X Ray Both Hand AP View

The AP (anteroposterior) hand position is an X‑ray view where the beam passes from the anterior (palmar) to posterior (dorsal) surface. The patient supinates the hand with fingers extended and slightly separated, palm facing the X‑ray tube; the central ray is directed perpendicular at the third metacarpophalangeal joint. It’s used for trauma or when a PA view isn’t possible.

AP view stands for anteroposterior projection: the X‑ray beam passes from the front (anterior) of the body to the back (posterior). It’s commonly used for bedridden or portable chest X‑rays. AP positioning can enlarge apparent heart and mediastinal size and alters lung markings compared with PA views, so clinicians account for projection when assessing cardiac size, tubes, lines, or lung pathology.

Standard hand X-ray views: PA (posteroanterior) for overall alignment and joint spaces; oblique (45°) to visualize metacarpals and joints; lateral to assess displacement and dorsal/volar angulation. Special views include scaphoid (PA with ulnar deviation or dedicated scaphoid), AP for infants, and Norgaard (ball‑catcher) for rheumatoid evaluation. PA, oblique and lateral are most commonly requested.

The PA (posteroanterior) hand view is taken with the palm flat on the detector so x‑rays enter from the dorsum; it’s the standard because it minimizes object-to-image distance, reduces magnification and shows true joint spaces and carpal relationships. The AP (anteroposterior) view has the palm facing the tube, produces more magnification and slight distortion, and is used when PA positioning isn’t possible.

For an AP chest radiograph, position the patient upright or supine facing the detector with the thorax centered, shoulders rolled forward and chin elevated. Center the x‑ray beam at mid‑thorax (approximately T7) perpendicular to the detector, instruct deep inspiration and hold, and remove clothing or artifacts from the field. Use appropriate exposure settings and shielding to minimize radiation and repeats.

The normal (functional/resting) position of the hand has the wrist slightly extended (about 20–30°) with slight ulnar deviation, metacarpophalangeal joints flexed roughly 35–45°, proximal interphalangeal joints flexed about 15–30°, and distal interphalangeal joints slightly flexed. The thumb is opposed and mildly abducted across the palm, enabling an efficient grip and balance between intrinsic and extrinsic muscles.