Thumb : PA Oblique

Thursday, March 5, 2015

PA projection of the Thumb in oblique view rotated medially.

Pathology Demonstrated:
  • Fracture and/or dislocation of the distal and proximal phalanges, distal metacarpal, and associated joints are shown.
  • Some pathologic processes, such as osteoporosis and osteoarthritis, also may be demonstrated.
Technical Factors:
  • IR size - 18 x 24cm (8 x 10 inches)
  • Division in third crosswise
  • Detail screen, tabletop
  • Digital IR - use lead masking
  • 50 to 60 kV range
Thumb x-ray
PA Oblique Rotated Medially
  • Place lead shield over patient's lap to shield gonads.
Patient Position:
  • Seat patient at end of table, with elbow flexed about 90degrees with hand resting on casstte.
Part Position:
  • Abduct thumb slightly with palmar surface of hand in contact with cassette. (This action naturally places thumb in a 45degrees oblique position.)
  • Align long axis of thumb with long axis of third of IR that is being exposed.
  • Center first MCP joint to CR and to center of portion of IR being exposed.
Central Ray:
  • CR perpendicular to IR, directed to first MCP joint
  • Minimum SID of 40 inches (100cm)
  • Collimate on four sides to thumb, ensuring that all of first metacarpal is included.

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