Hand X-ray positioning
How to position for each of the 8 hand X-ray views: where the patient goes, where to centre, which receptor and distance to use, and what a good image looks like.
By the ScanFlo Editorial Team · Updated
In this section · X-ray positioning
- X-ray positioning guides
- Skull positioning
- Face & sinuses positioning
- Soft tissue neck positioning
- C-spine positioning
- Chest positioning
- Shoulder positioning
- Humerus positioning
- Elbow positioning
- Forearm positioning
- Wrist positioning
- Hand positioning
- T-spine positioning
- Abdomen positioning
- L-spine positioning
- Sacrum & SI joints positioning
- Pelvis positioning
- Hip positioning
- Femur positioning
- Knee positioning
- Tibia & fibula positioning
- Ankle positioning
- Foot positioning
X-ray positioning/Hand
The routine hand views are Finger PA, Hand PA, Single finger lateral, Thumb AP and Thumb lateral. Finger oblique, Hand lateral and Hand oblique come in when you need to answer a particular question, or when the patient can't manage a routine view. Each guide walks you through the set-up step by step, with a short video, exposure settings for different patient sizes and what a good image should show.
A radiographer is still checking these guides.
Routine views
Extra views
All views in this region
- Finger PA
- Hand PA
- Single finger lateral
- Thumb AP
- Thumb lateral
- Finger oblique
- Hand lateral
- Hand oblique
Quick reference
Where to centre, how far and which receptor, for every hand view at a glance. Open a guide for the full set-up.
| Projection | Centre on | SID | Receptor | Breathing |
|---|---|---|---|---|
| Finger PA | the proximal interphalangeal joint | 100 cm | 18×24 portrait | No breathing instruction needed |
| Hand PA | the head of the third metacarpal | 100 cm | 18×24 portrait | No breathing instruction needed |
| Single finger lateral | the proximal interphalangeal joint | 100 cm | 18×24 portrait | No breathing instruction needed |
| Thumb AP | the first metacarpophalangeal joint | 100 cm | 18×24 portrait | No breathing instruction needed |
| Thumb lateral | the first metacarpophalangeal joint | 100 cm | 18×24 portrait | No breathing instruction needed |
| Finger oblique | the proximal interphalangeal joint | 100 cm | 18×24 portrait | No breathing instruction needed |
| Hand lateral | the second metacarpophalangeal joint | 100 cm | 18×24 portrait | No breathing instruction needed |
| Hand oblique | the head of the third metacarpal | 100 cm | 18×24 portrait | No breathing instruction needed |
Mistakes that lead to repeats
- Rotation on the finger PA: lay the finger flat.
- Joints closed on the hand PA: lay the fingers flat.
- Fingers overlap on the single finger lateral: fold the other fingers down.
- Base cut off on the thumb AP: include the carpometacarpal joint.
- Oblique thumb on the thumb lateral: flatten the palm.
- Overlap on the finger oblique: support at 45°.
Common questions
- Which hand views are routine?
- Usually Finger PA, Hand PA, Single finger lateral, Thumb AP and Thumb lateral.
- What distance (SID) do hand X-rays use?
- 100 cm for every hand view here.
- Do hand X-rays need a grid?
- No. These parts are thin enough that a grid isn't needed.
Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up every hand projection in a 3D room and score your positioning. See ScanFlo XR →