X-rays - Midhand, fingers
Fractures, dislocations, and osteoarthritis are common at the midhand and fingers as well as in the metacarpophalangeal and interphalangeal joints. Precise radiographs are essential.
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As a standard, the midhand is examined using a dorsopalmar and an oblique view (zither playing position). This usually enables fracture detection, but not the determination of the palmar fragment dislocation in the case of subcapital fractures of the metacarpals IV or V. In this type of fracture, a strictly lateral view is required as a third plane.
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On the fingers, the dorsopalmar and oblique images are for orientation purposes only. In case of a fracture or dislocation, the affected finger ray must be examined separately in dorsopalmar and strictly lateral projections. The quality criterion for a correctly positioned lateral image of a finger is the freely visible joint space and the exact projection of the phalangeal condyles onto each other.
Due to the opposition of the thumb, X-rays of the first ray are taken separately in palmodorsal (back of the thumb on the detector) and lateral projections.