Thumb series

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.

Indications

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 

Projections

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