Lateral in Flexion Hand Xray Positioning

Wednesday, April 11, 2018

Lateral Projection hand - Lateromedial in Flexion

Image receptor: 8 x 10 inches, lengthwise

Patient Position

  • Let patient seat at the end of the radiographic table.
  • Ask the patient to rest the forearm on the table, and place the hand on the IR with the ulnar aspect down.


Part Position:

  • Center the image receptor to the MCP joints, and adjust it so that its midline is parallel with the long axis of the hand and forearm.
  • With the patient relaxing the digits to maintain the natural arch of the hand, arrange the digits so that they are perfectly superimposed.
  • Have the patient hold the thumb parallel with the IR, or if necessary immobilize the thumb with tape or a sponge.
  • Shield gonalds.

Central Ray

Central ray is perpendicular to the MCP joints, entering MCP joint of the second digit

Structure shown

This projection produces a lateral image of the bony structures and soft tissues of the hand in their normally flexed position. It also demonstrates anterior or posterior displacement in fractures of the metacarpals.

Evaluation Criteria

The following should be clearly demonstrated:
  • Superimposed phalanges and metacarpals
  • Superimposed distal radius and ulna
  • Flexed digits
  • No motion or superimposition of the first digits

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