Wrist - External Oblique

Adult

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Name of projection	Wrist - PA Oblique (External Rotation)
Area Covered	Distal radius and ulna, carpals, mid metacarpal area
Pathology shown	Fracture, dislocation, arthritis, foreign body
Radiographic Anatomy	Wrist Radiographic Anatomy
IR Size & Orientation	24 X 30cm Landscape, divided in thirds usually fits 3 projections, use lead masking for unused area
Film / Screen Combination	Detail (CR and DR as recommended by manufacturer)
Bucky / Grid	No
Filter	No
Exposure	52 kVp 3.2 mAs
FFD / SID	100cm
Central Ray	Directed at mid-metacarpal area Perpendicular to the IR
Collimation	Centre: mid-carpal area Shutter A: mid metacarpal to one quarter of distal radius and ulna Shutter B: Skin margin
Markers	Distal and Lateral Marker orientation AP
Shielding	Gonadal (check your department's policy guidelines)
Respiration	Not applicable
Positioning	Seat patient at end of table Flex elbow to 90 degrees Supinate hand and wrist on IR Slightly flex hand to get carpal area flat against IR Rotate wrist and hand internally 45° Can use a 45° sponge for support / stability
Critique PACEMAN	Positioning Area Covered Half the metacarpals, carpals, one quarter of distal radius and ulna Collimation Centre: Mid-carpal area Shutter A: Mid metacarpals to one quarter of distal radius and ulna Shutter B: Skin margin Exposure Bony trabecular patterns and cortical outlines are sharply defined Soft tissues are visualised Sufficient contrast and density to demonstrate the scaphoid fat stripe
Special Notes

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