Indications for imaging
Injury, pain, carpal tunnel syndrome,
Anatomy Demonstrated Distal radius and Ulna, carpal bones and proximal metacarpals.
Wrist Lt Anatomy Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders,
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
Wrist Lt PA Patient Position Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy
Direct lead rubber gonad protection using a "half
Ensure the lower limbs and torso are not below the table top in
the primary beam.
The vertical central ray is centered to midway between the
medial and lateral skin margins to the mid carpal region
approximately 1 cm distal to the ulna styloid process.
18 x 24 cm
Plaster cast will need approximately 10 kv more when wet 5 Kv
more when dry.
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
Limits of the examination, superiorly the lower quarter of the
radius and ulna, distally the metacarpals, lateral and medially
the skin margins.
The distal radio ulna joint should be visualised, in true DP
position the metacarpals should be evenly superimposed.
Exposure, adequate penetration to visualise all bone detail and
low enough contrast to visualise the soft tissues.
Wrist Rt DP http://www.vh.org
Related Projections Hand DP
Hand DP "Ball catching for rheumatoid)
Hand DP Oblique
Thumb Lat. Wrist AP
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