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X-RAY THE HAND

X-Ray Images the Hand


You have a request for an X-ray examination of the hand and/or thumb. You have the assistance of additional personnel if required. You will need properly equipped X-ray exposure room with various sizes of film in cassettes, sandbags, lead apron, letter markers, and various sponges.

1.  Select the required view(s) based on the request.

2.  Gather the necessary materials and supplies.

a.  Appropriate cassettes.

b.  Sandbags.

c.  Lead apron.

d.  Letter markers.

e.  Calipers.

f.  Radiolucent blocks.

3.  Prepare the patient.

a.  Bring the patient into the X-ray room.

b.  Ensure the patient is properly dressed.

(1)  Ensure the patient's jewelry is removed as necessary.

(2)  Ensure the patient's sleeves are rolled up as necessary.

c.  Explain the procedure, if applicable.

d.  Seat the patient facing the X-ray table.

4.  Place the lead apron across the patient's lap.

5.  Measure the body part through the entry-exit site of the central ray.

6.  Set the control panel.

a.  Consult the technique chart.

b.  Set the appropriate mAs and kVp on the control panel.

7.  Select the proper size cassette.

NOTE: Use 1/2 of a 10" x 12" cassette for the PA and oblique views, and an 8" x10" cassette for the lateral view.

8.  Place the cassette onto he table according to the desired position.

a.  Crosswise for the PA and oblique views.

b.  Lengthwise for the lateral view.

9.  Position the overhead tube.

a.  Set the tube angle perpendicular to the film.

b.  Set the source to image receptor distance (SID) to 40 inches (101 cm).

c.  Center the tube to the portion of the cassette being used.

d.  Adjust the conefield to full field coverage.

10.  Position the hand

a.  PA view.

(1)  Center the hand to the appropriate half of the cassette.

(2)  Place the palmar surface of the hand flat against the cassette.

(3)  Separate the fingers equally.

(4)  Center the head of the third metacarpal to the appropriate half of the cassette.

NOTE: The oblique view of the thumb is obtained in this view.

 

b.  Oblique view.

(1)  Center the hand to the appropriate half of the cassette.

(2)  Adjust the metacarpal plane to form a 45 degree angle to the cassette.

(3)  Flex the fingers slightly and separate them to avoid superimposition of the anatomy being demonstrated.

(4)  Center the head of the third metacarpal to the appropriate half of the cassette.

NOTE: The lateral view of the thumb is obtained in this view.

c.  Lateral view.

 

(1)  Center the hand to the cassette.

(2)  Place the hand perpendicular to the cassette with the ulnar surface on the cassette.

(3)  Extend and place fingers in a fanned position.

(4)  Place a radiolucent block under the thumb to maintain the thumb in a PA position.

(5)  Center the head of the second metacarpal to the center of the cassette.

NOTE: The lateral view will identify anterior and posterior displacement in cases of fractures.

11.  Immobilize the body part by placing a sandbag over the forearm.

12.  Place the lead apron across the patient's lap.

13.  Place the appropriate letter marker on the cassette.

14.  Tell the patient "DO NOT MOVE."

15.  Make the exposure.

16.  Tell the patient, "RELAX," and remove the immobilization.

17.  Develop the exposed film with patient identification.

 

 

David L. Heiserman, Editor

Copyright   SweetHaven Publishing Services
All Rights Reserved

Revised: June 06, 2015