Interpreting a hand X-ray is a very valuable skill given how commonly it is ordered. The following guide helps walk you through a comprehensive approach to understand and interpreting hand X-rays. As a refresher read this guide on the fundamentals of X-ray studies to help learn some of the basics.
When interpreting any radiological study it is important to have a clear algorithm. As a general guideline, try to save the area of pain/suspected pathology LAST when you are conducting your evaluation of the imaging.
- Bone: begin by commenting on the quality of the bone mineralization that you observe (is there any ostopenia?)
- Radius/Ulna: evaluate the long bones in the arm and evaluate their cortexes. Evaluate for fracture
- Carpal bones
- Joint spaces: make sure there is no joint space narrowing between the following strucutres
- Radius/Ulna and Carpal bones
- Glial spaces
- Carpal bones and MCPs
- MCPs and PIPs
- PIPS and DIPS
- Soft tissues: evaluate for any signs of soft tissue swelling
Page Updated: 07.31.2017