Hand Oblique
Position the Patient
- Seated at table
- Place hand on IR
- Rotate hand 45° externally
- (use support if needed)
- Fingers may be relaxed and slightly separated
Words That Work
“Place your hand palm-down on the plate. I’m going to turn your whole hand and wrist until they’re halfway between flat and completely on their side—about 45 degrees. Rest your hand against this support, keep your fingers straight and gently separated, and hold still. This angle helps keep the hand bones from overlapping.”
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Oblique hand positioning
Set Up the Shot
- Center here
- Central ray
- Third MCP joint
- Include this in the field
- Collimation
- Entire hand and distal wrist
- Set the distance
- SID
- 40"
- Check the technique
- Technique
- 55-60 kVp
- Follow facility protocols
Common Pitfalls
- •Incorrect obliquity (not 45°)
- •Finger overlap
- •Entire hand and distal wrist not included
Evaluate the Image
What should be visible?
- All phalanges
- All metacarpals
- Carpals
- Distal radius and ulna
Does the image pass?
- ✓45° oblique shown
- ✓No finger overlap that hides anatomy
- ✓Entire hand and distal wrist included