Scaphoid series X-ray positioning (trauma)
An extra wrist view, used when a routine one is not enough. The patient sits, the beam passes back to front (PA), straight on to the receptor, and the centring point is the scaphoid.
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. Seat the patient at the holder; the palm on the detector in ulnar deviation, resting on a pad. Take both views as shown.
Centring & collimation
Central ray
PACentre: the scaphoid.
Beam: PA, perpendicular to the receptor.
Collimate: the carpus
Distance, receptor & grid
| Setting | Value | Notes |
|---|---|---|
| SID | 100 cm | |
| Receptor | 18 × 24 cm | landscape |
| 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 | 53 | 0.5 | 0.5 |
| S | 53 | 0.5 | 0.5 |
| M | 53 | 0.63 | 0.5 |
| L | 53 | 1 | 0.5 |
These start from a classic film-screen chart (53 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 scaphoid waist is shown in two projections.
- No overlap with the trapezium.
- 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 |
|---|---|---|
| Waist hidden | No deviation | Use ulnar deviation and the pad. |
Common questions
- Where do you centre for a scaphoid series (after injury) X-ray?
- The centring point is the scaphoid.
- What distance and beam angle does a scaphoid series (after injury) need?
- 100 cm from the tube to the receptor. The beam passes back to front (PA), straight on to the receptor.
- What size receptor, and do you need a grid?
- Use an 18 × 24 cm receptor, landscape, 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 scaphoid series (after injury)?
- Waist hidden. Usual cause: no deviation. The fix: use ulnar deviation and the pad.
Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a scaphoid series (after injury) in a 3D room and score your positioning. See ScanFlo XR →
Written by the ScanFlo team from everyday radiographic practice.