Hand (lateral view)

Dr Aditya Shetty et al.

The lateral hand view is an orthogonal view taken along with the PA view of the hand. Often an additional projection, the lateral view is used primarily to assess for foreign bodies and/or displacement of fractures/dislocations.

  • patient is seated alongside the table
  • hand is externally rotated by 90 degrees from the PA position so that the palm is perpendicular to the image receptor
  • fingers are kept extended with thumb abducted
  • fingers should ideally be separated to minimise superimposition and increase diagnostic information contained in the image
  • lateral projection
  • centring point
    • over the head of the second metacarpal
  • collimation
    • anteroposterior to the skin margins
    • distal to the tips of the fingers
    • proximal to include one-third of the distal radius and ulna
  • orientation  
    • portrait
  • detector size
    • 18 cm x 24 cm
  • exposure
    • 50-60 kVp
    • 3-5 mAs
  • SID
    • 100 cm
  • grid
    • no

Fingers should appear equally separated. The third and fourth digits in this image are mostly superimposed so more care should have been taken to separate these. (This, however is of no concern if that is not the area of interest - e.g. if the patient states no pain in that area.)

Correct lateral positioning is evidenced by the following:

  • interphalangeal joint spaces are open
  • metacarpals are mostly superimposed, with slight over rotation externally allowing the fracture at the base of the 5th metacarpal to be visualised
  • posterior aspect of the distal radius and ulna are superimposed

Lower kVp is used to detect foreign body in the soft tissue; to help identify region of interest, a radio-opaque marker can be placed at cutaneous wound

For follow-up, collimation to the area of interest only can be utilised (e.g. if there is a known fracture of the 5th metacarpal, only include to midshaft of proximal phalanx distally.


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Article Information

rID: 29821
Section: Radiography
Synonyms or Alternate Spellings:
  • Lateral view of the hand

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Cases and Figures

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    Figure 1: left hand lateral positioning
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    Left Hand Lateral
    Figure 2: left hand lateral
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