Hand (bilateral PA view)

Dr Henry Knipe and Dr Aditya Shetty et al.

The bilateral PA view often compliments the ball-catcher view. It is often done to investigate signs of rheumatoid arthritis and osteoarthritis.

  • patient may be seated alongside or facing the table
  • both hands are pronated with their palmer surfaces placed on the detector 
  • posterior-anterior bilateral projection
  • centering point
    • between the two hands at the level of the metacarpophalangeal joints 
  • collimation
    • laterally to the skin margins
    • distal to the skin margins of the finger tips
    • proximal to the include one-third of the distal radius and ulna
  • orientation  
    • landscape
  • detector size
    • 24 cm x 30 cm
  • exposure
    • 50-60 kVp
    • 3-5 mAs
  • SID
    • 100 cm
  • grid
    • no

There is neither overlap of the midshafts of the metacarpals nor is there overlap of the phalange bases.  

Hands are equal distance apart. 

The projection should appear to mimic that of a PA hand 

The hand is not a technically challenging radiograph, always ensure the fingers are equal distance apart and the detector is high enough to avoid overlap at the wrist. 

Always include the wrist joint on your PA radiograph, patients may have referred pain from pathology other than the hand.  

Radiographic views
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Article information

rID: 29819
Section: Radiography
Synonyms or Alternate Spellings:
  • Posteroanterior view of both hands
  • Posteroanterior (PA) view of both hands

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Cases and figures

  • Figure 1: bilateral PA hand
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  • Figure 2: bilateral clindodactyly
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