Positioning of the wrist for scaphoid radiography

PurposeThe purpose of this cadaver study was to determine the ideal position of the wrist for scaphoid radiography.Materials and methodsFour cadaver wrists were rotated around their longitudinal axis in 15° increments and exposures were taken. Seven postero-anterior images were taken as well. Thus, 18 images of each wrist were available for assessment. Views were determined in which the main anatomic regions of the scaphoid were visualized undistorted. The size and localization of the overlap of other carpal bones were also evaluated. Finally, views with the best visualization of anatomic landmarks were selected. The results of these three investigations were compared to literature data.ResultsWe consider the following four images the most valuable in the diagnostic imaging of scaphoid bone: (1) Postero-anterior view in ulnar deviation of wrist and fist position of the hand; (2) oblique view in 60° of pronation; (3) oblique view in 60° of supination; (4) lateral view.ConclusionWe concluded that our four views are sufficient for proper radiographic evaluation of the scaphoid.