Coyle Method Elbow Radiography Techniques Quiz

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Questions and Answers

In a Bennett's fracture, which bone is involved?

Fracture extending through first IP joint

Trapezium bone

Scaphoid bone

Base of first metacarpal (correct)

What special positioning method can be performed to demonstrate a Bennett's fracture?

PA axial projection (Brewerton method)

Lateral in extension

Modified Robert's Method (correct)

Fan lateral

Where is the CR centered for a PA projection of the hand?

Third MCP joint (correct)

Third PIP joint

Second MCP joint

Mid-aspect of third metacarpal

A minimum of how many inches of the forearm should be included radiographically for a PA projection of the hand?

1" Signup and view all the answers

True/False: Slight superimposition of the distal third, fourth, and fifth metacarpals may occur with a well-positioned PA oblique projection of the hand.

True Signup and view all the answers

Which lateral projection of the hand best demonstrates the phalanges without excessive superimposition?

Fan lateral Signup and view all the answers

Which lateral projection of the hand best demonstrates a possible foreign body in the palm of the hand?

Lateral in extension Signup and view all the answers

What type of CR angle is required for the AP axial projection (Brewerton method)?

15 degrees proximal toward the ulna Signup and view all the answers

What is the required rotation for an oblique projection of the wrist?

45 degrees Signup and view all the answers

Which positioning error results in a majority of the carpal bones being superimposed in a PA oblique wrist projection?

Excessive lateral rotation Signup and view all the answers

What is the pathology term for 'reduction in the quantity of bone or atrophy of skeletal tissue'?

Osteoporosis Signup and view all the answers

What is the required CR angulation to the long axis of the hand for the carpal canal (tunnel) projection?

25 to 30 degrees Signup and view all the answers

Which pathology term describes 'narrowing of joint space with periosteal growths on the joint margins'?

Osteoarthritis Signup and view all the answers

What change in manual exposure factors is needed for osteopetrosis?

Increase (+) Signup and view all the answers

Which routine projections are required for a study of the forearm?

AP and lateral Signup and view all the answers

For a patient unable to fully extend the elbow for the AP projection, which alternative projection(s) should be performed?

Two AP projections with humerus parallel to IR Signup and view all the answers

Which routine projection of the elbow best demonstrates the radial head, neck, and tuberosity with slight superimposition of the ulna?

AP oblique with 45-degree lateral rotation Signup and view all the answers

True/False: Lead (gonadal) shielding is not required for upper limb radiographs if the patient can sit upright for these exams.

False Signup and view all the answers

Which projection of the elbow best demonstrates the coronoid process in profile?

AP oblique with 45-degree medial rotation Signup and view all the answers

What is the best position to evaluate the posterior fat pads of the elbow joint?

Lateral, flexed 90 degrees Signup and view all the answers

How much is the upper limb rotated for a lateral (rotation) oblique projection of the elbow?

45 degrees laterally Signup and view all the answers

How much and in which direction should the CR be angled for the trauma axial lateral projection (Coyle method) involving the radial head?

45 degrees toward shoulder Signup and view all the answers

Which error was present in the PA wrist radiograph with ulnar deviation?

Poor part positioning due to radial deviation rather than ulnar deviation Signup and view all the answers

What was the repeatable error present in the pediatric PA forearm radiograph?

Poor part positioning because proximal radius crossing over ulna as a result of PA Signup and view all the answers

What was the possible error in the AP elbow radiograph?

Elbow rotated laterally, evident by slight separation of radius and ulna Signup and view all the answers

What error was present in the lateral elbow radiograph?

Elbow over-flexed and not true lateral Signup and view all the answers

What was the repeatable error present in the AP elbow radiograph?

Elbow rotated laterally, evident by slight separation of radius and ulna Signup and view all the answers

In which radiograph was there an aspect of prisiform cut off laterally?

PA wrist with ulnar deviation Signup and view all the answers

What was the possible error in the lateral elbow radiograph related to collimation and CR?

Satisfactory collimation; CR slightly off-center to elbow joint Signup and view all the answers

What was the repeatable error present in the lateral elbow radiograph?

Elbow over-flexed and not true lateral Signup and view all the answers

What specific positioning routine should be used to determine the extent of a Colles' fracture?

AP and lateral forearm projections to include the wrist Signup and view all the answers

Which special projection can be used to demonstrate the region of the wrist to locate a possible foreign body in the dorsal aspect?

Tangential projection - Carpal bridge projection Signup and view all the answers

If a patient is unable to pronate the upper limb for the AP oblique-medial rotation projection to demonstrate the coronoid process, what other projection could be performed?

Trauma axial lateral projection - Coyle method for coronoid process Signup and view all the answers

Which special projection is best 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?

Carpal canal position (Gaynor-Hart method) Signup and view all the answers

When initial wrist radiographs are inconclusive, what additional projection can be performed to demonstrate the region of the wrist to locate a possible foreign body in the dorsal aspect?

Tangential projection - Carpal bridge projection Signup and view all the answers

Which special position can be used in addition to routine hand projections to evaluate a patient for early evidence of rheumatoid arthritis?

AP axial projection (Brewerton method) Signup and view all the answers

What special projection can be performed 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?

PA stress (Folio method) projection Signup and view all the answers

Study Notes

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.

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Description

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.

Elbow Radiography Techniques Quiz