upper

Question 1

Radiographic projection of the first CMC joint.

Answer 1

AP PROJECTION
ROBERT METHOD

Question 2

Angled 15 degrees proximally along the long axis of the thumb and entering the first CMC joint

Answer 2

Long and Rafert modification

Question 3

• Angled 10 to 15 degrees proximally along the long axis of the thumb and entering the
  first MCP joint.

Answer 3

Lewis modification

Question 4

Sprain or tearing of ulnar collateral ligament of thumb at MCP joint as a result of acute
hyperextension of thumb;

Answer 4

skier’s thumb

Question 5

Both hands rotated laterally side by side to place thumbs parallel to IR (cassette) for true PA projection of both thumbs.

Answer 5

PA STRESS THUMB PROJECTION
FOLIO METHOD

Question 6

• Patient’s forearm on the table with the palmar surface on top of the IR .
• Center the IR to the MCP joints.
• Spread the fingers slightly
  CR - Perpendicular to the 3rd MCP joint.

Answer 6

PA PROJECTION

Question 7

• Patient’s forearm on the table with the hand pronated.
• Oblique the hand Approx. 45 degrees.
• Use a 45-degree foam wedge.
• Center the IR to the MCP joints
  CR - Perpendicular to the 3rd MCP joint.

Answer 7

PA OBLIQUE PROJECTION
Lateral rotation

Question 8

Best demonstrate a
clearer image of the 1st
CMC joint than the
standard AP projection

Answer 8

BURMAN METHOD

Question 9

• Hand rotated laterally into
  45 degree oblique
  position; resulting in true
  PA projection of the thumb
• CR perpendicular to level of
  the MCP joints.
• Useful for the diagnosis
  of the ulnar collateral
  ligament (UCL) rupture in
  the MCP joint of the
  thumb (Skier’s thumb).
• Also known as the patient
  controlled stress
  radiography of the thumb.

Answer 9

FOLIO METHOD

Question 10

• Hand & forearm in same
  horizontal plane
• Hand pronated with
  fingers extended

Answer 10

PA PROJECTION

Question 11

Hand and forearm in
same horizontal plane as
film.
* Pronate hand with fingers
extended.
* Oblique hand from prone
towards lateral.

Answer 11

PA OBLIQUE

Question 12

• Best demonstrate
  fractures/dislocations
  of the distal, middle and
  proximal phalanges and
  distal metacarpals.
• Hand & forearm in same
  horizontal direction as
  film
• Flex elbow

Answer 12

LATERAL

Question 13

recommended when
there is a suspected
joint injury.

Answer 13

AP PROJECTION

Question 14

• CR perpendicular to the
  3rd MCP joint
• 1 inch or 2.5 cm of distal
  forearm should be
  included in the
  radiograph.
• Flex elbow 90°.

Answer 14

HAND PA PROJECTION

Question 15

• CR perpendicular to 3rd
  MCP joint
• Flex elbow 90°.
• Pronate hand.

Answer 15

HAND PA OBLIQUE

Question 16

• Flex elbow 90°
• Hand in lateral position
  with the ulnar aspect
  down (lateromedial)
  against the IR.
• Palmar surface
  perpendicular to IR

Answer 16

EXTENSION

Question 17

• demonstrate
  anteroposterior
  displacements of
  fractures of
  metacarpals
• Flex elbow 90°
• Maintain the natural arch of the hand, arrange the digits so that they are perfectly
  superimposed.
• Flex fingers into a natural
  flexed position with thumb
  slightly touching the 1st
  finger.
• Thumb should be parallel
  to film
• Fingers are
  superimposed with the
  entire hand in a true
  lateral position.

Answer 17

FLEXION

Question 18

• useful
  for diagnosing possible
  trauma to the digits
• Align long axis of hand to
  long axis of film
• Rotate hand and wrist
  into a lateral position
  with the thumb side up
  (ulnar side down).
• Spread fingers and thumb
  into a fan position.
• Thumb should be
  projecting away from
  the palm and parallel to
  the film.

Answer 18

FAN LATERAL

Question 19

• Best demonstrate
  anterior or posterior
  displacements of bony
  structures.

Answer 19

HAND LATERAL

Question 20

small bony growth
occurring on dorsal
surface of the 3rd
metacarpocarpal joint

Answer 20

CARPE BOSSU OR CARPAL BOSS

Question 21

best demonstrate the
carpal boss.

Answer 21

lateral with the
wrist in palmar flexion

Question 22

• Semi-or half supinated
  both hand at 45 degrees
• Cupped as if the patient
  were going to catch a
  ball
• Best demonstrate
  fractures at the base of
  the 5th metacarpal.
• Best demonstrate early
  evidence of rheumatoid
  arthritis.

Answer 22

NORGAARD
BALL CATCHERS POSITION

Question 23

Used to demonstrate
bony erosion of MC
heads & phalangeal
bases of finger.

Answer 23

HAND AP AXIAL
BREWERTON METHOD