Hand (oblique view)

Dr Aditya Shetty et al.

The hand oblique view is part of a two view series metacarpals, phalanges, carpal bones and distal radial ulnar joint. 

  • patient is seated alongside the table
  • the affected arm if possible is flexed at 90° so the arm and hand can rest on the table
  • the hand is rotated externally by 45 degrees from the basic PA position with fingers kept in extension and parallel to image receptor
  • shoulder, elbow, and wrist should all be in the transverse plane, perpendicular to the central beam
  • the hand and elbow should be at shoulder height which makes radius and ulna parallel (lowering the arm makes radius cross the ulna and thus relative shortening of radius)
  • posteroanterior projection
  • centring point
    • third metacarpal head
  • collimation
    • laterally to the skin margins
    • proximal  to include distal radioulnar 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

Fingers are positioned parallel to image receptor, indicated by open interphalangeal and metacarpophalangeal joint spaces. Correct obliquity is evidenced by the following:

  • midshafts of 3rd to 5th metacarpals do not overlap
  • some overlap of the distal heads of the 3rd to 5th metacarpals
  • no overlap of the distal heads of the 2nd and 3rd metacarpals

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.


Radiographic views
Share article

Article Information

rID: 29817
Section: Radiography
Synonyms or Alternate Spellings:
  • Oblique view of hand
  • Dorsopalmar oblique view
  • DP (dorsopalmar) hand view

Support Radiopaedia and see fewer ads

Cases and Figures

  • Drag
    Left Hand Oblique...
    Figure 1: left hand PA oblique positioning
    Drag here to reorder.
  • Drag
    Left Hand Oblique
    Figure 2: left hand PA oblique
    Drag here to reorder.
  • Drag
    Figure 3: paediatric right hand PA oblique
    Drag here to reorder.
  • Drag
    Figure 4: infant right hand PA oblique
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.