CLINICAL LAB

DIGITS, HAND, WRIST, FOREARM, ELBOW & HUMERUS PROCEDURES

DIGITS:
PA PROJECTION

LATERAL PROJECTION (lateromedial or mediolateral)

PA OBLIQUE PROJECTION (450 lateral rotation)

IR: 18x24 cm
CR: Perp to proximal interphalangeal (PIP) joint

THUMB:
AP or PA PROJECTION

LATERAL PROJECTION

PA OBLIQUE PROJECTION

IR: 18x24 cm
CR: Perp to metacarpophalangeal (MCP) joint

HAND:
PA PROJECTION

PA OBLIQUE PROJECTION (450 lateral rotation)

IR: 18x24 or 24x30 cm

CR: Perp to 3rd metacarpophalangeal (MCP) joint

LATERAL PROJECTION (lateromedial or mediolateral) (fan lateral)

IR: 18x24 or 24x30 cm
CR: Perp to 2nd metacarpophalangeal (MCP) joint

AP OBLIQUE PROJECTION (450 medial rotation)

Norgaard Method (ball-catcher’s position) – rheumatoid arthritis
IR: 24x30 cm
CR: Perp midway between 2 hands, level of metacarpophalangeal (MCP) joint
WRIST:
PA or AP PROJECTION

LATERAL PROJECTION (lateromedial)

PA or AP OBLIQUE PROJECTION (450 lateral or medial rotation)

IR: 18x24 or 24x30 cm

CR: Perp to midcarpal area

PA PROJECTION (ulnar deviation)

Scaphoid
CR: Perp to scaphoid, angled 10-150 proximal or distal

PA PROJECTION (radial deviation)

Opens interspaces between carpals on medial side
CR: Perp to midcarpal area

WRIST: (SCAPHOID)
PA AXIAL PROJECTION
Stecher Method
IR: 18x24 or 24x30 cm, elevate 200
CR: Perp to scaphoid or 200 towards elbow

WRIST: (SCAPHOID SERIES)

PA & PA AXIAL PROJECTIONS
Rafert-Long Method (ulnar deviation)
CR: Perp to scaphoid PA 00, PA Axial 10, 20 & 300 cephalad angle

WRIST: (CARPAL BRIDGE)

TANGENTIAL PROJECTION (inferosuperior or superoinferior)
Gaynor-Hart Method
Inferosuperior (hyperextend wrist)
CR: 1” distal 3rd metacarpal, 25-300 to long axis

Superoinferior (dorsiflexion of the wrist)

CR: Tangential to carpal canal
FOREARM:
AP PROJECTION (hand supinated)
IR: 35x43 cm
CR: Perp to mid forearm

LATERAL PROJECTION (elbow 900)

IR: 35x43 cm
CR: Perp to mid forearm

ELBOW:
AP PROJECTION (hand supinated)

LATERAL PROJECTION (lateromedial, elbow 900)

AP OBLIQUE PROJECTION (medial rotation)

Coronoid process

AP OBLIQUE PROJECTION (lateral rotation)

Radial head & neck

IR: 18x24 or 24x30 cm

CR: Perp to elbow joint

ELBOW: (DISTAL HUMERUS & PROXIMAL FOREARM)

Patient cannot fully extend elbow
AP PROJECTION (partial flexion)
CR: Perp to elbow joint

AP PROJECTION (acute flexion)

CR: Perp to humerus, 2” superior to olecranon

PA PROJECTION (acute flexion)

CR: Perp to forearm, 2” distal to olecranon

ELBOW: (RADIAL HEAD)

LATERAL PROJECTION (lateromedial, elbow 900)
Four-position series:
1st – hand supinated as much as possible
2nd – hand true lateral
3rd – hand pronated
4th – hand extreme internal rotation
ELBOW: (RADIAL HEAD & CORONOID PROCESS)
AXIOLATERAL PROJECTION
Coyle Method
Radial head: (pronate hand, elbow 900)
CR: Perp to elbow joint, 450 toward shoulder
Coronoid process: (pronate hand, elbow 800)
CR: Perp to elbow joint, 450 toward coronoid process

HUMERUS:
AP PROJECTION
IR: 35x43 cm
CR: Perp to mid humerus

LATERAL PROJECTION (lateromedial or mediolateral)

IR: 35x43 cm
CR: Perp to mid humerus

HUMERUS: (TRANSTHORACIC)
Lawrence Method
TRANSTHORACIC LATERAL PROJECTION

CR: Perp to surgical neck humerus