Hand PA
Position the Patient
- Place hand flat on IR
- Fingers may be relaxed and slightly separated
Words That Work
“Place your hand palm-down on the plate, like someone is going to trace around it. Keep your wrist, palm, and fingers flat, with your fingers gently spread apart. Don’t let your hand tilt or rotate. Hold still.”
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PA hand positioning
Set Up the Shot
- Center here
- Central ray
- 3rd 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
- •Finger overlap hiding anatomy
- •Rotation
- •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?
- ✓No rotation
- ✓No finger overlap that hides anatomy
- ✓Entire hand and distal wrist included