Wrist special views: carpal canal, deviation and carpal bridge

Patient and part

These views add to the routine PA, oblique and lateral wrist. For the carpal canal, the Gaynor-Hart method, the palm faces down on the IR and the wrist is hyperextended as far as the patient can tolerate, so the long axis of the hand is near vertical. The patient pulls the fingers back with the other hand or a strip of tape, and the hand is rotated about 10 degrees toward the radial side to keep the hamate and pisiform apart. For a PA in ulnar deviation, the hand turns toward the little finger side without lifting. For a PA in radial deviation, it turns toward the thumb side. For the carpal bridge, a tangential view of the back of the wrist, the hand lies palm up with the wrist flexed about 90 degrees so the back of the hand rests on the IR.