1. The Hand

2. Things to know 3 views PA (Posterior to Anterior) Oblique (rotated) Lateral (on side) 62 KVP @3 mAs Measures 3 (adjust KV according to size)

3. Things to Know 10 X 12 divided in half crosswise Know cassette sizes by sight 8x10, 10x12, 11x14, 14x17 Know the difference between crosswise and lengthwise

4. Positioning Have patient sit at end of table on a stool Place lead shield on lap Pronate the hand so that the palm in on the surface of the cassette Long axis of hand with long axis of IR Center hand to IR (find middle of Cassette place central ray there)

5. Central Ray is Perpendicular to the Third MCP joint SID 40 Collimate to skin border on all sides

6. Radiograph Critic Entire hand and wrist A least 1 inch of distal radius and ulna No rotation Joints spaces of fingers open.

7. Oblique hand Other half of 10 x 12 Marker Shield 64 @ 3 Measures 3

8. Positioning Leave hand in pronate position Rotate entire hand and wrist laterally to a 45 degree angle (can use sponge) Separate all the digits

9. CR is perpendicular to 3 RD MCP joint SID 40 Collimation all sides

10. Radiograph Critic Oblique position of hand and wrist About 1 in of distal radius and ulna Mid-shafts of 3,4,5 don’t overlap The distal heads of 3,4,5, should overlap some.

11. Lateral Hand 8 x 10 lengthwise Shield Marker 66 @ 3 Measures 4

12. Positioning Place the medial side of hand on IR (thumb up) True lateral position Extend fingers Position thumb away from fingers

13. CR perpendicular to second MCP joint SID 40 Collimate all sides

14. Radiograph Critic Entire lateral hand and wrist Thumb free of imposition 1 inch of radius and ulna No rotation seen by superimposition of radius and ulna and digits.