Hand Lateral is a radiography positioning projection of the Upper Extremity. Seated with medial side of hand on IR. SID 40". The centering point is located second mcp joint, medial side of hand on ir.. The central ray is perpendicular to the second mcp joint.. Image-quality criteria include hand shown in true lateral with no rotation or overlap., all phalanges, metacarpals, and carpals included.. Standard exposure ranges from 55 to 65 kVp, 3 to 5 mAs, at an SID of 40 inches (102 cm).
Anatomy demonstrated
- Distal, middle, and proximal phalanges of all five digits.
- Metacarpals of all five rays.
- Carpal bones of the wrist.
- DIP, PIP, and MCP joint spaces.
Patient preparation
- Verify patient identity using two identifiers.
- Remove rings, bracelets, and radiopaque items from the hand.
- Seat the patient at the end of the table.
- Place forearm on table with medial side of hand on IR.
- Extend all fingers fully and rest hand on IR.
Position & centering point
Second MCP joint, medial side of hand on IR.
Central ray
Perpendicular to the second MCP joint.
Exposure / technique
- kVp
- 55–65
- mAs
- 3–5
- SID
- 40" (102 cm)
- Notes
- Tabletop technique. Medial side of hand on IR.
Image-quality criteria
- Hand shown in true lateral with no rotation or overlap.
- All phalanges, metacarpals, and carpals included.
- Joint spaces open and clearly visible.
- Soft tissue and bone trabeculae sharp, no motion blur.
- Collimation: 1 inch on all sides, 1 proximal to ulnar styloid.
Common errors / ARRT traps
- 1 Hand rotated supinating or pronating rotates off-axis.
- 2 Lateral side of hand on IR inverts the lateral view.
- 3 Fingers flexed or overlapped obscures joint spaces.
- 4 CR off-centered clips digits or wrist anatomy.
Clinical indications
- Hand trauma evaluation when PA views are inadequate.
- Suspected hand joint instability or dislocation.
- Assessment of hand soft tissue injury or swelling.
- Post-operative follow-up of hand fixation hardware.
Aligned to the 2025 ARRT Content Specifications.