Overview

The oblique hand radiograph rotates the hand approximately 45 degrees to profile metacarpals and phalanges. This projection reduces overlap and improves detection of fractures. It is routinely obtained with PA and lateral views for comprehensive assessment.

Technique

Rotate the hand laterally about 45 degrees and center the detector to the third metacarpal. Ensure consistent rotation and immobilize the hand to minimize motion. Use appropriate collimation to include the entire hand.

Clinical Indications

Oblique hand views are indicated for trauma and suspected occult fractures. They help visualize metacarpal neck and shaft injuries and joint subluxations. Correlate with clinical exam and consider CT for complex fractures.

Image Assessment

Inspect cortical margins for fracture lines and evaluate joint congruity. Assess for rotational deformity and malalignment. Report findings and recommend orthopedic follow up when indicated.