Hand - Ballcatchers

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Hand - "Ball-catchers"
Area Covered	Both hands from the carpal area and entire digits
Pathology shown	Radiographic signs of rheumatoid arthritis
Radiographic Anatomy	Hand Radiographic Anatomy
IR Size & Orientation	24 x 30cm Landscape
Film / Screen Combination	Detail (CR and DR as recommended by manufacturer)
Bucky / Grid	No
Filter	No
Exposure	50 kVp 2.5 mAs
FFD / SID	100cm
Central Ray	Midway between the hands at the level of the metacarpophalangeal joints Perpendicular to the IR
Collimation	Centre: At the level of the metacarpophalangeal joints, midway between the hands Shutter A: To include distal phalanges to 2.5cm of the distal radius and ulna Shutter B: 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 Supinate hands Medial side of hands together and in the centre of the IR Roll the hands 45° so their lateral aspect is up Two 45° sponges can be used under the posterior aspect of the hand to achieve this Cup the fingers slightly as though catching a ball Abduct thumb slightly to avoid superimpostion
Critique PACEMAN	Positioning The hand is obliqued 45°, shown by 2nd through to 5th mid-shafts of the metacarpals do not overlap Bases of phalanges do not overlap Open metacarpophalangeal joints Thumbs free of superimposition Area Covered Phalanges, metacarpals and carpals Collimation include distal phalanges and carpal area Exposure Density such that the joint space margins of the metacarpophalangeal joints are clearly demonstrated Bony trabecular patterns and cortical outlines are sharply defined
Special Notes