Wrist PA

Overview

The PA wrist radiograph evaluates carpal bones distal radius and ulna for fractures and degenerative change. The patient places the palm flat on the detector with the wrist in neutral. This view is the foundation for wrist imaging and guides further projections.

Technique

Center the detector to the mid carpal region and ensure the wrist is flat without rotation. Use appropriate collimation to include the distal forearm and proximal metacarpals. Immobilize the hand to reduce motion artifact.

Clinical Indications

PA wrist is indicated for trauma pain and suspected scaphoid or distal radius fractures. It assesses carpal alignment and joint space narrowing. Additional oblique and lateral views complement the PA projection.

Image Assessment

Inspect cortical margins for fracture lines and evaluate carpal spacing and alignment. Look for signs of scapholunate dissociation and degenerative changes. Recommend targeted views or CT for occult injuries.

Hand PA

Overview

The PA hand radiograph evaluates phalanges metacarpals and carpometacarpal joints for fractures and arthritis. The palm is placed flat on the detector with fingers extended. This view is standard for hand trauma and chronic disease assessment.

Technique

Center the detector to the third metacarpal and ensure fingers are parallel and separated slightly. Use appropriate exposure and immobilize the hand to reduce motion. Include the distal forearm when indicated for wrist pathology.

Clinical Indications

PA hand is indicated for trauma deformity and suspected infection or arthritis. It helps detect fractures dislocations and erosive changes. Additional oblique and lateral views provide complementary information.

Image Assessment

Evaluate cortical continuity joint spaces and alignment of the metacarpals and phalanges. Look for subluxation and periarticular erosions in inflammatory disease. Document findings relevant to surgical or conservative management.

Finger PA

Overview

The PA finger radiograph evaluates phalanges and interphalangeal joints for fractures and dislocations. The finger is placed flat on the detector with slight separation from adjacent digits. This targeted view provides high resolution assessment of small bone injuries.

Technique

Center the detector to the affected digit and collimate tightly to reduce dose. Use a small focal spot and appropriate exposure for fine detail. Immobilize the finger and use positioning aids for comfort.

Clinical Indications

PA finger is indicated for trauma localized pain and suspected foreign body. It helps detect tuft fractures avulsions and joint subluxations. Additional oblique and lateral views complement the PA projection.

Image Assessment

Inspect cortical margins for fracture lines and evaluate joint spaces for subluxation. Look for soft tissue swelling and foreign bodies. Report findings and recommend follow up imaging if healing assessment is required.

Chest PA Upright

Overview

The PA upright chest radiograph is a standard view for evaluating the lungs and heart. The patient stands facing the detector with shoulders rolled forward. This view minimizes cardiac magnification and improves visualization of pulmonary markings.

Technique

Instruct the patient to take a deep inspiration and hold breath during exposure. Ensure the scapulae are out of the lung fields and the chin is elevated. Use appropriate exposure factors for body habitus.

Clinical Indications

PA upright chest is used for routine chest evaluation and screening. It assesses cardiopulmonary disease and follow up of known conditions. It is preferred when the patient can stand and cooperate.

Image Assessment

Evaluate lung fields heart size and mediastinal contours on the PA view. Check for symmetry and presence of lines tubes or devices. Compare with prior studies for interval change.