Lateral Projection, Burman and Fiolle Method - Wrist Xray Positioning

Wednesday, April 11, 2018

Lateromedial Rotation

Image Receptor: 8 x 10 inches, lengthwise or crosswise for 2 images.

Patient Position:

  • Let patient seat at the end of the radiographic table.
  • Have the patient rest the arm and forearm on the table to ensure that the wrist is in a lateral position.

Part Position:

  • Have the patient flex the elbow 90 degrees to rotate the ulna to the lateral position.
  • Center the IR to the carpals, and adjust the forearm and hand so that the wrist is in a true lateral position.
  • Shield gonads.

Central Ray:

Central ray is perpendicular to the wrist joint.

Structure shown:

The radiograph will show a lateral projection of the proximal meracarpals, carpals and distal radius and ulna. This position can also be used to demonstrate anterior or posterior displacement in fractures.

Evaluation Criteria:

  • The following should be clearly demonstrated
  • Distal radius and ulna, carpals and proximal half or metacarpals.
  • Superimposed distal radius and ulna.
  • Superimposed metacarpals.
  • Radiographic density similar to PA or AP and oblique radiographs, which requires increased exposure factors to compensate for greater part thickness.

Burman Method Wrist

Suggested that the lateral position of the scaphoid should be obtained with the wrist in palmar flexion because this action rotates the bone anteriorly into a dorsovolar position. This position, however is valuable only when sufficient flexion is permitted.

Fiolle Method

This was the first to describe a small bone growth occurring on the dorsal surface of the third CMC joint. He termed the condition carpe bossu (carpal boss) and found that it is demonstrated best in a lateral position with the wrist in palmar flexion.

wrist xray
Carpal Boss

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