There are several notes to remember when we x-ray or radiograph the upper extremities, which includes the fingers (phalanges), the hands (metacarpals), the wrist (carpals), the radius and ulna (arm) and the humerus (forearm), of the human body.
For lateral projections of the forearm and elbow, the patient’s shoulder and elbow must be on the same horizontal plane
In all radiographic examinations of the upper limb, at least 2
projections must be taken, 900 apart from each other
Radiographic examinations of the joints generally require a minimum of 3 projections: AP/PA, Lateral and at least 1 oblique
Kilovoltages for imaging of the upper limb range from 40 – 70 kVp
Detail or slow-speed film-screen combination are preferred for small bony fractures
To prevent foreshortening or elongation, the CR should be directed perpendicular to long bones
Anatomic structures should be aligned parallel to the long axis of the cassette
When radiographing long bones, both joints should be included in the collimation field
Rotation of the arm is contraindicated when a humeral fracture or shoulder dislocation is suspected
The use of a breathing technique when obtaining a transthoracic lateral projection blurs the lung detail, allowing for better visualization of the cortex of the humerus
