Lateral finger X-ray positioning
One of the routine hand views. The patient sits, the beam passes from side to side, straight on to the receptor, and the centring point is the proximal interphalangeal joint.
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
Still being checked: a radiographer is reviewing this guide. If your department does it differently, follow your department.
Patient position
Sitting. Cover half the detector with lead; extend the injured finger with a stick and fold the others away.
Centring & collimation
Central ray
lateralCentre: the proximal interphalangeal joint.
Beam: lateral, perpendicular to the receptor.
Collimate: the whole finger and its metacarpal head
Distance, receptor & grid
| Setting | Value | Notes |
|---|---|---|
| SID | 100 cm | |
| Receptor | 18 × 24 cm | portrait |
| Placement | On the holder | No grid |
| Angulation | None | Perpendicular to the receptor |
Marker & breathing
- Marker: R or L marker on the side nearest the detector
- Breathing: No breathing instruction needed.
Exposure by patient size
Treat these as a starting point. Your detector, your generator and the patient in front of you will all move the numbers.
| Patient size | kV | mAs (chart) | mAs (DR default) |
|---|---|---|---|
| XS | 46 | 0.5 | 0.5 |
| S | 46 | 0.5 | 0.5 |
| M | 46 | 0.5 | 0.5 |
| L | 46 | 0.8 | 0.5 |
These start from a classic film-screen chart (46 kV, 8 mAs at 140 cm) and are adjusted for a digital detector at 100 cm. The DR column is what ScanFlo's console suggests; each step up or down changes the mAs by about a quarter.
Image quality checklist
- The finger is separated from the others.
- Joints open.
- The anatomical side marker is visible, correct and clear of the anatomy.
- Collimation borders are visible on all sides, no wider than the area requested.
Faults & how to fix them
| Fault | Cause | Fix |
|---|---|---|
| Fingers overlap | Others not folded away | Fold the other fingers down. |
Common questions
- Where do you centre for a single finger lateral X-ray?
- The centring point is the proximal interphalangeal joint.
- What distance and beam angle does a single finger lateral need?
- 100 cm from the tube to the receptor. The beam passes from side to side, straight on to the receptor.
- What size receptor, and do you need a grid?
- Use an 18 × 24 cm receptor, portrait, on the holder. No grid is needed.
- Where does the lead marker go?
- R or L marker on the side nearest the detector.
- What goes wrong most often on a single finger lateral?
- Fingers overlap. Usual cause: others not folded away. The fix: fold the other fingers down.
Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a single finger lateral in a 3D room and score your positioning. See ScanFlo XR →
Written by the ScanFlo team from everyday radiographic practice.