Babeh Edi

Wrist Oblique

Indications for imaging Injury, pain, rheumatology, Anatomy  Demonstrated Distal radius and Ulna, carpal bones and proximal metacarpals. Rt Wrist Oblique Anatomy Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, Londony 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 on the cassette with the fingers flexed to maximise contact of the wrist with the cassette.The wrist and forwearm are then externally rotated 45 degrees and supported on a foam pad . Rt Wrist Oblique Patient Position Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London 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. Central Ray The vertical central ray is centered to midway between the medial and lateral skin margins to the mid carpal region. Exposure Factors Kv mAS FFD (cm) Grid Focus AEC Cassette 60 4 100 No Fine No 18 x 24 cm 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. The first metacarpal should be separate from the second, the distal scaphoid should be projected clear of the capitate. Exposure, adequate penetration to visualise all bone detail and low enough contrast to visualise the soft tissues. Wrist Rt Oblique Radiograph Related Projections Hand DP Hand DP "Ball catching for rheumatoid) Hand DP Oblique Fingers Lat. Thumb AP Thumb Lat. Wrist AP Wrist Lat Wrist PA Wrist AP Angled for Scaphoid Additional modalities M.R.. for internal soft tissue structures, CT may be helpful, RNI for equivocal fractures, macro-radiography for the carpal bones.