Proximal and distal oblique radiography of the wrist: value in occult injuries

Fractures of the scaphoid and capitate bones are frequently nondisplaced at the initial examination. In addition, obliquity of the fracture line may result in the fracture not being profiled on routine views. Angling the radiographic tube 30 degrees off the vertical toward the elbow results in elongation of the scaphoid and capitate bones and improves visualization of the scaphoid over routine posteroanterior radiographs. Reversing the angle of the tube to 30 degrees from the vertical toward the fingertips further elongates the capitate. This is useful for delineating occult fractures of the capitate.