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Endgames Case Review

A child with a painless, deformed wrist

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k246 (Published 14 February 2018) Cite this as: BMJ 2018;360:k246

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Re: A child with a painless, deformed wrist

Many thanks for your Endgames contribution. Unfortunately it contains a commonly held misconception that a standard wrist or hand x-ray is Anteroposterior (AP). They are in fact Posteroanterior (PA) or Dorsopalmar (DP) - same thing, different terms.

The true anatomic position has the palms facing anteriorly. The image is taken with the palm down hence the thumb of a right hand xray is on the left and vice versa.

A day spent with the radiographers ensures an appreciation of how images are acquired and gives a great amount of respect for this group of colleagues. It allows us to appreciate their art and means we have a new respect when we simply write out a form for what is to follow.

Competing interests: No competing interests

18 February 2018
Dan Armstrong
Consultant Hand and Wrist Surgeon
Pulvertaft Hand Cetnre
Pulvertaft Hand Centre Derby
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