Finger (PA view)

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Finger PA view is a standard projection for radiographic assessment of the fingers; it is one of three views of the finger series.

Indications

This projection is best to access the joint spaces and distal, middle and proximal phalanx in the AP plane. It is not advisable to only obtain one view of the fingers (or any extremity) given how subtle pathology can be in this region. Note that the AP position of the finger radiograph is not the AP position of the thumb (this is a different radiograph all together).

Patient position

  • patient is seated alongside the table (similar to the projection of hand)
  • palmar aspect of pronated hand is placed over detector and extended fingers are kept in its contact with little separation, allowing interphalangeal joint spaces to appear open.

Technical factors

  • posteroanterior projection
  • centering point
    • approximately over the proximal interphalangeal joint
  • collimation
    • laterally to the adjacent fingers 
    • proximal to include the carpometacarpal joint
    • distal to the tips of the distal phalanges 
  • orientation  
    • portrait
  • detector size
    • 18 cm x 24 cm
  • exposure
    • 50-60 kVp
    • 1-5 mAs
  • SID
    • 100 cm
  • grid
    • no

Image technical evaluation

Digit is visualized to include the carpometacarpal joint. Alongside finger is included to ensure the correct finger identified. The concavity of the metacarpal shafts is equal.

Practical points

The PA finger is not a technically challenging radiograph, always ensure the fingers are equal distance apart and either label or include adjacent fingers to prevent any diagnostic errors .