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XR Hand

XRNo contrastMSK
Indications
  • Hand pain/trauma
  • Suspected fracture/dislocation
  • Arthritis (RA, OA, gout)
  • Foreign body
  • Postoperative evaluation
Patient prep
  • Remove rings and radiopaque objects from hand
Contrast
None / non-contrast
Technique
  • PA: hand pronated flat on IR, fingers slightly separated, CR perpendicular to 3rd MCP joint
  • PA oblique: 45 deg lateral rotation on sponge wedge, CR to 3rd MCP
  • Lateral: fan lateral (fingers fanned) or extended; CR to 2nd MCP
  • SID 40 inches; kVp ~55-60; tabletop
Series / Sequences
#Series / SequencePlaneNotes
1PAFrontalHand flat and pronated; CR to 3rd MCP joint
2PA obliqueOblique45 deg external rotation on wedge sponge; CR to 3rd MCP
3LateralSagittalFan lateral; CR to 2nd MCP; good for foreign body localization and displacement
Key points
  • Ball-catcher's / Norgaard (AP oblique, both hands, 45 deg) for early rheumatoid arthritis
  • Dedicated finger or thumb series if injury is isolated to a digit
  • Fan lateral separates digits to reduce superimposition
References
• Bontrager's Handbook - Hand
• Merrill's Atlas Vol 1 - Upper Limb
• Radiopaedia: Hand series link
Source: Researched — verify against your institution
‹ PreviousXR Forearm
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.