Forearm series

The forearm series is comprised of an anteroposterior and lateral projection. The series examines the entire radius and ulna including articulations distally and proximal. Typically requested for midshaft injuries, the forearm series is not a 'two-for-one' projection of the wrist and the elbow joint due to divergent beam (Figure 1) artefact at both ends of the image .

Indications

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

• trauma 
• bony tenderness
• suspected fracture
• obvious deformity
• non-traumatic pain 
• suspected foreign body 

Projections

Standard projections

• anteroposterior view 
  • demonstrates the radius and the ulna in the natural anatomical position
• lateral view
  • projection 90° to the AP view
  • illustrates partial overlapping of the radius and ulna

Modified trauma projections

Where patients are in a considerable amount of pain, these two projections may replace the standard projections instead to obtain diagnostic images of the radius and ulna whilst requiring little to no patient movement.

• posteroanterior view
  • demonstrates PA wrist distally and lateral elbow proximally
• horizontal beam lateral view
  • demonstrates lateral wrist distally and AP elbow proximally
  • modified lateral projection that requires little to no patient movement
  • produces a diagnostic lateral projection without risking patient pain

Patient Preparation

Patients should remove any jewelry or clothing over the arm to avoid artifact.