Dorsi-palmar:

Position of patient and image receptor
The patient is seated alongside the table with the affected arm nearest to the table.
• The forearm is pronated and placed on the table with the palmer surface of the hand in contact with the image receptor.
• The fingers are separated and extended but relaxed to ensure that they remain in contact with the image receptor.
• The wrist is adjusted so that the radial and ulna styloid processes are equidistant from the image receptor.
• A sandbag is placed over the lower forearm for immobilisation.

Direction and location of X-ray beam
• The collimated vertical beam is centred over the head of the 3rd metacarpal.

Essential image characteristics
• The image should demonstrate all the phalanges, including the soft tissue of the fingertips, the carpal and metacarpal
bones and the distal end of the radius and ulna.
• The interphalangeal and metacarpo-phalangeal and carpometacarpal joints should be demonstrated clearly.
• No rotation of the hand.

Radiation protection/dose
• Careful technique and close collimation will assist in reducing the patient dose.