Thumb X-Ray: Evaluation of Fractures, Arthritis, and Deformities

Introduction

The complex architecture of the thumb has developed over millions of years and offers the hand a strong grip while enabling us to fine-tune specific activities. However, a beginner may need help to accurately scan the thumb because of its intricate structure and tiny size. Due to its dynamic nature, improved resolution for tiny structures, cheap cost, and ease of use in the hands of qualified individuals, ultrasound or X-ray is often considered to be a better imaging investigation than magnetic resonance imaging (MRI).

20 % of all visits to emergency rooms are due to traumatic hand and finger injuries. In addition, sports and work-related incidents might result in common injuries. Patients who appear with piercing or blunt injuries, hand infections, or hand pain with no known etiology are evaluated with radiographs of the hand. For instance, a conventional thumb series, including posteroanterior (PA), oblique, and lateral views, should be performed on patients with suspected metacarpal fractures. Depending on mobility, the anteroposterior or posteroanterior projection can be used interchangeably. The first metacarpal and its articulations are thoroughly examined. The thumbs greatly impact daily lives, and if a thumb injury is severe enough, it can have life-altering effects. Let us learn in detail about thumb X-rays and their uses further.

What Is a Thumb X-Ray?

The majority of soft tissue and skin that thumb X-rays can penetrate is skin, whereas metal and bone are more difficult to penetrate. As a result, images will display various black-and-white tones when different bodily tissues absorb different radiation levels. Checking for fractured bones after an accident is one of the most frequent uses of a thumb X-ray, but they are also employed in various other situations. Medical disorders may be recognized, diagnosed, and treated with thumb X-rays. It is an important step that is routinely taken foremost in the diagnostic procedure. The AP (anteroposterior) view is one of the common perspectives used to evaluate the thumb. When the patient cannot get into the posture needed for the AP view, the PA (posteroanterior) view might be used. They are a component of the series of three view thumbs. The PA view will have some magnification.

What Are the Indications of a Thumb X-Ray?

There are several situations where thumb X-rays are recommended, including:

1. A metacarpal dislocation.

2. Joint pain or deformity.

3. Gamekeeper's thumb.

4. Have arthritic alterations.

5. Ligamentous attachment areas.

6. Trauma.

How Is a Thumb X-Ray Performed?

The following steps are included in the thumb X-ray procedure:

1. Preparation: The patient is advised to remove any jewelry or metallic items obstructing the X-ray picture during preparation.

2. Positioning: The thumb of the patient's hand is placed between two X-ray plates so it may be scanned.

3. Radiation: Ionizing radiation is briefly exposed during the activation of the X-ray equipment to provide a picture of the thumb bones.

4. Picture capture: An electronic copy of the X-ray image is taken and saved for further analysis by a radiologist.

5. Review: The radiologist examines the X-ray pictures to identify any issues involving the thumb, and the results are sent to the patient's doctor.

The technique is rapid, painless, and non-invasive.

What Are the Projections Used in Thumb X-Ray?

PA Hand View:

• Projection: The patient is seated with their palms flat against the film. The fingers are splayed slightly apart and extended.

• X-ray Beam: Directed posteriorly to anteriorly, perpendicular to the cassette, and centered at the middle finger metacarpophalangeal joint (MCPJ).

• Display: fractures of the metacarpal and phalangeal bones and arthrosis of the hand's tiny joints.

Lateral Hand View:

• Projection: The fingers should be spaced apart to prevent overlapping as a sponge supports them.

• X-ray Beam: pointed perpendicular to the cassette, radial to the ulnar, and centered at the MCPJ of the index finger.

• Display: Phalangeal fractures, minor joint dislocations, and arthrosis are evident.

PA Oblique Hand View:

• Position: The hand is turned 45 degrees from the cassette on its radial side. The fingers are fanned apart and supported on a sponge to prevent overlapping.

• X-Ray Beam: Directed posterior to anterior, perpendicular to the x-ray cassette, and centered at the middle finger (MCPJ).

• Display: The scaphoid-trapezoid-trapezium articulation and metacarpal fractures (which are difficult to spot on the lateral view due to the overlapping of the metacarpals) (may show arthrosis in older patients).

Standard Thumb Series:

To examine individuals who have experienced thumb trauma or who may have thumb arthritis, standard thumb series radiographs are done. This collection of videos comprises lateral view, oblique view, and hyperpronated pronated anteroposterior (AP) thumb views.

What Are the Conditions Under Which Thumb X-Rays Are Used?

Thumb X-rays have a wide range of applications.

1. A doctor may prescribe an X-ray to screen for specific malignancies in various locations on the thumb by spotting atypical tumors, growths, or bumps.

2. When a patient is suffering discomfort, edema, or other anomalies that call for an inside examination of the body, a thumb X-ray is utilized to examine the affected part of the body. An X-ray can assist a doctor in determining the origin of the issue.

3. Thumb X-rays can diagnose a condition, track its development, choose a course of therapy, and assess its effectiveness.

4. Doctors use thumb X-rays to find foreign things within the body and as a reference for setting fractured bones.

5. Thumb X-rays are used to identify the source of symptoms, including discomfort, soreness, swelling, or a deformity of the thumb, other fingers, hand, wrist, or even ankle.

6. An X-ray of the thumb might reveal cysts and infections.

7. Thumb X-rays are utilized both before and after surgery to evaluate the results of the procedure.

What Are the Potential Risks and Complications of Thumb X-Rays?

Although X-rays are typically considered safe, a thumb X-ray may have certain dangers and consequences. A few of these are:

1. Ionizing radiation is used in X-rays and can be dangerous in high amounts. However, the radiation exposure from a single X-ray is often low and considered safe.

2. A rare allergic reaction to the contrast substance used in certain X-rays can occur in humans.

3. A person should avoid X-rays during pregnancy because the radiation they emit may damage the fetus as it develops.

4. Metal in the body, such as a metal implant or jewelry, can impact X-rays and produce artifacts on the X-ray image.

The advantages of using a thumb x-ray to diagnose a medical issue often outweigh the dangers. However, one should still talk to the doctor about the worries before the examination.

Conclusion

An X-ray of the thumb is a useful diagnostic technique for assessing the thumb's bones and joints, to sum up. The advantages of the X-ray in properly detecting a medical issue are typically thought to exceed the dangers and consequences of the treatment, which are generally seen as being minor and outweighed by radiation exposure and potential damage to a growing fetus. Before receiving an X-ray of the thumb, discussing any concerns one might have with the doctor is important.