Hand series (pediatric)

The hand series for pediatrics often consist of a posteroanterior and lateral view only in order to minimize radiation dose to the patient. Depending on the department and clinical indication, an additional oblique view may also be done.

Patients should remove any jewelry on the hand. 

The use of gonadal and fetal shielding has been deemed as non-beneficial to patients' health in current evidences 1-3 and should not be used during plain film imaging on pediatric patients. Shielding can obscure anatomical regions of interest, resulting in a repeated examination or compromised diagnosis.

The major difficulty in pediatric hand radiography relates to:

To overcome this, a variety of techniques can be used 4:

  • distract the patient with toys, games and/or conversation
  • using the swaddling technique; wrap the child in a blanket to promote comfort and sleep
  • have the child sit on the parent's lap to ensure they are comfortable

Children will find it difficult to keep their hand still; particularly if the limb is injured. One option is to have a parent or radiographer hold the child's hand; however, their hand may appear on the radiograph and obscure the child's anatomy. Placing radiopaque items such as a clear clipboard on top of the child's hand can be useful for keeping the child's hand flat and still for the posteroanterior view. However, placing items on top of the child's hand should be used only if it will not injure the child further. 

Article information

rID: 74273
Section: Radiography
Synonyms or Alternate Spellings:
  • hand radiograph paediatric
  • paediatric hand x ray

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