Hand (oblique view)

The DP (dorsopalmar) oblique hand view is also referred to as the anterior oblique or PA oblique view.

Patient position

• patient is seated alongside the table as with PA view
• the hand is rotated externally by 45 degreesfrom the basic PA position with fingers kept in extension and parallel to image receptor

X-ray beam features

• vertical beam is first centred

  Collimation:

  To include entire hand to distal forearm, centring approximately over fifth metacarpal head and then the tube is turned to make it obliquely centred over third metacarpal head.

  Marker Placement: AP, lateral and distal

  Grid: No

  SID: 100cm

  Exposure Factors: 50 kV, 1.6 mAs

  Please Note: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 Critique

  (Figure 2)

  Collimation

  Collimation is appropriate with entire hand is visualised, including distal forearm.

  Positioning

  Fingers are positioned parallel to image receptor, indicated by open interphalangeal and metacarpophalangeal joint spaces. Correct obliquity is evidenced by the following:

  • midshafts of 3rd to 5th metacarpals do not overlap
  • some overlap of the distal heads of the 3rd to 5th metacarpals
  • no overlap of the distal heads of the 2nd and 3rd metacarpals

  Exposure

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