X-ray Examination of Upper Limbs

Upper Limbs Radiography

Radiography of upper limb is an x-ray examination of bones, cartilage, soft tissue pathology and locating foreign materials in upper extremities, it includes Fingers, Hands, Wrist, Elbow, Distal and Proximal Humerus. Before an x-ray examination, be sure to remove all radiopaque materials present in upper limb. Patient is seated on side or at the end of radiographic table for his/her comfort. The Image receptor is placed in a position that patient is comfortable whenever position may make and to help relax their extremity (particularly the hands) and this will prevent unwanted motion during exposure. Comfortable seating position of patient result in relaxation and their cooperation in maintaining the preferred position. Central ray is directed to the center of IR and in at the correct angle, this will prevent narrowing the joint spaces and obscuring the image. 

A separate radiograph is taken when performing both hand and wrist to prevent distorted images, principally in the joint spaces. On a multiple exposure in one Image Receptor, the unexposed side of image receptor should be covered with lead, especially in computed radiography Image receptor. Because these IR are sensitive to radiation and may absorbed and record scattered radiation exposure.

Shielding, Collimation and Markers:

Place lead shielding on patients on pelvis area; lead impregnated rubber or lead apron is commonly use. Close collimate only on part in which being examined especially for all upper limb radiograph to provide optimal radiographic images. And right or left markers, patient’s identification is essentially correct side.

X-ray of Fingers:

Basic Projections:

PA View
Oblique View
Lateral View

Xray of Thumb:

Basic Projections:                                     Special Projections / Methods

Anteroposterior (AP) View                      Modified Robert's Method
Posteroanterior Obliques (PA) View       PA Stress "Skier's Thumb" Method
Lateral View


Hand X ray

Basic Projections:

Posteroanterior (PA) HAND
Posteroanterior Obliques
Lateral Projections / Extension and Flexion