OBLIUQE HAND 

Pathology demonstrated : 

Fractures and dislocations of the phalanges,metacarpals, and all joints of the  hand 

• Pathologic processes, such as osteoporosis and osteoarthritis 

IR Size : 

24 /30

IR Position : 

Lengthwise / tabletop

Sheilding : 

Shielding Shield radiosensitive tissues outside region of interest

Patient position : 

Seat patient at end of table with elbow flexed  about 90° and hand and forearm resting on table

Part Position : 

Pronate hand on IR; center and align long axis of hand with long  

axis of IR. 

• Rotate entire hand and wrist laterally 45° and support with  

radiolucent wedge or step block, as shown, so that all digits are  separated and parallel to IR (see Exception)

CR : 

third MCP joint

Collimation : 

Collimate on four sides to hand and  wrist

Criteria : 

Anatomy Demonstrated: • Oblique projection of the entire  hand and wrist and about 2.4 cm (1 inch) of distal forearm  are visible. 

Position: 

• Long axis of hand and wrist should be aligned  with IR.

• 45° oblique is evidenced by the following:

midshafts of metacarpals should not overlap; some overlap  of distal heads of third, fourth, and fifth metacarpals but no  overlap of distal second and third metacarpals should occur;  excessive overlap of metacarpals indicates over-rotation, and  too much separation indicates under-rotation. 

• MCP and IP  joints are open without foreshortening of midphalanges or  distal phalanges, indicating that fingers are parallel to IR.