X-rays - Whole-hand views

Radiographs of the whole hand are taken in the diagnostics of severe hand injuries, inflammatory systemic diseases, and in congenital malformations. Three views are often used.

Whole hand projections are used to screen all skeletal elements and joints of the hand. Usually, both hands are assessed simultaneously in one projection, which corresponds to a presentation in pronation with mild ulnar deviation. These radiographs are therefore unsuitable for morphometric measurements. The radiograph is centered at the level of the metacarpal III head.

There are two different projections for the oblique radiographs. The commonly used Zitherspieler view is a 45-degree semi-pronated radiograph, while the Norgaard view is taken with a 45-degree semi-supination exposition. With the Norgaard view, the dorsoradial joint parts are free projected. Thus, erosions can be early detected in the so-called "bare areas". According to the current guidelines, the initial diagnosis of arthritic diseases is usually performed using whole-hand images in two planes, while follow-up examinations can be limited to dorsopalmar views.

Tags: Hand, X-rays, Zitherspieler, Norgaard, Whole hand