Indications for imaging
Injury, pain, carpal tunnel syndrome,
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Anatomy Demonstrated
Distal radius and Ulna, carpal bones and proximal metacarpals
Wrist Rt lateral Anatomy
Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders,
London
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Basic Patient Position
The patient sits alongside the long edge of the table arm
extended palm downwards, or at the end of the table with he
elbow flexed at 90 degrees, hand and wrist flat rotated exteranl
to bring the radio and ulna styloid processes in vertical
alignment.
Wrist Lt Lateral Patient Position
Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy
Saunders, London
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Radiation protection
Direct lead rubber gonad protection using a "half
apron".
Ensure the lower limbs and torso are not below the table top in
the primary beam.
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Central Ray
The vertical central ray is centered to a point 1 cm distal to the
radial styloid process midway between the
medial and lateral skin margins.
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Exposure Factors
Kv |
mAS |
FFD (cm) |
Grid |
Focus |
AEC |
Cassette |
65 |
5 |
100 |
No |
Fine |
nO |
18 X 24 CM |
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Evaluation of the Image
ID and markers must be present and correct in the appropriate
area of the film
Evidence of collimation on four sides equally around the
centering point.
Limits of the examination, superiorly the lower quarter of the
radius and ulna, distally the metacarpals, lateral and medially
the skin margins.
Distal radius, ulna and proximal metacarpals should be
superimposed,
Exposure, adequate penetration to visualise all bone detail and
low enough contrast to visualise the soft tissues.
Wrist Rt lateral
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Related Projections
Hand DP
Hand DP "Ball catching for rheumatoid)
Hand DP Oblique
Fingers Lat.
Thumb AP
Thumb Lat. Wrist AP
Wrist PA
Wrist Oblique
Wrist AP Angled for Scaphoid
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Additional modalities
M.R.. for internal soft tissue structures, CT may be
helpful, RNI for equivocal fractures, macro-radiography for
schaphoid.
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