Hand X-ray

A hand x-ray looks at the small bones of the palm and fingers — most often after a punch, a crush, or a jammed finger. Because a hand fracture that heals even slightly rotated leaves a finger that no longer closes straight, these films get repeated during healing.

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What it is

There are nineteen bones in the palm and fingers, and they are small, overlapping, and unforgiving of being put back slightly wrong. A hand x-ray reads the position of each one. The commonest finding is a break in a metacarpal — one of the long bones in the palm — with the break at the base of the little finger, from striking something with a closed fist, common enough to have its own nickname. What the film is being read for is not just the presence of a crack but its angle and rotation, because a finger bone that unites at a twist will cross over its neighbour when the hand makes a fist. Views are taken from the front, the side, and an angle so the bones are not stacked on top of each other.

Why it is done

  • To find a break in a palm or finger bone after a punch, a fall, a crush, or a jammed fingertip
  • To measure how far a broken bone has angled or rotated, which decides whether it can be splinted or needs fixing
  • To check that a fracture is still in position a week or two into treatment
  • To locate a foreign body such as a shard of glass or metal embedded in the hand
  • To assess the pattern of joint damage in arthritis, where which joints are affected helps identify the type

What to expect

The hand is laid flat on the plate, palm down, then turned on its side and angled for the remaining views; a positioning sponge is often used to hold a sore finger steady. Each exposure is momentary and the visit takes only a few minutes. Nothing needs to be done beforehand and there is no after-effect. With a confirmed fracture, a repeat film about one to two weeks later is usual to confirm nothing has shifted. A radiologist provides the formal reading.

Questions worth asking

  • How many x-rays across the whole course of treatment, and is each visit billed as a new study?
  • If the hand and the wrist are both filmed, are those two separate codes on the bill?
  • At urgent care, is the x-ray bundled into the visit charge or added as a separate line, and is the reading included?
  • If a single finger is the problem, is a finger x-ray a cheaper code than a whole hand, and which was ordered?
  • Will a hand surgeon's office re-take films at the first appointment rather than use the ones already taken, and can the images be sent over instead?

What Hand X-ray costs by state

Hand X-ray prices at hospitals

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Sources

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