Standard Hand X-ray Coverage of the Thumb

Standard Hand Radiographic Protocol

• The American College of Radiology guidelines specify that hand radiographs should include all metacarpals and phalanges of all five digits, including the complete thumb ray 1
• The American College of Radiology guidelines recommend that hand radiographs should include the carpometacarpal joints 2
• Standard views include posteroanterior (PA), lateral, and oblique projections, as specified by the American College of Radiology guidelines 1

Thumb-Specific Imaging Considerations

• A three-view radiographic examination is necessary to adequately visualize thumb pathology, as relying on only 2 views is inadequate, according to the American College of Radiology guidelines 1
• The American College of Radiology guidelines recommend that if thumb imaging is specifically needed, ensure the order specifies "hand" or "thumb" to guarantee complete coverage of the first ray 1