Wrist Lateral is a radiography positioning projection of the Upper Extremity. Seated with elbow flexed 90 degrees, wrist lateral. SID 40". The centering point is located midcarpal area, medial side of wrist on ir.. The central ray is perpendicular to the midcarpal area.. Image-quality criteria include wrist shown in true lateral with no rotation or tilt., radius, ulna, carpals, and proximal metacarpals included.. Standard exposure ranges from 60 to 70 kVp, 3 to 5 mAs, at an SID of 40 inches (102 cm).
Anatomy demonstrated
- Distal radius and ulna in lateral projection.
- Radiocarpal joint space.
- Carpal bones: scaphoid, lunate, triquetrum, pisiform.
- Proximal metacarpals in lateral view.
Patient preparation
- Verify patient identity using two identifiers.
- Remove watches, bracelets, and radiopaque items from the wrist.
- Seat the patient at the end of the table.
- Flex elbow 90 degrees. Place medial side of wrist on IR.
- Position wrist lateral (thumb pointing up).
Position & centering point
Midcarpal area, medial side of wrist on IR.
Central ray
Perpendicular to the midcarpal area.
Exposure / technique
- kVp
- 60–70
- mAs
- 3–5
- SID
- 40" (102 cm)
- Notes
- Tabletop technique. Elbow flexed 90 degrees, wrist lateral.
Image-quality criteria
- Wrist shown in true lateral with no rotation or tilt.
- Radius, ulna, carpals, and proximal metacarpals included.
- Radiocarpal joint space open and clearly visible.
- Bone trabeculae and soft tissue sharp, no motion blur.
- Collimation: 2.5 inches distal and proximal to wrist joint.
Common errors / ARRT traps
- 1 Wrist rotated supinating or pronating off true lateral.
- 2 Lateral side of wrist on IR inverts the lateral view.
- 3 Fingers extended or flexed changes soft tissue outline.
- 4 CR off-centered clips carpal or metacarpal anatomy.
Clinical indications
- Wrist trauma evaluation when PA views are inadequate.
- Suspected wrist joint instability or dislocation.
- Assessment of wrist soft tissue injury or swelling.
- Post-operative follow-up of wrist fixation hardware.
Aligned to the 2025 ARRT Content Specifications.