Finger (oblique view)

Last revised by Andrew Murphy on 23 Mar 2023

The finger oblique view is a standard projection for radiographic assessment of the fingers

The oblique view s not required for follow-up studies, or 'query foreign body' unless specifically requested. It is, however, a very useful projection in the acute setting and should be included in the acute finger series to ensure no subtle pathology is missed 2

  • the patient is seated alongside the table (similar to a projection of hand)

  • from a pronated position for PA fingers, the hand is rotated approximately 45 degrees (thumb side up), resting on a sponge if required (see Figure 1)

  • fingers are separated to avoid superimposition

  • the long axis of the finger should run parallel to the image receptor (in horizontal and vertical planes)

  • posteroanterior oblique projection

  • centering point

    • approximately over the proximal interphalangeal joint

  • collimation

    • laterally to the skin margins

    • proximal to include the carpometacarpal joint

    • distal to the tips of the distal phalanges 

  • orientation  

    • portrait

  • detector size

    • 18 cm x 24 cm

  • exposure

    • 50-60 kVp

    • 1-5 mAs

  • SID

    • 100 cm

  • grid

    • no

Digit is examined to include the carpometacarpal joint. The condyles of the phalanges are oblique as seen via little superimposition of the two domes. There is a noted uneven concavity of the mid-shaft of the metacarpal. On the raised side, there is more soft tissue

The oblique finger has a proven high diagnostic yield, patients may not be able to maintain an oblique position, you can assist them via a small 30-degree sponge. 

Excessive superimposition of the of the metacarpals indicates the hand is externally elevated too much.

Separation of the metacarpals (almost a PA view) means the hand must be raised slightly.

ADVERTISEMENT: Supporters see fewer/no ads