Fingers : Latera Projection

Tuesday, March 11, 2014

X-ray of the Fingers : Lateromedial and Mediolateral View

Lateral view of finger a fracture and /or dislocation of the distal middle, and proximal phalanges; distal metacarpal; and associated joints are shown. Some pathology, such as osteoporosis and osteoarthritis also may be demonstrated.

Technical Factors

IR size - 18 x 24 cm (8 x 10 inches)
Division in thirds crosswise
Detail screen, tabletop
Digital IR - use lead masking
50 to 60 kV range

Patient position, Gonadal Shielding and Accessories

Seat patient at the end of the table, with elbow flexed about 90degrees with hand and wrist resting on cassette and fingers extended.
Place lead shield over patient's lap to shield gonads.
Use Sponge support block.

Lateral Projection - 2nd through 5th Digits : Part Position

finger xray
Mediolateral Projection : 2nd Digit
Place hand in lateral position (thumb side up) with finger to be examined fully extended and centered to portion of IR being exposed ( see note for second digit lateral).
Align and center finger to long axis of potion of IR being exposed and to CR.
Use sponge block or other radiolucent device to support finger and prevent motion. Flex unaffected fingers.
Ensure that long axis of finger is parallel to IR.

Central Ray

CR perpendicular to IR, directed to PIP joint
Minimum SID of 40 inches (100cm)
Collimate on four sides to affected finger.

Second Digit Positioning

For second digit, a mediolateral is advised if the patient can assumed this position. Place the second digit in contact with cassette. Definition of image is improved with less OID

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