Image Analysis of a Thumb
On Tuesday, February 23, 2016, I performed a finger routine exam on the right thumb with indirect supervision with Vinton technologist Maria Davis. This was performed at Virginia Gay Hospital in Vinton, Iowa. I used Phillips equipment in CR form. The patient (67 years old) came in with right thumb pain saying she got it caught in something that Sunday. The order said she was having distal interphalangeal joint pain, and I confirmed with her that area was the most painful. Her hand was very bruised and swollen, but she wasn’t having as much pain as before, so she was able to do the positions well. Due to an odd malfunction with the reader at VGH, there is sometimes a slight hairline through the images taken on the 8X10 …show more content…
Looking closer, I think there was slight inward rotation because the concavity actually seems a little uneven, with more curve on the medial side of the phalanx. The metacarpal bone doesn’t seem to demonstrate enough concavity through the midshaft on either side to indicate major rotation. Slight rotation is also suspected due to the difference of soft tissue on either side of the bones. It seems like the medial aspect of the thumb has more soft tissue than the lateral. The joint spaces all appear open, indicating the bones and the joint spaces are parallel to the image receptor. There also doesn’t seem to be any foreshortening of the phalanges showing no flexion or extension of the thumb. With collimation, I got really lucky, I didn’t have my metacarpophalangeal joint as the landmark for the central ray so the thumb wasn’t centered directly in the middle of the image. I am lucky that I didn’t cut off any of the proximal metacarpal due to inadequate CR placement. If I had centered the MCP joint right in the middle of the IR, there would be more of the hand and wrist, and the trapezium carpal bone would actually be
On Tuesday, February 23, 2016, I performed a finger routine exam on the right thumb with indirect supervision with Vinton technologist Maria Davis. This was performed at Virginia Gay Hospital in Vinton, Iowa. I used Phillips equipment in CR form. The patient (67 years old) came in with right thumb pain saying she got it caught in something that Sunday. The order said she was having distal interphalangeal joint pain, and I confirmed with her that area was the most painful. Her hand was very bruised and swollen, but she wasn’t having as much pain as before, so she was able to do the positions well. Due to an odd malfunction with the reader at VGH, there is sometimes a slight hairline through the images taken on the 8X10 …show more content…
Looking closer, I think there was slight inward rotation because the concavity actually seems a little uneven, with more curve on the medial side of the phalanx. The metacarpal bone doesn’t seem to demonstrate enough concavity through the midshaft on either side to indicate major rotation. Slight rotation is also suspected due to the difference of soft tissue on either side of the bones. It seems like the medial aspect of the thumb has more soft tissue than the lateral. The joint spaces all appear open, indicating the bones and the joint spaces are parallel to the image receptor. There also doesn’t seem to be any foreshortening of the phalanges showing no flexion or extension of the thumb. With collimation, I got really lucky, I didn’t have my metacarpophalangeal joint as the landmark for the central ray so the thumb wasn’t centered directly in the middle of the image. I am lucky that I didn’t cut off any of the proximal metacarpal due to inadequate CR placement. If I had centered the MCP joint right in the middle of the IR, there would be more of the hand and wrist, and the trapezium carpal bone would actually be