L2 Hand.pptxL2 Hand.pptxL2 Hand.pptxL2 Hand.pptx

L2 Hand.pptxL2 Hand.pptxL2 Hand.pptxL2 Hand.pptx

1. HAND RADIOGRAPHY By Mr. Dinesh Sekar MSc Radiology Asst Professor Department Of Radiology  

2. At the end of this lecture, the student will be able to: Explain and Demonstrate The Radiographic positioning for Hand Identify basic and advanced views used Apply the appropriate Positioning for individual cases

3. Hand Posterior - anterior ~ dorsi Palmar Anterior oblique ~ dorsi Palmar oblique Posterior oblique ~ both hands (ball catcher's or Norgaard projection)

4. 1. Posterior anterior - Dorsi Palmar Position of patient and cassette The patient is seated alongside the table with the affected arm nearest to the table. The forearm is pronated and placed on the table with the palmer surface of the hand in contact with the cassette. The fingers are separated and extended but relaxed to ensure that they remain in contact with the cassette. The wrist is adjusted so that the radial and ulna styloid processes are equidistant from the cassette. A sandbag is placed over the lower forearm for immobilization

5. Direction and centring of the X-ray beam The vertical central ray is centered over the head of the third metacarpal.

6. KVP and mAs for Dorsi-Palmar view KVP - 60 mAs - 5

7. Posterior anterior - Dorsi Palmar

8. 2. Anterior oblique - Dorsi- palmar oblique Position of patient and cassette From the basic postero-anterior position, the hand is externally rotated 45 degrees with the fingers extended. The fingers should be separated slightly and the hand supported on a 45-degree non-opaque pad. A sandbag is placed over the lower end of the forearm for immobilization.

9. Direction and centring of the X-ray beam The vertical central ray is centred over the head of the fifth metacarpal. The tube is then angled so that the central ray passes through the head of the third metacarpal, enabling a reduction in the size of the field.

10. KVP and mAs for Anterior Oblique - dorsi-palmar oblique KVP - 60 mAs - 6

11. Anterior Oblique - Dorsi- palmar oblique

12. 3. Posterior-Oblique - both hands (ball catcher's or Norgaard projection Position of patient and cassette T he patient is seated alongside the table. However, if this is not possible due to the patient ’ s condition, the patient may be seated facing the table Both forearms are pronated and placed on the table with the palmer surface of the hands in contact with the cassette. The fingers are separated and extended but relaxed to ensure that they remain in contact with the cassette. The wrists are adjusted so that the radial and ulna styloid processes are equidistant from the cassette. A sandbag is placed over the lower forearms for immobilization.

13. Direction and centring of the X-ray beam The vertical central is centred over a point midway between the inter- phalangeal joints of both thumbs.

14. KVP and mAs posterior oblique - both hands KVP - 60 mAs - 6

15. Posterior oblique - Both hands

16. Summary At the end of the experiment , the student will be able to explain and demonstrate basic and advanced Radiographic positioning for Hand.

17. Reference Clark's Positioning in Radiography Handbook of Medical Radiography - C.Ramamohan

18. Disclaimer All data and content provided in this presentation are taken from the reference books, internet – websites and links, for informational purposes only.