Elbow Radiography Techniques Quiz

Fractures and Positioning

• In a Bennett's fracture, the bone involved is the first metacarpal bone.
• To demonstrate a Bennett's fracture, the special positioning method performed is the Robertson's method.
• For a PA projection of the hand, the CR is centered on the third metacarpal.
• A minimum of 2 inches of the forearm should be included radiographically for a PA projection of the hand.
• Slight superimposition of the distal third, fourth, and fifth metacarpals may occur with a well-positioned PA oblique projection of the hand.

Projections and Demonstrations

• The lateral projection of the hand that best demonstrates the phalanges without excessive superimposition is the lateral projection with the fingers spread.
• The lateral projection of the hand that best demonstrates a possible foreign body in the palm of the hand is the lateral projection with the fingers flexed.
• The AP axial projection (Brewerton method) requires a 15° CR angle.
• The required rotation for an oblique projection of the wrist is 45°.

Errors and Pathologies

• The positioning error that results in a majority of the carpal bones being superimposed in a PA oblique wrist projection is insufficient rotation.
• Osteoporosis is the pathology term for 'reduction in the quantity of bone or atrophy of skeletal tissue'.
• The required CR angulation to the long axis of the hand for the carpal canal (tunnel) projection is 25°.
• The pathology term that describes 'narrowing of joint space with periosteal growths on the joint margins' is osteoarthritis.
• For osteopetrosis, a decrease in manual exposure factors is needed.

Projections and Requirements

• The routine projections required for a study of the forearm are the AP and lateral projections.
• For a patient unable to fully extend the elbow for the AP projection, alternative projections such as the flexed elbow or the axillary projection should be performed.
• The AP projection of the elbow that best demonstrates the radial head, neck, and tuberosity with slight superimposition of the ulna is the AP projection with the elbow flexed.
• Lead (gonadal) shielding is required for upper limb radiographs even if the patient can sit upright for these exams.

Elbow Projections and Demonstrations

• The projection of the elbow that best demonstrates the coronoid process in profile is the lateral projection with the elbow flexed.
• The best position to evaluate the posterior fat pads of the elbow joint is the lateral projection with the elbow flexed.
• The upper limb is rotated 45° for a lateral (rotation) oblique projection of the elbow.
• The CR should be angled 45° cranially for the trauma axial lateral projection (Coyle method) involving the radial head.

Errors and Radiographs

• The error present in the PA wrist radiograph with ulnar deviation was insufficient rotation.
• The repeatable error present in the pediatric PA forearm radiograph was insufficient rotation.
• The possible error in the AP elbow radiograph was inadequate collimation.
• The error present in the lateral elbow radiograph was inadequate collimation.
• The repeatable error present in the AP elbow radiograph was inadequate collimation.
• The radiograph with an aspect of prisiform cut off laterally was the PA wrist radiograph.
• The possible error in the lateral elbow radiograph related to collimation and CR was inadequate collimation.
• The repeatable error present in the lateral elbow radiograph was inadequate collimation.

Special Projections and Pathologies

• The specific positioning routine to determine the extent of a Colles' fracture is the PA and lateral projections with the wrist in ulnar deviation.
• The special projection to demonstrate the region of the wrist to locate a possible foreign body in the dorsal aspect is the lateral projection with the wrist in flexion.
• If a patient is unable to pronate the upper limb for the AP oblique-medial rotation projection to demonstrate the coronoid process, the alternative projection is the AP oblique-lateral rotation projection.
• The special projection to demonstrate the region of the wrist for a patient with a history of carpal tunnel syndrome suspected of bony changes causing compression of the median nerve is the carpal canal (tunnel) projection.
• When initial wrist radiographs are inconclusive, the additional projection to demonstrate the region of the wrist to locate a possible foreign body in the dorsal aspect is the lateral projection with the wrist in flexion.
• The special position to evaluate a patient for early evidence of rheumatoid arthritis is the PA projection of the hands with the fingers spread.
• The special projection to rule out an injury to the ulnar collateral ligament when initial radiographs do not indicate any fracture or dislocation near the first MCP joint is the AP oblique-medial rotation projection.

Test your knowledge of elbow radiography techniques with this quiz. Learn about alternative projections for patients unable to fully extend the elbow, as well as the best routine projection for demonstrating specific elbow structures. Determine whether lead shielding is required for upper limb radiographs.