Pathology Demonstrated :
Warning: if patient has possible wrist trauma, don’t
attempt this position before routine wrist series
has been completed to rule out possible #’s of distal forearm and/or wrist
Pathology demonstrated
Fx of carpals on the ulnar side, especially the
lunate, triquetrum, pisiform, and hamate
IR Size :
18*24
IR Position :
Crosswise / tabletop
Sheilding :
place lead shield over patient’s lap
Pateint Position :
seat pt at end of table with
elbow flexed 90o. Place wrist and hand on
cassette, palm down. Shoulder, elbow, and
wrist should be on same horizontal plane
Part Position :
Position wrist as for a PA projection – palm down and hand and wrist aligned to center of long axis of portion of IR being exposed, with scaphoid centered to CR Without moving forearm, gently evert hand (move toward ulnar side) as far as patient can tolerate without lifting or rotating distal forearm
CR :
CR to IR centered to midcarpal area
Collimation :
collimate on 4 sides to carpal region
Criteria :
Structures Shown:
• The distal radius and ulna, the carpals, and the proximal metacarpals are visible.
• The carpals are visi-ble, with adjacent interspaces more open on the medial (ul-nar) side of the wrist.
Position:
• The long axis of forearm is aligned to the side border of the IR - Extreme radial deviation is evidenced by the angle of the long axis of the metacarpals to that of the radius and ulna and the space between the triquetrum / pisiform and the styloid process of the radius. - No rotation of the wrist is evidenced by the appearance of the distal radius and ulna.