Hand series

The hand series consists of posteroanterior, oblique, and lateral projections. Although additional radiographs can be taken for specific indications.

The series primarily examines the radiocarpal and distal radioulnar joints, the carpals, metacarpals, and phalanges.

Indications

Hand x-rays are indicated for a variety of settings, including:

• trauma with suspected fracture
• suspected metacarpal dislocation
• foreign body detection and localization
• investigation of joint pain and/or deformity
• rheumatoid arthritis
• osteoarthrosis

Projections

Standard projections

• PA view
  • demonstrates the metacarpals, phalanges, radius and ulna in the natural anatomical position
  • excellent view to inspect the metacarpals
  • ideal for identifying early signs of rheumatoid arthritis and osteoarthritis
• oblique view
  • external oblique projection of the hand
• lateral view
  • projection 90° to the PA view demonstrates multiple carpal bones overlapping, often used to determine fracture displacement
  • used to localize foreign bodies

Additional projections

• lateral fan view: offers a view of the individual middle and distal phalanges, avoiding overlap
• lateral flexion view
• ball-catcher view (also known as Nørgaard projection): specialized view used to demonstrate the metacarpophalangeal (MCP) joints, often requested in the context of rheumatoid arthritis