1.4. Position: Drop the shoulder to place entire upper limb on the same horizontal plane and align and center forearm along the axis and parallel. With the lateral position the elbow should be 90 degrees along the axis of the image receptor.
1.5. Anatomy Demonstrated: AP projection of the entire radius and ulna is shown, with a minimum of proximal row carpals and distal humerus and pertinent soft tissues, such as fat pads and stripes of the wrist and elbow joints. With the lateral position the entire radius and ulna, proximal row or carpal bones, elbow, and distal end of the humerus are visible as well as pertinent soft tissue, such as fat pads and stripes of the wrist and elbow joints.
2. Elbow
2.1. SID 40 inches
2.2. Projections: AP, lateral position, internal medial position, and external lateral oblique position
2.3. Position: extend the arm on the image receptor with AP, internal medial, and external lateral but with the external lateral rotate the arm 45 degrees externally, and with the lateral position the elbow should be 90 degrees, and the central ray should be in the middle of the elbow
2.4. Anatomy Demonstrated: distal humerus, elbow joint space, and proximal radius and ulna are visible
2.5. Central Ray: Mid-elbow joint
3. Humerus
3.1. SID 40 inches
3.2. Projection: AP and lateral
3.3. Central ray: midhumerus
3.4. Position: Have the patient stand at the wall bucky in an AP position with the arm extended out and with the lateral position, have the patient stand in PA projection but in an RAO with the arm flexed in 90 degrees.
3.5. Anatomy Demonstrated: Lateral view of entire humerus and glenohumeral joint should be visualized through the thorax superimposition of the opposite humerus
4. Thumb
4.1. SID 40 inches
4.2. Projections: AP, oblique, lateral
4.3. Position: Depending on which projection make sure the thumb is lateral on the central ray to the first metacarpophalangeal joint, but with the AP project make sure the hand is turned over, in the oblique it is at 45 degrees and the lateral at 90 degrees.
4.4. Fractures: The most common fracture for the thumb is the Bennett's fracture on the AP thumb which is a fracture in the first metacarpal.
4.5. Anatomy Demonstrated: Distal and proximal phalanges, first metacarpal, trapezium (superimposed), and associated joints according to which projection
4.6. Central Ray: first metacarpal bone
5. Hand
5.1. SID- 40 inches
5.2. Projections: PA, Oblique, Lateral, Alterative positions: extension and flexion
5.3. PA Hand: The patient's hand should be prone with the central ray at the 3rd MCP.
5.4. Oblique Hand: The patient's hand should be at a 45 degree angle from the IR at the 3rd MCP.
5.5. Lateral Hand: The patient's hand should be placed lateral with the thumb side up with the central ray at the 3rd MCP.
5.6. Anatomy Demonstrated: Distal and proximal phalanges, first metacarpal, trapezium, and associated joints are visible as well as the interphalangeal and metacarpophalangeal joints
6. Fingers
6.1. SID 40 inches
6.2. Projections: PA, Oblique, Lateral
6.3. Central Ray: PIP
6.4. Position: Position the patient where their elbow is 90 degrees with the wrist resting on the IR and fingers
6.5. Anatomy Demonstrated with all positions: Distal, middle, and proximal phalanges; distal metacarpal, and associated joints
7. Wrist
7.1. SID 40 inches
7.2. Projections: PA, Semi Prone, Lateral, and Semi Supine
7.3. Central Ray: midcarapal bones
7.4. Position: align and center hand and wrist to the IR either pronated or supine depending which projected is assigned . However with the oblique is done at a 45 degree angle, and the elbow should be at 90 degrees.
7.5. Fractures: The fractures included in the wrist are the Barton's fracture, Colles fracture, and Smith's fracture.
7.6. Anatomy Demonstrated: distal radius and ulna, carpals and at least the midmetacarpal area are visible
