TP RX CO - INCIDENCE ET ANGLE
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Questions and Answers

Quelle est la technique d'incidence fondamentale pour une radiographie de la main ?

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Quel est le critère de réussite pour une radiographie d'un doigt ?

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Quelle préparation doit-on faire pour une radiographie du coude ?

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Quel angle doit être respecté pour la position du bras lors de la radiographie de l'avant-bras ?

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Pour quel type de fracture l'incidence rétro olécranienne de laquerrière est-elle indiquée ?

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Quel est le critère de réussite lors d'une incidence radiographique du pied ?

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Quel angle doit être formé par le rayon ascendant lors de la radiographie du pied ?

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Quelle est la position correcte du patient pour une vue de face du pied ?

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Lors de la préparation du patient pour une radiographie de la cheville, que doit-on s'assurer ?

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Qu'est-ce qui caractérise une incidence de Walter-Muller ?

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Quelle structure se trouve entre le naviculaire et le calcanéum lors de la radiographie du pied ?

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Quel angle de déviation est recommandé pour le pied lors d'une vue en profil ?

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Quel est le critère pour que la malléole soit considérée correctement superposée dans une radiographie?

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Quelle technique est utilisée pour examiner le dégré d'amplitude de crevasse?

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Quels indicateurs doivent être visibles pour produire l'angle entre le 5ème et le 1er métatarse?

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Quel angle est recommandé pour le rayon lorsqu'on réalise une radiographie de la jambe?

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Pourquoi ne doit-on jamais réaliser une radiographie par la face pour un trauma?

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Quelle technique est décrite pour l'incidence du calcanéum?

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Quel est le bon positionnement du pied pour vérifier le hallux valgus?

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Quel est le positionnement requis pour le gros orteil en vue latérale?

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Quelle est la valence des pieds lorsque l'angle est grand?

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Quel est l'angle recommandé pour visualiser le tibia et le péroné lors d'une radiographie?

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Study Notes

Membres Supérieurs (Main, Avant-bras, Mains et Coudes)

  • Main: Anatomy includes phalanges (proximal, medial, distal), metacarpals and carpals (trapeze, trapezoid, capitate, hamate, pisiform, triquetrum, scaphoid). Joints identified include interphalangeal (IP), metacarpophalangeal (MCP), and carpometacarpal (CMC).
  • Incidence face en PA: Light source targets the area to be irradiated; the central ray should align with the base of the middle finger, allowing visualization of radius and ulna in the wrist. Patients lie with legs to the side for protection. Lead apron needed. Cassette size 24x30, divided for both a PA (one side) and profile view (on the other side).
  • Technique: Table horizontal; 1-1.15 minute exposure time; table-top technique; small focal spot (18x24); 45 kV; 2.5 mAs (+10 kV for plaster). Too white an image suggests too high a kV. Patient's hand, wrist, and forearm should be free of jewelry.
  • Position du patient: Forearm resting on the table, hand in prone position, fingers separated, aligned in the centre of the imaging plate. Index finger should be on the right side.

Membres Supérieurs (Doigts)

  • Critères de réussite: All aspects of the digit and underlying joints should be visible. Preference for a frontal-lateral orientation first, followed by a lateral if required. This usually requires support (foam/foam) above the subject's hand.
  • Radiographie Trapèze/Méta-carpienne: The X-ray examination always starts using the thumb as a direct starting point. A standard 2D frontal and 2D lateral view is required for all digits using a comparison method.
  • Important Note: All radiographies should be done using a comparative method for both hands.
  • Incidence: Additional X-rays (3/4) are taken at certain angles and positions using the indicated standards (3/4 or front-side angle at 45°) that are specific to a particular injury type or suspected condition.

Avant-bras

  • Technique/Position: The palm-side should be facing up. The position should center on the middle of the forearm. Use either a sheet or 4 smaller cassettes for greater coverage.

Coude

  • Technique: A standard, frontal and lateral X-ray procedure is necessary. Details as to which positions or angles need to be used are based on the trauma or the issue.
  • Criteria: The radiologist should assess the radiographs for a fully visible view of the elbow joint in both the anatomical frontal and lateral positions.

Pied - Articulations

  • Anatomy: The anatomy of the foot includes the talus, calcaneus, navicular, cuboid, and cuneiforms. Metatarsal and phalangeal bones are also relevant.
  • Joints: Clinically relevant joints include Chopart's and Lisfranc's joints, both of which are critical to evaluate for trauma or problems.
  • Technique (frontal/lateral): Standard radiographic positions (using appropriate x-ray settings) are employed for front-side and side views, with an additional special posture/view for injuries requiring additional views.
    • Criteria: A successful image should display all relevant metatarsals and phalanges in these anatomical views; the alignment/relationship of the bones will show up well, and the radiologist should use this as the criteria for success in the required positions.

Pied (cheville)

  • Criteria: Both malleoli (ankle bones) are shown aligned, with the talus clearly depicted. Tibio-fibular joints must be clearly visible. The sinus tarsi must be clear.
  • Technique: For both frontal and lateral X-rays, an appropriate technique is applied.

Pied en charge (frontal)

  • This position is never used in the case of trauma, but is used for injuries/abnormalities not related to trauma.
  • In this position, the patient's feet are placed on the cassette with their feet together in a standing position.
  • This necessitates the use of an appropriate method to indicate the relevant views (angle).

Jambe

  • Technique/Position: The image should display both the ankle and knee joints. The centre should be on the middle of the leg. Double cassette method for the whole leg, for better image capture.
  • Criteria: The knee joint's condyle (on the inside and outside) should be clearly visible, while the ankle bones should be in proper alignment.
  • Important Note (all radiographs): The criteria for success is that the whole joint is properly aligned, as this will be useful for diagnosing any potential issues.

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