1. According to Part 17 2004 Annex A of the DICOM standard -
Explanation of patient orientation.

It says on page 13: For hands, the direction labels are based on the
standard anatomic position. For the left hand illustrated for
example, LEFT will always be in the direction of the thumb,
irrespective of position changes.

Q1. If a modality sends you a left hand and the Patient Orientation
(0020,0020) labels is R/H but the thumb is on the right side of the
image. Is this correct?

Q2. If a modality send you a image of a hand and the image laterality
(0020,0062) is "B". Is this legal? Then how can you tell if the
Patient Orientation labels e.g R/H is correct?

Q3. Annex A provides an explanation of how to use the patient
orientation data elements. Does the modality needs to follow this
when it updates/polulates the Patient Orientation (0020,0020) tag of
the image?

If not, then for a AP chest image with Image Laterality (0020,0062) =
"L" and Head at the top, the modality may label it as "R/F" instead of
"L/F". Is this correct?


Wayne Tran