Wrist - PA (Clenched Fist)

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Wrist - PA (Clenched Fist)
Area Covered	Mid and proximal metacarpals, carpals, distal radius and ulna, and associated joints; soft tissue
Pathology shown	Normally performed as part of a functional series of the wrist to compare the appearance of the scaphoid. This technique potentially increases the scapho-lunate distance and has an affect on ulnar variance. Often performed in conjunction with the Wrist in (Ulnar and Radial) deviation, see functional views of the wrist
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 2.5 mAs
FFD / SID	100cm
Central Ray	Directed to midcarpal area Perpendicular to IR
Collimation	Centre: Midcarpal area Shutter A: From mid metacarpal to one quarter of the 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	Patient seated at end of table Elbow flexed to 90° Hand pronated (palm down) Hand and forearm resting on table IR under wrist Hand clenched
Critique PACEMAN	Positioning Area Covered Proximal to midmetacarpals, carpals, and distal radius and ulna Collimation Centre: midcarpal area Shutter A: From mid metacarpal to one quarter of the 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