Thumb series

Last revised by Weiling Tan on 9 May 2023

The thumb series is comprised of a posteroanterior, oblique, and lateral projection. The posteroanterior projection is interchangeably performed anterioposter or posteroanterior depending on mobility. It examines in detail the first metacarpal and its articulations. Thumbs have a vital impact in our day to day lives, often injuries of the thumb can have life-changing consequences if they are serious enough 2

See fractures of the thumb for more information.


Thumb x-rays are indicated for a variety of settings including:

  • suspected metacarpal dislocation
  • foreign body detection and localization
  • investigation of joint pain or deformity
  • mechanism-specific injuries such as skier's thumb 


Standard projections
  • AP/PA view
    • demonstrates the first metacarpal in the natural anatomical position
    • excellent view to inspect shafts of the metacarpal
    • excellent view to evaluate any avulsions at the ulnar corner of the base of the proximal phalanx (see figure 4)    
  • oblique view
    • external oblique projection of the thumb
  • lateral view
    • orthogonal view of the AP/PA view 
    • essential view to examine joint spaces

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