1. Select the required view(s) based on the request.
2. Gather the necessary materials and supplies.
a. Appropriate cassettes.
b. Radiographic film.
d. Letter markers.
f. Positioning sponges.
g. Lead shielding.
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 sleeve is rolled up as necessary.
c. Explain the procedure if applicable.
d. Seat the patient facing the X-ray table.
4. Measure the body part through the entry-exit site of the central ray.
5. Set the control panel.
a. Consult the technique chart.
b. Set the appropriate mAs and kVp on the control panel.
6. Select the proper size cassette.
NOTE: Use 1/2 of a 10" X 12" cassette for each view.
7. Place the cassette on the table crosswise.
8. 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 film being used.
d. Adjust the conefield to full field coverage (for the 1/2 of the film).
9. Position the elbow.
a. AP view.
(1) Place the arm in full extension with the palm facing up and the shoulder at the same level as the cassette.
(2) Position the epicondyles parallel to the cassette.
(3) Center the elbow to the appropriate half of the cassette.
(4) Center the midepicondylar plane to the cassette.
b. Lateral view.
(1) Flex the elbow to 90 degrees.
(2) Position the epicondyles and styloids perpendicular to the cassette.
(3) Ensure the shoulder is on the same plane as the cassette with the humerus in contact with the tabletop.
(4) Center the elbow to the appropriate half of the cassette.
(5) Center the lateral epicondyle to the cassette.
NOTE: The humerus should enter the upper edge of the cassette with the forearm exiting the lateral edge.
10. Immobilize the body part by placing a sandbag on or against the hand.
11. Place the appropriate identification marker on the cassette.
12. Place the lead apron across the patient's lap.
13. Tell the patient "DO NOT MOVE."
14. Make the exposure.
15. Tell the patient, "RELAX," and remove immobilization.
16. Process the film.