Hand x-ray is a radiation technique used in cases of suspected fractures and dislocations of the metacarpal bones, anomalies in the development of the hand, degenerative-dystrophic and inflammatory processes of various etiologies, malignant and benign neoplasia of the bones of the hand. The study is carried out without special training. Two or three projections are used to assess the condition of the bones and joints of the hand. The images show the metacarpal bones, metacarpophalangeal joints and wrist bones. Due to the significant radiation load, the technique is not recommended for use in childhood and during gestation.
Indications
Hand x-ray is prescribed if fractures and dislocations of the metacarpal bones are suspected. In orthopedics, the study is used for malformations and arthrosis of various genesis, in oncology – for tumor lesions, in rheumatology – for diseases accompanied by damage to small joints of the hand. In purulent surgery, the procedure is used for arthritis, the spread of the purulent process of the hand with infected wounds, panaritia, hand phlegmon.
Methodology of conducting
The picture is taken so that the wrist bones and metacarpophalangeal joints are visible on the film. This makes it possible to identify all violations of the interposition of the bones of the hand, to clarify the nature, degree and direction of displacement of fragments in fractures. The standard projections established in radiology when taking pictures of the bones of the hand are straight and oblique. In traumatology, the oblique projection is usually replaced by a lateral one, despite the fact that on a strictly lateral radiograph, the shadows of the metacarpal bones overlap each other. The choice of a lateral projection is due to the fact that this variant of x-ray allows you to better assess the ratio of bones and the direction of displacement of fragments.
Depending on the nature of the injury, the doctor may prescribe hand x-ray in two projections (straight and oblique, straight and lateral, oblique and lateral) or in three projections (straight, oblique and lateral). To take a picture in a direct projection, the patient’s hand is placed on the table, palm down, with the fingers shifted. The palm should fit snugly to the table. To make a side X-ray, the brush is placed sideways on the table. The picture in the oblique projection is performed by placing the brush with the palm of the hand on the table, slightly lifting the brush from the side of the thumb and placing a small pillow under the palm. The patient’s fingers are spread apart at the same time.