Finger : PA Oblique Projection

Monday, December 12, 2011

Oblique Projection 2nd to 5th Digits - Medial and Lateral Rotation

Oblique view of the finger can taken with hands rotated medially or laterally, common practice of taking an oblique view of the 2nd to 5th fingers is rotated laterally, but some technicians rotate the hand medially from the prone position of the hand, in this rotation it has an advantage of improve image detail and increase the ability to clearly visualize the fracture on the finger because of decrease OID. Fractures and or dislocations of the distal, middle, and proximal phalanges; distal metacarpal; and associated joints are visible and some pathology condition such as osteoporosis and osteoarthritis also possibly demonstrated if present.

finger xray
Lateral Rotation : Fingers Oblique

Technical Factors

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

Shielding and Accessories

Place lead shield over patient's lap to shield gonads.
45degrees foam wedge block or step wedge

Patient Position

Seat patient at end of table, with elbow flexed about 90degrees with hand and wrist resting on cassette and fingers extended.

Part Position : PA Oblique - Lateral Rotation

Place hand with fingers extended against 45degrees foam wedge block, while placing hand in a 45degrees lateral oblique (thumb side up).
Position hand on cassette so that long axis of the finger is aligned with long axis of the portion of IR that is being exposed.
Separate fingers and carefully place finger that is being examined against block, so it is supported in a 45degrees oblique and parallel to IR.

Central Ray and Collimation

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

Optional Medial Rotation

Second digit also may be taken in a 45degrees medial oblique (thumb side down) with thumb and other fingers flexed to prevent superimpositon. This position places the part closer to IR for improved definition but may be more painful for the patient.

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