Free Hand and Finger X-ray Viewer with AI Explanation

Hand and Finger X-ray Views, and What Each One Answers

A posteroanterior view of the whole hand, palm flat against the plate, is the survey film: it lays out all five metacarpals and fourteen phalanges in one exposure and is usually the first thing ordered after a fall or a crush injury, because it screens every digit at once for an obvious fracture or dislocation.

A whole-hand PA is a poor tool for judging a single injured finger in detail, because on the oblique projection of a whole-hand series the fingers fan out and overlap each other — a hairline fracture or a small avulsion at the base of one phalanx can sit directly behind a neighboring digit and disappear. That is why a finger with a clinically suspected fracture gets its own dedicated three-view series: a PA of that digit alone, a true oblique of that digit alone, and a true lateral of that digit alone, shot so the finger is isolated from the others instead of sharing a frame with them. The dedicated lateral in particular is what resolves an intra-articular step-off or a volar plate avulsion at the joint that a whole-hand oblique would otherwise hide behind bone overlap.

The thumb gets its own series rather than sharing the hand series, because its axis of motion is rotated roughly ninety degrees relative to the fingers, so a standard hand PA and oblique project the thumb at odd, foreshortened angles. A dedicated thumb series repositions the hand so the thumb itself is shot true PA, true oblique, and true lateral, which is what a suspected first metacarpal or trapezium fracture, or a Bennett or Rolando fracture at the thumb's base, actually needs to be read accurately.

When a thumb injury raises concern for a torn ulnar collateral ligament — classically a skier's thumb from a fall onto an outstretched hand, or a gamekeeper's thumb from chronic strain — a plain PA and lateral cannot show ligament laxity, since ligaments do not appear on a radiograph. A stress view, taken with gentle valgus force applied across the metacarpophalangeal joint while the exposure is made, instead shows how far the joint gaps open under that stress, which is a bone-position proxy for how much the ligament itself has given way.

The Brewerton view is a more specialized request: the hand is positioned with the MCP joints flexed and the beam angled roughly thirty degrees from the vertical, which projects the metacarpal heads clear of the overlapping carpal bones behind them. It is the view radiologists reach for when they need an unobstructed look at the metacarpal heads themselves — for a subtle fracture, an early erosive change from inflammatory arthritis, or a foreign body lodged near a knuckle after a punch injury — detail a standard PA hand film tends to bury under bone-on-bone overlap.

Hand Conditions on X-ray

How It Works

Why Rotation Is Judged at the Bedside, Not on Film

A metacarpal shaft fracture can heal with the finger rotated relative to its neighbors even when the bone looks well aligned on both the PA and lateral projections, because a single static image cannot capture how a finger points when the whole hand is flexed into a fist. That is why rotational alignment is a clinical exam finding, not a radiographic one: a clinician has the patient make a fist and checks that every fingernail points in the same plane and that no finger crosses over its neighbor, since even a few degrees of rotation at the fracture site becomes an obvious scissoring of the fingertip once the hand is closed. A radiograph confirms angulation, shortening, and displacement at the fracture line; it is the fist, not the film, that catches rotational malalignment.

What This Viewer Lets You Do With One Hand Radiograph

Window and level controls remap which shades of gray the display stretches across a thin bone: pull the window toward bone detail and the cortex of a phalanx or metacarpal separates sharply from the soft tissue around it; pull it toward soft tissue and swelling around a joint or a foreign body near a knuckle becomes easier to trace. Zoom lets you isolate a single phalanx or a single joint at a size no printed film would show, and an invert toggle flips the grayscale so a faint fracture line or a small lucent gap at a joint margin can stand out against the opposite background.

The measurement tool drops calipers directly on the image, which is useful in two very different ways on a hand film: measuring the angulation at a metacarpal neck fracture — the detail that decides whether a boxer fracture needs reduction or can be splinted as it sits — and sizing a small avulsion fragment at a finger joint, where a few millimeters of fragment size can change whether a hand surgeon treats it conservatively or considers fixation.

When a study includes a dedicated three-view series for a single injured digit, the viewer opens the PA, oblique, and true lateral of that finger side by side, so a subtle step-off seen on the lateral can be checked directly against the same joint on the oblique without losing your place between images.

AI Explanation vs a Hand Surgeon's Second Opinion

An AI read of a rendered hand frame can translate dense report shorthand into plain language and point out roughly where a finding sits on the image, but it is not a substitute for a hand surgeon or radiologist reviewing the original study, and it will not catch everything a trained eye would. Treat it as preparation for the conversation with your clinician — especially when a report mentions a volar plate avulsion, a mallet fragment, or angulation at a metacarpal neck that might need reduction.

Why Use Our Free X-ray Viewer

Making Sense of the Report Language

A “volar plate avulsion” is a small bone chip pulled off the base of a finger bone where the volar plate ligament anchors, usually from a jammed or hyperextended finger; the ligament itself never appears on film, only the fragment it tore loose. A “mallet fragment” is the same idea at the far end of the finger, at the fingertip joint, where the extensor tendon avulses a chip of bone instead of stretching, leaving the fingertip unable to straighten on its own.

“Boxer fracture angulation” refers to how far the head of the fifth metacarpal has tipped forward, into the palm, after a fracture at its neck — usually from punching something with a closed fist. The angulation number in degrees is the main input into whether a hand surgeon reduces the fracture or lets it heal as positioned.

“Joint subluxation” means two bone ends at a finger or thumb joint have partly slipped out of their normal alignment without fully dislocating, often seen at the PIP or MCP joint after a jam or sprain. “Erosive change” describes small punched-out defects at a joint margin, a pattern inflammatory arthritis leaves behind as it eats into bone at the joint edge rather than narrowing the joint space evenly the way mechanical wear does.

Supported X-ray Formats

One Flat Projection, No Slices to Scroll

A radiograph is a single two-dimensional shadow of everything the beam passed through, compressed onto one plate. There is no depth information to scroll through like a CT stack, and nothing to reconstruct into a rotating 3D model the way volumetric imaging allows. Bones that sit in front of and behind each other in that one projection overlap on the film, which is exactly why a suspected finger fracture gets its own isolated three-view series instead of relying on the whole-hand survey film alone — each additional angle is the only way to recover the depth information a single flat image cannot contain.

Frequently Asked Questions

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