Wrist X-Ray PA

Carpal bones and distal radius-ulna.

Patient seated.
Wrist pronated on the detector.
Fingers slightly flexed.
Central ray: perpendicular to the IR.

Radiocarpal joint

Complete visualisation of carpus and distal radius-ulna.
No rotation.
Good bone definition.

Check for metallic objects.
Always mark the examined side (R/L) before exposure.
Paediatric patient: reduce kVp by 5–10%, mAs ÷2. The distal radial physis is normally visible as a radiolucent band — do not confuse with a fracture line. In suspected distal radius fracture (fall on outstretched hand): compare with the contralateral side if the pattern is equivocal. Greenstick fractures (incomplete, one cortex intact) are frequent and may be subtle.