American Society of Radiologic Technologist (ASRT) Practice Exam

When a radiographer cannot extend the patient's fingers fully for a PA projection, what should they consider doing?

1. Leave the hand positioned for the PA projection with fingers flexed

2. Consider an AP projection of the hand

3. Force the fingers into extension by taping the hand

4. Skip the PA projection and obtain only lateral and oblique images

The correct answer is: Consider an AP projection of the hand

When a radiographer cannot extend a patient's fingers fully for a PA projection, opting for an AP projection is a suitable alternative. The PA (posteroanterior) projection requires the fingers to be fully extended to obtain an accurate representation of the hand's anatomy, and any significant flexion might obscure crucial details or lead to inaccurate interpretations. In contrast, an AP (anteroposterior) projection allows for a better visualization of the hand without requiring full extension of the fingers. This can be particularly beneficial if the patient's condition makes it difficult or painful to straighten the fingers. Additionally, the AP projection can still provide adequate diagnostic information by showing the relationships between the bones in a different alignment, thus making it a practical choice when the standard PA position cannot be achieved. Choosing the AP approach acknowledges the patient's physical limitations while still allowing for effective imaging of their hand, which is critical for accurate assessment and subsequent diagnosis.