Pediatric finger (oblique view)

Last revised by Andrew Murphy on 23 Mar 2023

The oblique finger view for pediatrics is an additional view examining the distal metacarpal, distal, middle and proximal phalanges of the finger of interest. 

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
  • centering point
    • approximately over the proximal interphalangeal joint
  • collimation
    • laterally to the adjacent fingers 
    • proximal to include the carpometacarpal joint
    • distal to the tips of the distal phalanges 
  • orientation  
    • portrait
  • detector size
    • 18 cm x 24 cm
  • exposure 1
    • 40-46 kVp
    • 0.8-2 mAs
  • SID
    • 100 cm
  • grid
    • no

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

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Case 1
    Drag here to reorder.
  • Updating… Please wait.

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

     Thank you for updating your details.