<![CDATA[ABSTRACT Radiographic examination of the wrist joint in cases of chronic wrist pain generally begins with standard posteroanterior (PA) and lateral projections; however, certain abnormalities involving the scapholunate region and scaphoid may not always be optimally identified using standard projections alone. This study focused on the examination procedure and the role of the Pencil Grip View in evaluating the wrist joint in patients with chronic wrist pain at the Radiology Department of Prof. Dr. R. Soeharso Orthopedic Hospital, Surakarta. This qualitative study employed a case study approach, with data collected through observation, interviews with one referring physician, three radiographers, and one radiologist, as well as documentation and literature review conducted from September 2025 to March 2026. The data were analyzed descriptively by examining the examination procedures, projection techniques, radiographic findings, and information obtained from the informants. The findings showed that the examination was performed using standard PA and lateral projections, followed by an additional bilateral Pencil Grip View according to clinical indications. No special patient preparation was required other than removing metallic objects from the examination area, while during the Pencil Grip View, the patient was instructed to grip a pencil to apply stress to the carpal structures. The main finding of this study showed that the use of the bilateral Pencil Grip View provided clearer additional radiographic information for evaluating the scapholunate region and scaphoid and, in the case examined, successfully demonstrated a right scaphoid fracture that was not identified on the standard PA and lateral projections. Therefore, the Pencil Grip View may serve as a relevant supplementary projection for chronic wrist pain with suspected dynamic abnormalities of the wrist joint, as it provides additional radiographic information beyond routine projections. ABSTRAK Pemeriksaan radiografi wrist joint pada kasus chronic wrist pain umumnya diawali dengan proyeksi posteroanterior (PA) dan lateral, tetapi kelainan tertentu pada daerah scapholunate dan scaphoid tidak selalu dapat teridentifikasi secara optimal melalui proyeksi standar. Penelitian ini berfokus pada prosedur pemeriksaan serta peranan proyeksi Pencil Grip View dalam evaluasi wrist joint pada kasus chronic wrist pain di Instalasi Radiologi RS Ortopedi Prof. Dr. R. Soeharso Surakarta. Penelitian menggunakan metode kualitatif dengan pendekatan studi kasus yang dilaksanakan melalui observasi pemeriksaan, wawancara dengan satu dokter pengirim, tiga radiografer, dan satu dokter spesialis radiologi, serta dokumentasi dan studi kepustakaan selama periode September 2025 hingga Maret 2026. Data dianalisis secara deskriptif dengan menelaah tahapan pemeriksaan, penggunaan proyeksi, hasil radiograf, dan informasi yang diperoleh dari informan. Hasil penelitian menunjukkan bahwa pemeriksaan dilakukan menggunakan proyeksi standar PA dan lateral, kemudian ditambahkan proyeksi bilateral Pencil Grip View sesuai indikasi klinis. Pasien tidak memerlukan persiapan khusus selain melepaskan benda logam di sekitar area pemeriksaan, sedangkan pada proyeksi Pencil Grip View pasien diminta menggenggam pensil untuk memberikan pembebanan pada struktur carpal. Temuan utama penelitian menunjukkan bahwa penggunaan proyeksi bilateral Pencil Grip View memberikan informasi radiografis tambahan yang lebih jelas dalam mengevaluasi daerah scapholunate dan scaphoid, serta pada kasus yang diteliti berhasil memperlihatkan fracture os scaphoid dextra yang tidak teridentifikasi pada proyeksi standar PA dan lateral. Dengan demikian, Pencil Grip View dapat menjadi proyeksi tambahan yang relevan pada chronic wrist pain dengan kecurigaan kelainan dinamis pada wrist joint karena memberikan informasi radiografis tambahan setelah evaluasi proyeksi rutin.]]>
