Hand - Lateral (Fan)

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Hand - Lateral
Area Covered	Hand, wrist and 2.5cm of distal forearm
Pathology shown	Displacement of fractures, location of foreign bodies.
Radiographic Anatomy	Hand Radiographic Anatomy
IR Size & Orientation	18 x 24cm Portrait
Film / Screen Combination	Detail (CR and DR as recommended by manufacturer)
Bucky / Grid	No
Filter	No
Exposure	54 kVp 3.2 mAs
FFD / SID	100cm
Central Ray	Directed to the 2nd metacarpophalangeal joint Perpendicular to the IR
Collimation	Centre: 2nd metacarpophalangeal joint Shutter A: Distal phalanges to 2.5cm of distal radius and ulna Shutter B: To include soft tissues
Markers	Distal and Lateral Marker orientation AP
Shielding	Gonadal (check your department's policy guidelines)
Respiration	Not applicable
Positioning	Patient seated at end of table Elbow flexed at 90° Hand and forearm resting on table Rotate hand and wrist into lateral position with thumb on up side For the "Fan" lateral, digits are spread out a step block may be used
Critique PACEMAN	Positioning The hand is in the "Fan lateral" lateral position, shown by 2nd through to 5th digits are separated with little superimposition of bony and soft tissue structures 2nd through to 5th metacarpals are superimposed Thumb has no superimposition Thumb position varies from PA to slightly oblique The interphalangeal joints are open Phalanges are not foreshortened (Note: the wrist is not necessarily lateral when the hand is. In a lateral wrist the radius and ulna are superimposed) Area Covered Phalanges, metacarpals, carpals and 2.5cm of distal radius and ulna Collimation Include the distal phalanges to the distal forearm and soft tissue Exposure Bony trabecular patterns and cortical outlines are sharply defined Soft tissues are visualised
Special Notes