Hand

Question 1

What is the standard protocol for a hand exam?

Answer 1

3 views, PA, oblique, lateral

Question 2

How should your patient be prepped before starting the hand x-rays?

Answer 2

Have patient take off any jewelry, seat them at end of table with affected side closest to the table

Question 3

For PA hand, how should the entire upper extremity be positioned?

Answer 3

Should have elbow bent at a 90 degree angle with elbow at shoulder level

Question 4

For PA hand the hand should be _______________________ on the IR

Answer 4

Prone, parallel

Question 5

What is the CR location for PA hand?

Answer 5

3rd MCPJ

Question 6

When properly collimated & centered, how much of the distal radius and ulna should be visible?

Answer 6

1”

Question 7

When evaluating your PA, what can be looked at to determine if there is any rotation? How should the metacarpal heads appear with no rotation?

Answer 7

Equal concavity on both sides of the metacarpal and phalangeal bodies
Equal amount of soft tissue on both sides of the phalanges
Fingernails, if visualized, in the center of each distal phalanx
Equal distance between the metacarpal heads

Question 8

When evaluating your PA, you notice that the IPJ’s of the 4th and 5th digits are closed and there is some foreshortening of the phalanges. What error occurred?

Answer 8

Fingers were flexed

Question 9

When evaluating your PA, you notice that there is soft tissue overlap of the 2nd and 3rd digits. What error occurred?

Answer 9

Fingers were not spread out enough

Question 10

Which way is the hand rotated for PA oblique?

Answer 10

External/Lateral rotation

Question 11

How much is the hand obliqued?

Answer 11

45 degrees

Question 12

What is the CR location for PA oblique?

Answer 12

3rd MCPJ

Question 13

How can you tell that you will not clip the soft tissue of the digits for PA oblique?

Answer 13

Look for the shadow of the fingers

Question 14

When properly positioned, how should the metacarpal heads be demonstrated for PA oblique? Metacarpal bases? Metacarpal shafts?

Answer 14

Metacarpal heads and base should be slightly overlapped. Metacarpal shafts should have minimal overlap from 3-5 digits, more concavity toward anterior side

Question 15

When evaluating your PA oblique, you notice that there is greater superimposition of the 3rd-5th metacarpal heads and there is overlap of the 4th metacarpal shaft over the 5th. What error occurred?

Answer 15

Hand is over rotated

Question 16

When evaluating the PA oblique, you notice that there is no superimposition of the 3rd & 4th metacarpal bases. What error occurred?

Answer 16

Hand is under rotated

Question 17

When evaluating your PA oblique, you notice that the interphalangeal joints are closed and there is foreshortening of the phalanges. What error occurred?

Answer 17

Fingers are flexed

Question 18

What projection is performed for lateral hand?

Answer 18

Lateromedial

Question 19

Why would you be performing an extension lateral of the hand? How would you position the part?

Answer 19

To localize foreign bodies. Hand would be placed in karate chop position with thumb extended out, 2-5 digits superimposed

Question 20

What is the more common lateral performed? How would you position the part?

Answer 20

Fan lateral, have patient make okay sign without fingers touching, spread out digits 3-5

Question 21

What is the CR location for lateral hand?

Answer 21

2nd MCPJ

Question 22

In a properly positioned lateral hand, how should the metacarpals be seen?

Answer 22

They should be superimposed

Question 23

When evaluating your lateral hand, you notice that the short metacarpal is demonstrated anterior to the other metacarpals. Which metacarpal are you seeing? What error occurred?

Answer 23

5th metacarpal, finger was not pulled back enough

Question 24

When evaluating your lateral hand, you notice that the long metacarpal is demonstrated anterior to the other metacarpals. Which metacarpal are you seeing? What error occurred?

Answer 24

2nd metacarpal, flexed,

Question 25

When evaluating your lateral hand, you notice that the radius is demonstrated anterior to the ulna. What error occured?

Answer 25

Hand is rotated anteriorly

Question 26

When evaluating your image, you notice that the ulna is demonstrated anterior to the radius. What error occurred?

Answer 26

Hand is rotated posteriorly

Question 27

For bone age bilateral hands, what is the method name?

Answer 27

Gruelich & ply method

Question 28

For bone age bilateral, what is the projection?

Answer 28

PA

Question 29

What can be determined from bone age bilateral image?

Answer 29

How much time a child will be growing, predicts puberty, and ultimate height

Question 30

CR location for bone age bilateral?

Answer 30

Mid hands, level of 3rd MCPJ