1st Carpometacarpal Joint AP Projection PDF

# 1st Carpometacarpal Joint **AP Projection; Methods** - **Robert Method (AP proj)** - Shoulder, elbow and wrist on same plane - Prevent carpal bones elevation and closing of 1st CMC Jt - Arm internally rotated, hand hyperextended, dorsal aspect of thumb against the IR. - **Rafert? Lo...

# 1st Carpometacarpal Joint **AP Projection; Methods** - **Robert Method (AP proj)** - Shoulder, elbow and wrist on same plane - Prevent carpal bones elevation and closing of 1st CMC Jt - Arm internally rotated, hand hyperextended, dorsal aspect of thumb against the IR. - **Rafert? Long Modification** - Proximally toward the wrist 15 Degrees - **Lewis Modification** 10-15 Degrees ## **1st CMC Jt** - **Robert Method A** - **Rafert? Long Modification B** 15 Degrees - **Lewis Modification C** 10-15 Degrees - **SS** - Arthritic changes - Fractures - 1st CMC jt displacement - Bennett's Fx - Rolando FX - transverse fx of metacarpal base - **ER** - Angulation Rationale: to protect soft tissue of the hand away from 1st CMC Jt. Open joint spaces ## **1st MCP Jt** - **Clearer Image of 1st CMC Jt** than normal AP proj. - **Magnified 1st CMC Jt** - Magnified concavoconvex outline 1st CMC jt - Trapezium in concave profile - Base of 1st metacarpal in convex profile ## **1st MCP Joint** **PA Projection** - **Folio Method (SKIER'S THUMB) PA proj** - Hand rested on medial aspect; - Distal portion of both thumbs wrap around by a rubber band - Thumb in a plane PA **Skier's Thumb** - Sprain or tear of the UCL of thumb. ## **Diagnosis** - **Diagnosis of (UCL) Ulnar Collateral Ligament Rupture** - Bilateral MCP jt and metacarpal angles - b/n level of MCP jt. of both hands.