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Which projection of the hands is recommended for early detection of rheumatoid arthritis?

  1. AP oblique (Norgaard method)

  2. Supine projection

  3. Radial deviation projection

  4. Fan beam projection

The correct answer is: AP oblique (Norgaard method)

The AP oblique projection, specifically the Norgaard method, is the recommended technique for the early detection of rheumatoid arthritis. This projection is beneficial because it allows for optimal visualization of the hands' phalanges and the metacarpophalangeal joints, where the earliest changes associated with rheumatoid arthritis often occur. The positioning in the Norgaard method helps to show the degree of joint space narrowing, erosions, and other early signs of inflammation that may be indicative of this condition. While the other projections may have their uses, they do not provide the same level of detailed assessment for early signs of rheumatoid arthritis. The supine projection is not specifically designed for effective examination of hand joints. The radial deviation projection may help in assessing certain wrist conditions but is not ideal for detecting the characteristic joint changes associated with rheumatoid arthritis. The fan beam projection, although useful in some imaging scenarios, does not specifically target the diagnostic needs for rheumatoid arthritis in the same way that the Norgaard method does. Thus, the choice of the AP oblique projection highlights its suitability and effectiveness for this purpose.