Imaging the wrist and hand  
 

Patients are positioned for wrist and hand radiographs according to standardized protocols, so that normal patterns can be discerned and abnormalities can be more readily identified.

The standard views of the wrist and hand are:

  1. Posteroanterior (PA)
  2. Posteroanterior oblique
  3. Lateral

Supplemental views include:

  1. PA with the wrist in ulnar deviation-for closer examination of the scaphoid
  2. anteroposterior view with the hand in 45° oblique position (also called the ball catcher view)-useful in early arthritis

It is extremely important to remember that multiple views of a given area may be required to figure out what the actual three-dimensional relationships are. My favorite example of this is the shadow cast by a particular cleverly designed sculpture. When light is shined on the sculpture from one direction, the shadow looks like a wine bottle; but when the light is moved 90°, the shadow looks like a wine glass.