Pediatric finger (oblique view)
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At the time the article was created Jessica Hui Shi Ng had no recorded disclosures.View Jessica Hui Shi Ng's current disclosures
At the time the article was last revised Andrew Murphy had no financial relationships to ineligible companies to disclose.View Andrew Murphy's current disclosures
The oblique finger view for pediatrics is an additional view examining the distal metacarpal, distal, middle and proximal phalanges of the finger of interest.
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To minimize radiation dose, only the PA and lateral finger views are typically performed for pediatrics. However, the oblique view may be performed upon request to view any subtle pathology that is not demonstrated well on the routine PA and lateral views.
- patient is either seated alongside the table or supine with arm outstretched
- from a pronated position for PA fingers, the hand is rotated approximate 45 degrees (thumb side up), resting on a sponge if required
- fully extend finger(s) of interest in order to open the interphalangeal spaces
- fingers are separated to avoid superimposition
- posteroanterior oblique projection
- approximately over the proximal interphalangeal joint
- laterally to the adjacent fingers
- proximal to include the carpometacarpal joint
- distal to the tips of the distal phalanges
- 18 cm x 24 cm
- 40-46 kVp
- 0.8-2 mAs
- 100 cm
Image technical evaluation
Finger is visualized with open interphalangeal joints, there is a noted uneven concavity of the mid-shaft of the metacarpal 2. No soft tissue overlap between fingers and the finger of interest is correctly labeled and identified.
Preparing the room beforehand (setting up the detector, exposure and preparing lead gowns) is important as pediatric patients may not remain still when their affected finger is moved onto the detector.
It is important for the radiograph to be free from motion artifact and rotation to avoid repeated x-rays.
- it may be necessary for the parent or radiographer to hold the patient in position
- ideally the parent should be in the child's direct line of sight
- techniques will vary based on the department
- distraction techniques can be utilized to avoid scattered radiation to parents and staff 3
- 1. A paediatric X‐ray exposure chart. (2014) Journal of Medical Radiation Sciences. 61 (3): 191. doi:10.1002/jmrs.56 - Pubmed
- 2. Whitley AS, Sloane C, Hoadley G et-al. Clark's positioning in radiography. Hodder Arnold Publication. ISBN:0340763906.
- 3. Ng JHS, Doyle E. Keeping Children Still in Medical Imaging Examinations- Immobilisation or Restraint: A Literature Review. (2019) Journal of medical imaging and radiation sciences. 50 (1): 179-187. doi:10.1016/j.jmir.2018.09.008 - Pubmed