Wrist PA in Ulnar Deviation

• Scaphoid, lunate, and triquetrum clearly visible.
• Pisiform without foreshortening.
• Capitate, hamate, and trapezoid.
• Trapezium and metacarpal bases.
• Distal third of radius and ulna.
• Radiocarpal and midcarpal joints open.

• Verify patient identity using two identifiers.
• Remove watches, bracelets, and radiopaque items from the arm.
• Seat the patient at the end of the table.
• Extend the forearm on the IR with palm up.
• Deviate the hand toward the ulnar side until a comfortable maximum is achieved.

At the scaphoid, with the hand deviated toward the ulnar side.

Perpendicular to IR, centered to the scaphoid.

kVp

60–70

mAs

2–4

SID

40" (102 cm)

Notes

Tabletop technique. No grid required.

• Carpal bones visible without superimposition, including scaphoid and pisiform.
• First through fifth metacarpal bases included.
• Distal radius and ulna both visible without overlap.
• Radial and ulnar borders of the wrist clear and distinct.
• Bone trabeculae sharp, no motion blur.
• Collimation: 2.5 inches distal and proximal to the wrist joint.

1. 1 Insufficient ulnar deviation leaves the scaphoid foreshortened.
2. 2 Radial deviation superimposes the carpals and obscures detail.
3. 3 Off-center CR clips the distal metacarpals or distal forearm.
4. 4 Pronation or supination changes the wrist angle.
5. 5 Motion blur from patient movement during the exposure.

• Suspected scaphoid fracture or avascular necrosis.
• Carpal bone fracture evaluation.
• Wrist pain or injury assessment.
• Post-operative follow-up of wrist hardware.