Interpreting A Hand X-Ray

OVERVIEW

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.

BASIC ALGORITHM

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.

1. Bone: begin by commenting on the quality of the bone mineralization that you observe (is there any ostopenia?)
   1. Radius/Ulna: evaluate the long bones in the arm and evaluate their cortexes. Evaluate for fracture
   2. Carpal bones
   3. MCPs
   4. DIPs
   5. PIPs
2. Joint spaces: make sure there is no joint space narrowing between the following strucutres
   1. Radius/Ulna and Carpal bones
   2. Glial spaces
   3. Carpal bones and MCPs
   4. MCPs and PIPs
   5. PIPS and DIPS
3. Soft tissues: evaluate for any signs of soft tissue swelling

Page Updated: 07.31.2017