POSITIONING: HAND ROUTINE

Summary

This video script demonstrates how to perform routine hand radiographic procedures, including PA and oblique views. For the PA view, the patient is positioned in semi-decubitus at the end of the image receiver, with the central ray directed at the third metacarpophalangeal joint. In the oblique view, the patient rotates their hand 45 degrees to achieve the correct positioning, with the central ray targeting the same joint. The radiographic marker is placed to identify the right side, although it may not be necessary in the oblique view if previously marked in the PA view.

Takeaways

• 😀 The hand positioning routine consists of PA (Posteroanterior) and oblique views.
• 😀 For the PA view, position the patient at the end of the image receiver in semi-decubitus (sitting).
• 😀 Centralize the central ray to the image receptor (IR), which is the table, and direct it to the third metacarpophalangeal joint.
• 😀 The radiographic marker should be placed in the middle third of the chassis to identify the right side of the patient.
• 😀 For the oblique hand view, position the patient at the end of the table and instruct the patient to turn their hand 45 degrees.
• 😀 The 45-degree rotation will result in an accurate oblique view of the hand.
• 😀 In the oblique view, the central ray should be directed to the middle of the third metacarpophalangeal joint.
• 😀 If a radiographic marker is needed, it should be placed in the middle third of the chassis in the oblique view.
• 😀 When using the radiographic marker in the PA view, it already marks the right side of the structure, so no additional marker is needed in the oblique view.
• 😀 The PA and oblique hand views require precise patient positioning and proper alignment of the central ray to obtain accurate radiographs.

Q & A

What is the patient positioning for a PA (Posteroanterior) hand radiograph?

For a PA hand radiograph, the patient should be positioned at the end of the image receptor in a semi-decubitus (sitting) position.

Where should the central ray be directed for a PA hand view?

The central ray should be centered to the image receptor at the level of the third metacarpophalangeal (MCP) joint.

What is the purpose of placing the radiographic marker in the middle third of the film during a PA hand radiograph?

The radiographic marker is placed in the middle third of the film to indicate the right side of the patient and help identify the structure in the image.

How is the oblique hand positioning different from the PA hand?

In the oblique hand view, the patient rotates the hand 45 degrees, whereas in the PA view, the hand is placed flat on the image receptor without rotation.

What should the patient do to achieve the 45-degree rotation for an oblique hand radiograph?

The patient should rotate their hand 45 degrees to achieve the true oblique position.

Where should the central ray be directed for an oblique hand radiograph?

The central ray should be directed to the middle of the third metacarpophalangeal (MCP) joint for the oblique hand radiograph.

Do you need to use the radiographic marker for an oblique hand radiograph if the PA radiograph was already marked?

No, if the PA radiograph has already been marked, there is no need to use a radiographic marker for the oblique hand view as the right side is already indicated.

When should you use the radiographic marker for an oblique hand radiograph?

The radiographic marker should be used if needed, particularly in the middle third of the film to identify the right side of the structure in the oblique view.

Why is the central ray directed to the third MCP joint in both PA and oblique hand radiographs?

The third MCP joint is used as the central reference point for both PA and oblique views to ensure proper alignment and accurate imaging of the hand.

What is the key difference in positioning the hand for a true oblique radiograph compared to the PA view?

In the true oblique hand view, the hand is rotated 45 degrees, whereas in the PA view, the hand is positioned flat without rotation.