Digits 2-5 Lateral is a radiography positioning projection of the Upper Extremity. Seated, affected digit in true lateral with adjacent fingers flexed away. SID 40". The centering point is located pip joint of the affected digit, in true lateral.. The central ray is perpendicular to the pip joint of the affected digit.. Image-quality criteria include digits shown in true lateral with no rotation or overlap., all phalanges and metacarpals included.. Standard exposure ranges from 55 to 65 kVp, 2 to 4 mAs, at an SID of 40 inches (102 cm).
Anatomy demonstrated
- Distal, middle, and proximal phalanges of digits 2-5.
- Metacarpals of digits 2-5.
- DIP, PIP, and MCP joint spaces.
- Soft tissue outline of the hand.
Patient preparation
- Verify patient identity using two identifiers.
- Remove rings, bracelets, and radiopaque items from the hand.
- Seat the patient at the end of the table.
- Extend the arm and flex the adjacent fingers away from the affected digit.
- Extend fingers fully. Rest hand and fingers on IR.
Position & centering point
PIP joint of the affected digit, in true lateral.
Central ray
Perpendicular to the PIP joint of the affected digit.
Exposure / technique
- kVp
- 55–65
- mAs
- 2–4
- SID
- 40" (102 cm)
- Notes
- Tabletop technique. Digits 2-3 rest radial side down; digits 4-5 ulnar side down.
Image-quality criteria
- Digits shown in true lateral with no rotation or overlap.
- All phalanges and metacarpals included.
- Joint spaces open and clearly visible.
- Soft tissue and bone trabeculae sharp, no motion blur.
- Collimation: 1 inch on all sides, 1 inch proximal to MCP joint.
Common errors / ARRT traps
- 1 Hand rotated supinating or pronating rotates digits off-axis.
- 2 Digits flexed or overlapped obscures joint spaces.
- 3 CR off-centered clips distal or proximal digits.
- 4 Lateral side of hand on IR inverts the lateral view.
Clinical indications
- Finger trauma evaluation when PA views are inadequate.
- Suspected finger joint instability or dislocation.
- Assessment of finger soft tissue injury or swelling.
- Post-operative follow-up of finger fixation hardware.
Aligned to the current ARRT Radiography Content Specifications.