Fingers (lateral view)

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

  • lateral index and middle fingers
  • lateral of ring and little fingers

Indications

The lateral projection is an ideal projection to assess the joint spaces for dislocations, arthropathic conditions and elucidate subtle avulsion fracture of the dorsal and volar aspects of the joint capsule.

Patient position

Lateral of index and middle fingers
  • patient seated alongside table
  • hand is pronated and then medially rotated further to keep the lateral aspect of the index finger in contact with cassette 
  • index finger is in extension while the middle finger is slightly flexed at metacarpophalangeal joint so as to avoid superimposition (only if imaging of this finger is required, otherwise it should be fully flexed, see Figure 1)
  • other fingers are fully flexed
Lateral of ring and little fingers
  • patient seated alongside the table
  • medial aspect of the extended little finger is kept in contact with cassette while ring finger is slightly flexed at metacarpophalangeal joint to avoid superimposition (only if ring finger requires imaging, otherwise it should be fully flexed, see Figure 2)
  • rest of the fingers are fully flexed

    Technical factors

    • lateral projection
    • centering point
      • approximately over the proximal interphalangeal joint
    • collimation
      • anteroposterior to the skin margins
      • 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

    There should be no foreshortening; all interphalangeal spaces are open and no obstruction by other digits over the digit of question.

    Practical points

    If the patient cannot maintain a lateral position as seen in Figures 1 and 2, a foam block can be used to wedge the injured finger away from the hand.