visible with minimal superimposition.
Common clinical indications for hand X-rays include trauma assessment, evaluation of arthritis, and detecting fractures or dislocations.

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Description

Test your knowledge on hand positioning, projection protocols, and clinical indications for hand fractures, dislocations, osteoporosis, osteoarthritis, and foreign bodies. Learn about general positioning guidelines and patient positioning for hand X-rays.