X-RAY OF WRIST JOINT

X-RAY OF WRIST JOINT

 X-ray Wrist Joint P/A View

Region: carpal bone, carpal joint

Pathology: fracture and osteoarthritis of ulna and radius bone, ligament injury of wrist joint

SID: 100 cm (40 inches)

Central Ray: perpendicular beam directed at the wrist joint

Respiration: unrelated

Position: 

1. The patient is placed in a sitting position.
2. The hand is protonated on the image receptor (IR).
3. Place the hand tightly on the IR with digits slightly flexed.
4. Place the wrist joint at the center of IR.
5. Lower the shoulder to align the joints of wrist, elbow and shoulder in a straight line.

Collimation: Include all structures from proximal portion of metacarpal bones to distal portion of ulna and radius bone.

Evaluation: 

1. The entire structures of carpals, distal radius and ulna should be observable in the image.

2. Carpal bones are superimposed in the true antero-posterior projection image.
3. Distal radioulnar joints must not overlap.
4. Distal ulnar, radius bone and proximal metacarpal bone should not bend excessively.

kVp-52, mAs-2.5

Tip: 

 

X-ray Wrist Joint Lateral View

Region: carpal bone, carpal joint

Pathology: fracture and osteoarthritis of ulna and radius bone, ligament injury of wrist joint

SID: 100 cm (40 inches)

Central Ray: perpendicular beam directed at the radial styloid

Respiration: unrelated

Position: 

1. The patient is placed in a sitting position.
2. Place the hand on image receptor (IR) in the true lateral position.
3. Place the second to fifth fingers vertically on the IR and stack on one another.
4. Adjust the posture to align wrist joint and elbow joint in a straight line.
5. Place the radial styloid process perpendicular to IR.

Collimation: Include all the structures from proximal portion of metacarpal bone to distal portion of ulna and radius bone.

Evaluation: 

1. The entire structures of bones involved in the wrist joint should be observable in the image.

2. Superimposition between pisiform and triquetrum and between trapezium and trapezoid should be identified
3. Distal radioulnar joints must not overlap.

kVp-53, mAs-4

Tip: 

X-ray Wrist Joint PA Oblique View

Region: carpal bone, carpal joint

Pathology: fracture and osteoarthritis of ulna and radius bone, ligament injury of wrist joint

SID: 100 cm (40 inches)

Central Ray: perpendicular beam directed at the wrist joint

Respiration: unrelated

Position

1. The patient is placed in a sitting position.
2. Protonate the filming hand and place the hand on 45° support block in external rotation state.
3. Adjust the posture to align wrist joint and elbow joint in a straight line.
4. Place scaphoid perpendicular to image receptor (IR).

Collimation: Include all structures from proximal portion of metacarpal bones to distal portion of ulna and radius bone.

Evaluation: 

1. The entire structures of bones involved in the wrist joint should be observable in the image.
2. Superimposition between pisiform and triquetrum and between trapezium and trapezoid should be identified
3. All hand structures except the thumb should have the projection of 45° rotation.
4. There can be enlargement of first to fourth fingers as they are further away from the IR.

kVp-52, mAs-3.2

Tip: 

1. When there is no support, make arch shape by bending fingers while the hand is in external rotation.