ULNAR DEVIATION WRIST

Pathology Demonstrated : 

( Vin )———> 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

Patology —> fx of scaphoid 

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 wrist and hand on cassette, palm down, and shoulder, elbow, and wrist 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 : 

Angle CR 10o to 15o proximally, along long axis of forearm and toward elbow. (CR should be ┴ to long axis of scaphoid) Center CR to scaphoid. (locate scaphoid at a point 2 cm or ¾ inch distal

and medial to radial styloid process)

Collimation : 

collimate on 4 sides to carpal region

Criteria : 

Structure shown : Distal radius and ulna, carpals, and proxi- a metacarpals are visible, 

• Scaphoid should be demonstrated clearly without foreshortening, with adjacent carpal in-aspaces open (evidence of CR angle).

Position : Long axis of wrist and forearm should be aligned with side border of IR. 

• Ulnar deviation should be evident by the angle of the long axis of the metacarpals to that of the radius and ulna. - No rotation of wrist is evidenced by appearance of distal radius and ulna, with minimal superimposition of distal radioulnar joint.