CAMRT Radiography Practice Exam

In a carpal canal projection, if the pisiform and hamulus are superimposed, which adjustment should be made?

1. Rotate the wrist medially 5 to 10 degrees

2. Flex the wrist slightly

3. Rotate the wrist laterally 5 to 10 degrees

4. Extend the wrist slightly

The correct answer is: Flex the wrist slightly

The choice to flex the wrist slightly in a carpal canal projection is based on the need to optimize the positioning to prevent superimposition of the pisiform and hamulus, which can obscure the region of interest. By flexing the wrist, the alignment of the carpal bones can be adjusted more favorably, allowing for a clearer view of the structures being examined. In this projection, the pisiform is often visualized on the palmar aspect of the wrist, and when it is superimposed over the hamulus of the hamate bone, it indicates that the wrist position may not be ideal for visualization. Slight wrist flexion helps to open the space between these bones, reducing superimposition and enhancing diagnostic quality. Other adjustments, like lateral rotation or extension of the wrist, could potentially lead to further superimpositions or misalignment of the structure that needs to be assessed, making them less appropriate choices in this context. Hence, flexing the wrist slightly provides a more accurate presentation of the carpal canal anatomy.