Hand radiogrpahy

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Faculty of Life and Allied health Sciences
Course Code: 19MRT212A / 19MRT213A
Course Title: Clinical Radiography- Positioning
Course Leader: Charlie Daniel. K
charliedaniel.ah.ls@msruas.ac.in

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Faculty of Life and Allied health Sciences
Lecture No . 02
Hand
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At the end of this lecture, the student will be able to:
Explain and Demonstrate The Radiographic positioning for Hand
Identify basic and advanced views used
Apply the appropriate Positioning for individual cases

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Faculty of Life and Allied health Sciences
Hand
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Posterior - anterior ~ dorsi Palmar
Anterior oblique ~ dorsi Palmar oblique
Posterior oblique ~ both hands (ball catcher's or
Norgaard projection)

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Faculty of Life and Allied health Sciences
1. Posterior anterior - Dorsi Palmar
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Position of patient and cassette
The patient is seated alongside the table with the affected arm
nearest to the table.
The forearm is pronated and placed on the table with the palmer
surface of the hand in contact with the cassette.
The fingers are separated and extended but relaxed to ensure
that they remain in contact with the cassette.
The wrist is adjusted so that the radial and ulna styloid processes
are equidistant from the cassette.
A sandbag is placed over the lower forearm for immobilization

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Faculty of Life and Allied health Sciences
Direction and centring of the X-ray beam
• The vertical central ray is centered over the head of the third
metacarpal.

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Faculty of Life and Allied health Sciences
KVP and mAs for Dorsi-Palmar view
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KVP - 60
mAs - 5

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Faculty of Life and Allied health Sciences
Posterior anterior - Dorsi Palmar

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Faculty of Life and Allied health Sciences
2. Anterior oblique - Dorsi-palmar oblique
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Position of patient and cassette
From the basic postero-anterior position, the hand is
externally rotated 45 degrees with the fingers extended.
The fingers should be separated slightly and the hand
supported on a 45-degree non-opaque pad.
A sandbag is placed over the lower end of the forearm for
immobilization.

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Faculty of Life and Allied health Sciences
Direction and centring of the X-ray beam
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The vertical central ray is centred over the head of the
fifth metacarpal.
The tube is then angled so that the central ray passes
through the head of the third metacarpal, enabling a
reduction in the size of the field.

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Faculty of Life and Allied health Sciences
KVP and mAs for Anterior Oblique - dorsi-palmar
oblique
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KVP - 60
mAs - 6

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Faculty of Life and Allied health Sciences
Anterior Oblique - Dorsi-palmar oblique

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Faculty of Life and Allied health Sciences
3. Posterior-Oblique - both hands (ball catcher's or
Norgaard projection
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Position of patient and cassette
The patient is seated alongside the table.
However, if this is not possible due to the patient’s condition, the
patient may be seated facing the table
Both forearms are pronated and placed on the table with the palmer
surface of the hands in contact with the cassette.
The fingers are separated and extended but relaxed to ensure that they
remain in contact with the cassette.
The wrists are adjusted so that the radial and ulna styloid processes
are equidistant from the cassette.
A sandbag is placed over the lower forearms for immobilization.

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Faculty of Life and Allied health Sciences
Direction and centring of the X-ray beam
• The vertical central is centred over a point midway between the
inter-phalangeal joints of both thumbs.

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Faculty of Life and Allied health Sciences
KVP and mAs posterior oblique - both hands
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KVP - 60
mAs - 6

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Faculty of Life and Allied health Sciences
Posterior oblique - Both hands

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Faculty of Life and Allied health Sciences
Summary
• At the end of the experiment , the student will be able to
explain and demonstrate basic and advanced
Radiographic positioning for Hand.

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Faculty of Life and Allied health Sciences
Reference
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Clark's Positioning in Radiography
Handbook of Medical Radiography - C.Ramamohan

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Faculty of Life and Allied health Sciences
Disclaimer
All data and content provided in this presentation are taken
from the reference books, internet – websites and links,
for informational purposes only.