Pediatric wrist (PA view)

Last revised by Andrew Murphy on 23 Mar 2023

The posteroanterior wrist view for pediatrics is one of three views in order to examine the carpal bones, distal radioulnar joint and metacarpals. 

This projection demonstrates the wrist joint in its natural anatomical position allowing for evaluation of the distal radius, ulna and carpal bones.

It is useful in diagnosing fractures and localizing foreign bodies in pediatric patients.

  • patient is either seated alongside the table or supine with arm outstretched
  • the affected wrist is placed with palm on the image receptor
  • the wrist and elbow should ideally be at shoulder height to demonstrate the radius and ulna correctly
  • posteroanterior projection
  • centering point
    • midcarpal region
  • collimation
    • laterally to the skin margins
    • include the metacarpals superiorly
    • include the distal third of the radius and ulna inferiorly
  • orientation
    • portrait
  • detector size
    • 18 cm x 24 cm
  • exposure 1
    • 40-52 kVp
    • 2-3 mAs
  • SID
    • 100 cm
  • grid
    • no

There is only minor superimposition of the metacarpal bases. The articulation between the distal radius and the ulna is open or has little superimposition. The concavity of the metacarpal shafts is equal 2

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 wrist 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

  • Normal pediatric wrist series
    Drag here to reorder.
  • Updating… Please wait.

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

     Thank you for updating your details.