True Lateral Radiographic Positioning Quiz for Hand
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Questions and Answers

What anatomy should be visible in a true lateral position of the hand, wrist, and forearm?

  • Proximal radius and ulna
  • Distal radius, ulna, carpals, and at least the midmetacarpal area (correct)
  • Phalanges and wrist joint
  • Proximal humerus and elbow joint

    • Where should the CR and center of collimation field be positioned in a true lateral hand, wrist, and forearm X-ray?

  • To midcarpal region (correct)
  • To the distal phalanges
  • To the elbow joint
  • To the proximal humerus

    • What is the optimal exposure for a true lateral hand, wrist, and forearm X-ray?

  • Optimal density (brightness) and contrast with no motion (correct)
  • Blurred image with visible motion
  • Low density and high contrast
  • High density and low contrast

    • What is the clinical indication for performing a true lateral hand, wrist, and forearm X-ray?

    <p>Fractures or dislocations of the distal radius or ulna</p> Signup and view all the answers

    What is the recommended CR position for a true lateral hand X-ray?

    <p>Perpendicular to the IR, directed to the second metacarpophalangeal joint</p> Signup and view all the answers

    What is the patient positioning for a true lateral hand X-ray?

    <p>Seat patient at end of table with elbow flexed about 90° and hand and forearm resting on table</p> Signup and view all the answers

    What is the purpose of using a compensation filter in a true lateral hand X-ray?

    <p>To ensure optimum exposure of phalanges and metacarpals due to differences in part thickness</p> Signup and view all the answers

    What is the purpose of aligning the long axis of the hand with the long axis of the IR in a true lateral hand X-ray?

    <p>To ensure proper positioning and minimize distortion</p> Signup and view all the answers

    What should the collimation field include in a true lateral hand X-ray?

    <p>Area of affected finger and distal aspect of metacarpal</p> Signup and view all the answers

    How should the fingers be positioned in a true lateral hand X-ray?

    <p>Separated with no overlapping of soft tissues</p> Signup and view all the answers

    Where should the CR and midpoint of the collimation field be in a true lateral hand X-ray?

    <p>To the PIP joint</p> Signup and view all the answers

    What indicates the correct positioning of the hand in a true lateral X-ray?

    <p>Open interphalangeal joints</p> Signup and view all the answers

    What is the recommended oblique angle for the oblique projection of the hand and wrist?

    <p>45°</p> Signup and view all the answers

    What should be visible in the fan lateral hand position?

    <p>Entire hand and wrist with about 2.5 cm of the distal forearm</p> Signup and view all the answers

    What should the lateral hand radiograph demonstrate in the lateral position?

    <p>Distal and proximal phalanges, first metacarpal, trapezium (superimposed), and associated joints</p> Signup and view all the answers

    What is the minimum recommended SID for hand radiography?

    <p>40 inches</p> Signup and view all the answers

    How should patients be positioned for hand radiography?

    <p>Seated at the end of the table with the elbow flexed about 90° and the hand and forearm resting on the table</p> Signup and view all the answers

    Where should the CR be directed for the fan lateral hand position?

    <p>To the second MCP joint</p> Signup and view all the answers

    What anatomy should be demonstrated in the PA hand position?

    <p>Entire hand and wrist with about 2.5 cm of the distal forearm</p> Signup and view all the answers

    What is the recommended IR size for hand radiography?

    <p>24 × 30 cm (10 × 12 inches) lengthwise</p> Signup and view all the answers

    What is the evaluation criteria for the PA hand position?

    <p>Optimal density and contrast with no motion, demonstrating soft tissue margins and clear, sharp bony trabecular markings</p> Signup and view all the answers

    What is the recommended shielding practice for hand radiography?

    <p>Using shielding to protect radiosensitive tissues outside the region of interest</p> Signup and view all the answers

    Where should the CR and center of collimation field be positioned in a PA hand position?

    <p>To the third MCP joint</p> Signup and view all the answers

    What is the recommended minimum source-to-image distance (SID) for hand X-ray imaging?

    <p>40 inches</p> Signup and view all the answers

    How should the patient's hand and wrist be positioned for hand X-ray imaging?

    <p>With fingers extended</p> Signup and view all the answers

    What is the purpose of recommended collimation in hand X-ray imaging?

    <p>To focus only on the affected finger</p> Signup and view all the answers

    What is the alternative routine for hand X-ray imaging?

    <p>Using a larger IR for the PA projection of the entire hand</p> Signup and view all the answers

    What is the recommended position for the second digit in hand X-ray imaging?

    <p>Thumb side down</p> Signup and view all the answers

    What should the lateral view demonstrate in hand X-ray imaging?

    <p>Concave appearance of the anterior surface of the phalanges</p> Signup and view all the answers

    What is the purpose of optional medial oblique positioning for the second digit in hand X-ray imaging?

    <p>To demonstrate the medial aspect of the finger</p> Signup and view all the answers

    What should the oblique view demonstrate in hand X-ray imaging?

    <p>45° oblique alignment of the finger</p> Signup and view all the answers

    What is the recommended positioning of the patient's forearm for hand X-ray imaging?

    <p>Resting on the table</p> Signup and view all the answers

    What is the recommended hand position for a different imaging procedure than the true lateral hand X-ray?

    <p>Pronated with fingers extended</p> Signup and view all the answers

    What is the recommended practice for shielding in hand X-ray imaging?

    <p>To protect radiosensitive tissues outside the region of interest</p> Signup and view all the answers

    What is the recommended image receptor (IR) size for hand X-ray imaging?

    <p>18 x 24 cm</p> Signup and view all the answers

    What is the recommended minimum source-to-image distance (SID) for hand X-ray imaging?

    <p>40 inches</p> Signup and view all the answers

    How should the patient's hand and wrist be positioned for hand X-ray imaging?

    <p>Palm down with the elbow flexed about 90°</p> Signup and view all the answers

    What is the purpose of aligning the long axis of the hand with the long axis of the IR in a true lateral hand X-ray?

    <p>To reduce distortion and elongation</p> Signup and view all the answers

    What anatomy should be demonstrated in the PA hand position?

    <p>Distal and proximal phalanges, metacarpals, and carpometacarpal joints</p> Signup and view all the answers

    What should the collimation field include in a true lateral hand X-ray?

    <p>Entire thumb and first metacarpal</p> Signup and view all the answers

    What is the purpose of using a compensation filter in a true lateral hand X-ray?

    <p>To minimize elongation and distortion</p> Signup and view all the answers

    What is the recommended IR size for hand radiography?

    <p>18 × 24 cm</p> Signup and view all the answers

    What is the patient position for the oblique thumb projection?

    <p>Thumb abducted with the palmar surface in contact with the IR</p> Signup and view all the answers

    What is the purpose of recommended collimation in hand X-ray imaging?

    <p>To minimize unnecessary exposure to adjacent structures</p> Signup and view all the answers

    What is the purpose of the recommended patient position for the oblique thumb projection?

    <p>To minimize superimposition of adjacent structures</p> Signup and view all the answers

    What is the recommended practice for shielding in hand X-ray imaging?

    <p>Shielding should cover the hand and wrist</p> Signup and view all the answers

    What is the recommended position for the second digit in hand X-ray imaging?

    <p>Medial oblique</p> Signup and view all the answers

    Study Notes

    Hand Radiography Positioning and Evaluation Criteria

    • The fan lateral hand position requires the CR to be directed to the second MCP joint.
    • For the fan lateral position, the entire hand and wrist, along with about 2.5 cm (1 inch) of the distal forearm, should be visible.
    • The oblique projection of the hand and wrist also requires about 2.4 cm (1 inch) of the distal forearm to be visible.
    • In the oblique position, the long axis of the hand and wrist should be aligned with the IR, and a 45° oblique angle is recommended.
    • The lateral hand radiograph should demonstrate the distal and proximal phalanges, first metacarpal, trapezium (superimposed), and associated joints in the lateral position.
    • Clinical indications for these hand radiography positions include fractures, dislocations, or foreign bodies of the phalanges, metacarpals, and all joints of the hand, as well as pathologic processes such as osteoporosis and osteoarthritis.
    • The minimum SID for hand radiography is 40 inches, and the recommended IR size is 24 × 30 cm (10 × 12 inches) lengthwise.
    • The shielding should be used to protect radiosensitive tissues outside the region of interest during hand radiography.
    • Patients should be seated at the end of the table with the elbow flexed about 90° and the hand and forearm resting on the table for hand radiography.
    • The CR for hand radiography should be perpendicular to the IR and directed to the third MCP joint.
    • For the PA hand position, the CR and center of collimation field should be to the third MCP joint, and the anatomy demonstrated should include the entire hand and wrist, along with about 2.5 cm (1 inch) of the distal forearm.
    • The evaluation criteria for the PA hand position include optimal density and contrast with no motion, demonstrating soft tissue margins and clear, sharp bony trabecular markings.

    Hand and Finger X-ray Imaging Procedures

    • Clinical indications for X-ray imaging include fractures, dislocations of phalanges, metacarpals, and associated joints, as well as pathologic conditions like osteoporosis and osteoarthritis.
    • Technical factors for X-ray imaging include a minimum source-to-image distance (SID) of 40 inches, an 18 x 24 cm image receptor (IR) size, and specific kV range for both analog and digital systems.
    • Patient positioning involves seating the patient at the end of the table, with the elbow flexed at 90° and the hand and wrist resting on the IR, with fingers extended.
    • Part positioning requires the hand to be placed in a lateral position with the finger to be examined fully extended and centered on the IR, with a sponge block for support and to prevent motion.
    • Recommended collimation involves collimating on four sides to the affected finger and distal aspect of the metacarpal, with optional medial oblique positioning for the second digit.
    • Evaluation criteria for the lateral and oblique views include the demonstration of specific anatomical structures, correct positioning of the finger, and optimal density and contrast with no motion artifacts.
    • An alternative routine involves using a larger IR for the PA projection of the finger to include the entire hand, followed by oblique and lateral projections of the affected finger only.
    • Shielding is recommended to protect radiosensitive tissues outside the region of interest.
    • The optional medial oblique position for the second digit involves a 45° rotation with the thumb side down, with specific accessories and shielding requirements.
    • The patient's forearm should be rested on the table, and the hand should be pronated with fingers extended for a different imaging procedure.
    • The lateral view should show the long axis of the finger aligned with the side border of the IR, and the finger should be in a true lateral position, as indicated by the concave appearance of the anterior surface of the phalanges.
    • The oblique view should demonstrate a 45° oblique alignment of the finger, with no superimposition of adjacent fingers, and specific criteria for correct positioning and exposure.

    Radiographic Imaging of the Hand and Thumb

    • The optimal positioning of the interphalangeal and metacarpophalangeal joints is crucial for a clear image.
    • The CR and center of collimation field should be at the first MCP joint for an accurate image.
    • The imaging is used for clinical indications such as fractures, dislocations, and pathologic processes like osteoporosis and osteoarthritis.
    • Technical factors include a minimum SID of 40 inches, IR size of 18 × 24 cm, and kV range of 50 to 60 for analog and digital systems.
    • The patient should be seated at the end of the table, with the elbow flexed about 90° and the hand resting on the IR, palm down.
    • The positioning of the hand involves starting with the hand pronated and thumb abducted, then rotating the hand slightly medial until the thumb is in a true lateral position.
    • The evaluation criteria for the image include optimal density and contrast with no motion, demonstrating soft tissue margins and clear, sharp bony trabecular markings.
    • The anatomy demonstrated in the image should include the distal and proximal phalanges, first metacarpal, trapezium, and associated joints.
    • The patient position for the oblique thumb involves abducting the thumb slightly with the palmar surface of the hand in contact with the IR.
    • The recommended collimation is to collimate on four sides to the thumb area, ensuring that all of the first metacarpal is included.
    • The hand should be internally rotated with fingers extended until the posterior surface of the thumb is in contact with the IR for the AP projection.
    • If the patient cannot position for the previous AP, the PA position is used, but it is not advisable due to the increased loss of definition caused by increased OID.

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    Description

    Test your knowledge of radiographic positioning with this quiz focusing on the true lateral position of the hand, wrist, and forearm. Identify the criteria for demonstrating the distal radius and ulna, carpals, and midmetacarpal area, and ensure proper alignment with the long axis of the IR.

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