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This video is going to demonstrate three projections of the hand, a PA, PA oblique, and lateral.

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Have the patient seated at a 90 degree angle to the table, shielded.

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I'm going to place the hand, palm or surface down, flex the elbow.

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Separate the digits slightly so there's no superimposition of the soft tissues.

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The hand will be centered to the image receptor at the third metacarpophalangeal joint.

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The hand should be parallel to the long axis of the image receptor.

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We have a 40 inch SID and a 10x12 or if you have an 8x10 use the smallest IR available.

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The central ray is perpendicular to the third MCP.

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This is a left hand, so we'll place the left marker lateral to the extremity.

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The next projection will be a PA oblique projection of the hand.

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We're going to rotate so that the metacarpals are 45 degrees to the image receptor.

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Make sure that the digits are parallel to the IR so that the interphalangeal joints

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are open and there's no foreshortening or distortion of the phalanges.

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The hand is still centered to the third metacarpophalangeal joint and the central ray is perpendicular

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to the third MCP.

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Again, place the left marker lateral to the extremity.

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The third and final projection of the hand is going to be a lateral projection, and it's

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a lateral medial, so the ulnar surface is down.

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We're going to do the fan lateral, so we'll separate the digits, make sure that they are

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extended so that the IP joints or the interphalangeal joints are open, metacarpal superimposed, and

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the central ray enters the second MCP. It's a lateral projection, so this time we'll place

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the left marker anterior to the extremity.