Thursday, March 20, 2014

Wrist X-ray Lateral |  Pathologic Demonstrated | Exposure Factor

In lateral wrist x-ray pathology demonstrated are  fracture and dislocation of distal radius and  ulna usually the doctor will request this projection when the patient experiencing a wrist pain, painful flexion of wrist such as ligament injury, anteroposterior dislocation of Barton's colles or smith fractures are shown.
Bartons fracture is an intra-articular fracture of distal radius and with dislocation of the radiocarpal or the joint of the radius and the carpal.
Osteoarthritis and priamirily in trapezium and the first CMC joint are may be demonstrated.

Exposure Factors: Use x-ray film size 18 x 24 cm or 8 x10 inches place in lengthwise,
Detail screen and rest the hand of patient in table top.
If digital Image receptor used, use lead masking
64 or add upto 6kV range; increased kilovolt peak or less 4 from PA to oblique.

    Shielding and Patient Position

    Place lead shield over patient's lap to shield gonads.
    Seat patient at end of table, with both arm and forearm resting in the table and elbow flexed about 90degrees. Place wrist and hands on cassette in thumb-up lateral position. Shoulder elbow, and wrist should be on same horizontal plane.

    Part Position and Central Ray

    Align and center hand and wrist to long axis of IR.
    Adjust hand and wrist into a true lateral position, with fingers comfortably flexed; or if support is needed to prevent motion, use a radiolucent support block and sanbag, and place block against extended hand and fingers are shown.
    CR perpendicular to IR, directed to midcarpal area
    Minimum SID 40 inches (100cm)


    • Collimate on four sides, including distal radius and ulna and the metacarpal area.

    Radigraphic Criteria of Lateral View of the Wrist

    • Structures Shown:
    • Distal radius and ulna, carpals, and at least the mid-metacarpal are visible.
    • Long axis of the hand, wrist, forearm should be align with long axis of IR 

     True Lateral Position is Evidenced by the Following:

    • Ulnar head should be superimposed over distal radius
    • Proximal second through fifth metacarpals all should appear aligned and superimposed.

    Collimation of CR

    • Collimation should be visible on four sides to area of affected wrist.
    • CR and center of collimation field should be to midcarpal region.

    Exposure Criteria:

    • Opimal density and contrast with no motion demonstrate clear, sharp bony trabecular markings and soft tissue, such as margins of pertinent fat pads of the wrist and borders of distal ulna, seen though the superimposed radius.

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