Fingers (lateral view)

Lateral view of fingers is divided into:

• X-ray of index and middle fingers
• X-ray of ring and little fingers

X-ray of index and middle fingers

Index and middle fingers can be radiographed together if required.

Patient position

• patient seated alongside table
• hand is pronated and then medially rotated further to keep the lateral aspect of index finger in contact with cassette 
• index finger is in extension while the middle finger is slight flexed at metacarpophalyngeal 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

X-ray of ring finger and little finger

Ring and little fingers can be radiographed together if required.

Patient position

• patient seated alongside table
• medial aspect of extended little finger is kept in contact with cassette while ring finger is slightly flexed at metacarpophalyngeal 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

X-ray beam features

Collimation:

To include finger of interest to mid metacarpal, centring approximately over the proximal interphalangeal joint of the finger of interest

If there is any suspected joint involvement, centre to a point over interphalangeal joint of the finger which is suspected to be involved.

Marker Placementplacement: AP, anterior and distal

Grid: Nono

SID: 100cm100 cm

Exposure Factorsfactors: 48 kV, 1 mAs

Please Notenote:These are average exposures using a Siemens DR system. Exposures may vary between different CR or DR systems and with different patient body habitus.

Image Critiquecritique

(Figure 3)

Collimation

Entire 5th digit is visualised to mid metacarpal.

Positioning

5th finger is positioned laterally, with superimposition of the phalangeal and metacarpal heads. Interphalangeal joint spaces visualised, indicating that the finger has been placed parallel to the image receptor and is in the correct lateral position.

Exposure

Appropriate exposure evidenced by adequate bony detail visible in entire finger, with soft tissue visualised clearly.