RAD POSI SUMMARY ALL
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Questions and Answers

What is the recommended angle for flexion of the knee during the PA Axial Projection using the Holmblad Method?

  • 60-70 degrees
  • 40-50 degrees (correct)
  • 30-40 degrees
  • 50-60 degrees

    • What is the required angle of the femur to the long axis of the leg for the Camp-Coventry Method?

  • 60 degrees
  • 90 degrees
  • 70 degrees (correct)
  • 45 degrees

    • What is the recommended lateral rotation angle for heel positioning in PA projection?

  • 20-25 degrees
  • 10-15 degrees
  • 5-10 degrees (correct)
  • 15-20 degrees

    • In a lateral projection of the knee, what angle should the knee not be flexed beyond to prevent fragment separation?

    <p>100 degrees</p> Signup and view all the answers

    During a PA axial oblique projection, what is the flexion degree of the knee to relax the muscle?

    <p>100 degrees</p> Signup and view all the answers

    Which projection method is also known as the mountain view?

    <p>Merchant Method</p> Signup and view all the answers

    What is the common range of knee rotation required for the PA oblique projection?

    <p>45-55 degrees</p> Signup and view all the answers

    What is the central ray angle for the Hughston method tangential projection?

    <p>45 degrees</p> Signup and view all the answers

    What rotational angle is required for the AP projection of the femorotibial joint until the interepicondylar line is parallel to the image receptor?

    <p>30-50 degrees</p> Signup and view all the answers

    In the PA projection for knee positioning, what should be the angle of the central ray (CR)?

    <p>50 caudad</p> Signup and view all the answers

    What is the recommended flexion of the knee to relax the muscles during the lateral projection for maximum joint cavity volume?

    <p>20-30 degrees</p> Signup and view all the answers

    How should the leg be positioned for the AP oblique internal rotation view of the knee?

    <p>45 degrees internally</p> Signup and view all the answers

    What is the purpose of performing an AP weight-bearing projection of the knee?

    <p>Assess joint space narrowing</p> Signup and view all the answers

    To perform an AP oblique lateral rotation of the knee, how should the leg be rotated?

    <p>45 degrees externally</p> Signup and view all the answers

    What is positioned ½ inch below the apex of the patella during the AP projection of the knee?

    <p>The central ray</p> Signup and view all the answers

    Why is the central ray directed parallel to the tibial plateau in the PA projection?

    <p>Due to the inclination of the tibia and fibula</p> Signup and view all the answers

    What is the correct position for the hand during the AP Neutral rotation?

    <p>Palm against the hip</p> Signup and view all the answers

    In the Inferosuperior Axial Projection using the Lawrence method, what should the arm's position be?

    <p>Abducted at 90 degrees</p> Signup and view all the answers

    What is oriented 45 degrees to the plane of the film in the AP Neutral rotation?

    <p>Epicondylar plane</p> Signup and view all the answers

    What is the CR angle when performing the Inferosuperior Axial Projection (Lawrence Method)?

    <p>Horizontally through the axilla</p> Signup and view all the answers

    During a Neutral rotation, which structure is partially superimposed by the greater tubercle?

    <p>Humeral head</p> Signup and view all the answers

    What flexion angle of the knee is recommended for the PA Axial Projection using the Holmblad Method?

    <p>40-50 degrees</p> Signup and view all the answers

    In the Beclere Method for AP Axial Projection, what is the position of the infrared receptor?

    <p>Under the popliteal region</p> Signup and view all the answers

    For the Camp-Coventry Method, how should the femur be positioned relative to the long axis of the leg?

    <p>70 degrees</p> Signup and view all the answers

    What is the primary anatomical feature demonstrated by imaging techniques like the Holmblad and Camp-Coventry Methods?

    <p>Intercondylar fossa</p> Signup and view all the answers

    What is the primary purpose of the AP Axial Projection?

    <p>To reduce magnification and improve recorded detail</p> Signup and view all the answers

    What is the required central ray orientation for the AP Axial Projection using the Beclere Method?

    <p>Perpendicular to the leg</p> Signup and view all the answers

    In what position should a patient be placed for an AP Axial Projection when upright?

    <p>Lordotic position at 0-15 degrees</p> Signup and view all the answers

    What should be the angle of the central ray (C.R.) for the PA Axial Projection?

    <p>15-30 degrees towards the shoulder</p> Signup and view all the answers

    What is a key characteristic of the Tangential Projection?

    <p>Useful for patients with multiple injuries</p> Signup and view all the answers

    Where should the central ray be directed for the Tangential Projection (Tarrant)?

    <p>25-35 degrees anterior and inferior to the midclavicle</p> Signup and view all the answers

    What does the term 'SS' refer to in the context of the AP Axial Projection?

    <p>Superimposition of structures</p> Signup and view all the answers

    Which projection requires the image receptor to be supported at an angle while touching the affected shoulder?

    <p>PA Axial Projection</p> Signup and view all the answers

    What is the proper degree of internal rotation required for the femorotibial joint in the AP projection?

    <p>30-50 degrees</p> Signup and view all the answers

    In the PA projection, what angle should the central ray (CR) be directed?

    <p>50 degrees caudad</p> Signup and view all the answers

    During the AP oblique internal rotation, how many degrees should the leg be rotated?

    <p>45 degrees</p> Signup and view all the answers

    What position should the patient be in for the lateral projection of the knee?

    <p>Lateral recumbent position</p> Signup and view all the answers

    What is the purpose of performing an AP weight-bearing projection of the knee?

    <p>To examine joint spaces and deformities</p> Signup and view all the answers

    What angle should be achieved for the femorotibial joint during the AP projection if the interepicondylar line is parallel to the image receptor?

    <p>30-50 degrees</p> Signup and view all the answers

    When performing an AP oblique lateral rotation of the knee, how should the leg be positioned?

    <p>Rotated 45 degrees externally</p> Signup and view all the answers

    What is the significance of the central ray being parallel to the tibial plateau in the PA projection?

    <p>To accurately visualize joint alignment</p> Signup and view all the answers

    What is the required medial rotation angle for the Lateromedial Oblique Projection of the foot?

    <p>45 degrees</p> Signup and view all the answers

    In the AP Axial Oblique Projection with medial rotation for the ankle, what angle must the foot be rotated?

    <p>30 degrees</p> Signup and view all the answers

    Which projection demonstrates the anterior subtalar joint?

    <p>AP Axial Oblique Projection (Medial Rotation Ankle)</p> Signup and view all the answers

    For the AP projection of the ankle, where should the central ray be directed?

    <p>Midway between the malleoli</p> Signup and view all the answers

    What is the purpose of the Isherwood method?

    <p>To demonstrate the talocalcaneal joint articulations separately</p> Signup and view all the answers

    In the AP Axial Oblique Projection with lateral rotation of the ankle, what is the angle of rotation?

    <p>30 degrees</p> Signup and view all the answers

    Which structure is best visualized in a Mortise view?

    <p>Talofibular joint</p> Signup and view all the answers

    What is the required angle for the central ray in the AP Axial Oblique Projection of the ankle?

    <p>5 degrees posteriorly</p> Signup and view all the answers

    What is the elbow flexion degree required for the lateral projection of the radial head?

    <p>90 degrees</p> Signup and view all the answers

    In the AP Acute Flexion (Jones Method), where should the central ray be directed?

    <p>2 inches superior or distal to the OP</p> Signup and view all the answers

    Which degree of elbow flexion is required to visualize the coronoid process in the oblique projection?

    <p>80 degrees</p> Signup and view all the answers

    What is the angulation of the central ray required for a PA Axial Projection for the olecranon process?

    <p>45-50 degrees</p> Signup and view all the answers

    What is the angle range for the CR when performing an AP Axial Projection in the lordotic position?

    <p>0-15 degrees upright</p> Signup and view all the answers

    During the Lateral Projection for the radial head, which position is required for the hand?

    <p>Supinated</p> Signup and view all the answers

    What is the primary advantage of the tangential projection (Tarrant)?

    <p>It is useful for patients with multiple injuries.</p> Signup and view all the answers

    What is the recommended positioning for the hand during the AP Oblique (Lateral Rotation) for viewing the radial head?

    <p>Hand in true lateral position with thumbs up</p> Signup and view all the answers

    Which flexion degree is required for the PA Axial Projection concerning the distal humerus?

    <p>75 degrees</p> Signup and view all the answers

    What is the specific central ray angle recommended for the CR in the tangential projection?

    <p>25-40 degrees</p> Signup and view all the answers

    What is the necessary positioning of the patient for clear visualization during the lateral projection?

    <p>Recumbent on the affected side</p> Signup and view all the answers

    For the PA axial oblique projection, what is the angle of rotation for optimal results?

    <p>15-30 degrees</p> Signup and view all the answers

    What does SS refer to in the context of the AP Axial Projection?

    <p>Superimposed Structures</p> Signup and view all the answers

    What additional adjustment should be made if the medial third of the clavicle is in question during the PA Axial Projection?

    <p>Add 15-25 degrees of lateral angle</p> Signup and view all the answers

    What is the appropriate flexion angle for the knee during the Holmblad Method?

    <p>40-50 degrees</p> Signup and view all the answers

    In the Beclere Method for AP Axial Projection, what is the required angle of the femur relative to the leg?

    <p>70 degrees</p> Signup and view all the answers

    What is the purpose of flexing the knee to 60 degrees in the Beclere Method?

    <p>To visualize the joint space effectively</p> Signup and view all the answers

    How should the central ray (CR) be directed for the PA Axial Projection using the Camp-Coventry Method?

    <p>Perpendicular to the long axis of the femur</p> Signup and view all the answers

    What specific anatomical feature is primarily revealed in the PA Axial Projection methods?

    <p>Intercondyloid fossa</p> Signup and view all the answers

    What is the required rotation of the leg and foot for the lateral (mediolateral) projection of the ankle?

    <p>450 degrees medially</p> Signup and view all the answers

    What is the central ray (CR) direction for the lateral (mediolateral) projection of the ankle?

    <p>Perpendicular to the ankle joint, entering the medial malleolus</p> Signup and view all the answers

    In an AP projection of the ankle, what is the ideal position of the plantar surface?

    <p>Vertically positioned</p> Signup and view all the answers

    When performing a stressed study of the ankle, which action is typically undertaken?

    <p>Forced inversion and eversion</p> Signup and view all the answers

    What is the expected space demonstrated between the talus and fibula in a lateral projection of the ankle?

    <p>Articulation is not demonstrated</p> Signup and view all the answers

    What does an open proximal tibiofibular joint signify during a medial rotation in the AP oblique projection?

    <p>Correct rotational position</p> Signup and view all the answers

    Which anatomical feature does the AP oblique projection of the knee medial rotation best visualize?

    <p>Proximal tibiofibular joint</p> Signup and view all the answers

    What condition can be evaluated through forced inversion and eversion studies of the ankle?

    <p>Joint separation and ligament tear</p> Signup and view all the answers

    What is the recommended knee rotation angle for the PA oblique projection?

    <p>45-55 degrees</p> Signup and view all the answers

    What is the purpose of flexing the knee no more than 10 degrees in a lateral projection?

    <p>To prevent fragment separation in patellar fractures</p> Signup and view all the answers

    For the Kuchendorf method PA axial oblique projection, how should the knee be positioned?

    <p>Rotate laterally so that the patella and medial condyle rest on the table, and flex the knee at 10 degrees</p> Signup and view all the answers

    What is the central ray angle for the Tangential Projection using the Hughston method?

    <p>40-45 degrees from horizontal</p> Signup and view all the answers

    In the Tangential Projection (Merchant Method), what is the position of the leg?

    <p>Seated or supine with the knee flexed at 40 degrees</p> Signup and view all the answers

    What is the significance of the PA Axial Oblique Projection in terms of visualization?

    <p>It demonstrates the patella with minimal superimposition</p> Signup and view all the answers

    What should the knee be flexed to during the Tangential Projection (Settegast Method)?

    <p>50-60 degrees</p> Signup and view all the answers

    What is the positioning of the patient during the Tangential Projection (Hughston Method)?

    <p>Prone with leg elevated</p> Signup and view all the answers

    What is the primary position of the hand during the AP Oblique (Medial Rotation) projection of the elbow?

    <p>Hand pronated</p> Signup and view all the answers

    When performing the Lateral projection of the elbow, what is a common position for the elbow joint?

    <p>90 degrees of flexion</p> Signup and view all the answers

    During the AP Partial Flexion projection, which areas of the arm are visualized?

    <p>Proximal forearm and distal humerus</p> Signup and view all the answers

    In the Coyle method (coronoid and radial head), what directional projection is specified?

    <p>Lateromedial projection</p> Signup and view all the answers

    What is the recommended abnormal positioning when a patient cannot execute ulnar flexion during elbow radiography?

    <p>Devote long axis 20 degrees laterally</p> Signup and view all the answers

    What is the primary goal of performing an Inferosuperior Axial Projection using the Lawrence method?

    <p>To visualize hill sachs lesion</p> Signup and view all the answers

    In the AP Neutral rotation, which anatomical structures should be positioned correctly?

    <p>Epicondylar plane 45 degrees to the film</p> Signup and view all the answers

    What is the correct position for the arm during the Inferosuperior Axial Projection?

    <p>Abducted 90 degrees</p> Signup and view all the answers

    What signifies the angle of the central ray during the Inferosuperior Axial Projection (Lawrence Method)?

    <p>Horizontal through the axilla at 15 degrees</p> Signup and view all the answers

    Which structure is best profiled with internal rotation during a radiographic examination?

    <p>Lesser tuberosity</p> Signup and view all the answers

    What is the correct body rotation angle for the Neer Method tangential projection?

    <p>45-60 degrees</p> Signup and view all the answers

    In the Blacket-Healy method, how should the patient's forearm be positioned during the procedure?

    <p>Forearm resting on the back</p> Signup and view all the answers

    What is the central ray (CR) angle for the Neer Method during the tangential projection?

    <p>10-15 degrees caudally</p> Signup and view all the answers

    Which structure is primarily evaluated by the Neer Method according to the positioning?

    <p>Coracoacromial arch</p> Signup and view all the answers

    During the Fisk Method, what positioning is required for the patient's elbow?

    <p>Flexed at 90 degrees</p> Signup and view all the answers

    What is the purpose of using equal weights (5-8 lbs) during the AP Axial Projection (Alexander Method)?

    <p>To allow visualization of the AC joint</p> Signup and view all the answers

    What is the central ray angle for the PA Axial Projection (Alexander Method)?

    <p>150 degrees to the AC joint</p> Signup and view all the answers

    During the PA Axial Oblique Projection (Alexander Method), how should the body be positioned?

    <p>Affect side in contact and rotated 45-60 degrees</p> Signup and view all the answers

    What is the primary anatomical structure visualized during the use of the AP Projection for the clavicle?

    <p>Clavicle midshaft</p> Signup and view all the answers

    In the context of the Alexander Method's projections, what does 'demons.dislocation/separation of joints superiorly' imply?

    <p>Radiographic findings indicative of superior joint separation</p> Signup and view all the answers

    Which projection is primarily focused on visualizing the medial side of the carpal bones?

    <p>PA with Ulnar Flexion/deviation</p> Signup and view all the answers

    What is the recommended angulation of the central ray (CR) for PA Axial projection using the Stecher method?

    <p>10 to 30 degrees towards the elbow</p> Signup and view all the answers

    Which method is best for demonstrating fractures of the scaphoid?

    <p>Gaynor-Hart Method</p> Signup and view all the answers

    What specific positioning is required to visualize the trapezium and its articulations?

    <p>Clements Nakayama Method</p> Signup and view all the answers

    What is the purpose of the PA Axial (Stecher) projection concerning the scaphoid?

    <p>To prevent foreshortening of scaphoid</p> Signup and view all the answers

    What angle should the CR be directed for the Tangential projection (Carpal Bridge)?

    <p>45 degrees caudally</p> Signup and view all the answers

    Which positioning technique is specifically utilized to visualize the lateral side of carpal spaces?

    <p>PA with Radial Flexion/deviation</p> Signup and view all the answers

    What is the significance of performing a Gaynor-Hart projection?

    <p>To demonstrate the hamate's hamulus and carpal tunnel syndrome</p> Signup and view all the answers

    What is the required orientation of the epicondylar plane in the AP Neutral rotation?

    <p>45 degrees to the plane of the film</p> Signup and view all the answers

    What are the weight recommendations for the AP Axial Projection using the Alexander Method?

    <p>5-8 lbs</p> Signup and view all the answers

    Which anatomical structure is best demonstrated in the Inferosuperior Axial Projection (Lawrence Method)?

    <p>Supraspinatus tendon</p> Signup and view all the answers

    In the Inferosuperior Axial Projection, what is the position of the arm?

    <p>Abducted and externally rotated</p> Signup and view all the answers

    During the PA Axial Oblique Projection using the Alexander Method, the arm should be positioned in what manner?

    <p>Across the chest</p> Signup and view all the answers

    What angle should the central ray be directed for the PA Axial Projection in the Alexander Method?

    <p>15° to the AC joint</p> Signup and view all the answers

    What is the relationship of the greater tubercle to the humeral head in AP Neutral rotation?

    <p>The greater tubercle partially superimposes the humeral head</p> Signup and view all the answers

    What is the central ray angle for the Inferosuperior Axial Projection using the Lawrence Method?

    <p>Horizontal through the axilla to the AC joint</p> Signup and view all the answers

    Which projection is primarily performed to demonstrate dislocation or separation of joints?

    <p>PA Axial Projection</p> Signup and view all the answers

    How should the patient's body be positioned during the PA Axial Oblique Projection using the Alexander Method?

    <p>Body rotated 45-60°</p> Signup and view all the answers

    What is the proper method to position the femur for the Holmblad Method?

    <p>At a 70-degree angle to the long axis of the leg</p> Signup and view all the answers

    What is the angle at which the femur should be positioned to the long axis of the leg during the Camp-Coventry Method?

    <p>70 degrees</p> Signup and view all the answers

    In which position should the patient be for the Beclere Method of AP Axial Projection?

    <p>Supine with knee flexed</p> Signup and view all the answers

    What is a key feature visualized by performing the PA Axial Projection using the Holmblad Method?

    <p>Intercondyloid fossa</p> Signup and view all the answers

    What is the required central ray (CR) orientation for the Beclere Method?

    <p>Perpendicular to the leg, entering the knee</p> Signup and view all the answers

    What is the primary position of the arm during the Grashey Method?

    <p>Arm slightly abducted</p> Signup and view all the answers

    What is the required central ray (CR) orientation for the Grashey Method?

    <p>⊥ to the shoulder joint</p> Signup and view all the answers

    Which projection is best for demonstrating fractures of the scaphoid and lunate dislocation?

    <p>Tangential projection (Carpal Bridge)</p> Signup and view all the answers

    For the PA Axial projection using the Stecher method, what is the recommended orientation of the cassette?

    <p>Inclined</p> Signup and view all the answers

    During the AP Oblique Projection (Apple Method), what technique is used to visualize the articular cartilage?

    <p>Weighted abduction</p> Signup and view all the answers

    In the Gaynor-Hart method, what position must the wrist be in?

    <p>Hyperextended</p> Signup and view all the answers

    In the AP Axial Oblique (Garth Method), what position should the elbow be in relative to the chest?

    <p>Elbow flexed and arm across the chest</p> Signup and view all the answers

    What is the range of body rotation required for the Garth Method?

    <p>30-45 degrees</p> Signup and view all the answers

    During a PA with Ulnar Flexion/deviation, which side of the carpal spaces is primarily visualized?

    <p>Lateral side</p> Signup and view all the answers

    Which of the following conditions is primarily evaluated using the AP Axial Oblique (Garth Method)?

    <p>Posterior dislocation of the shoulder</p> Signup and view all the answers

    What is the angle of the central ray in the Clements Nakayama Method?

    <p>45 degrees distally</p> Signup and view all the answers

    In the PA Axial (Stecher) projection, how must the central ray be directed?

    <p>Angled towards the elbow</p> Signup and view all the answers

    In the Pearson Method for Bilateral AP Projection, what is the position of the shoulders relative to the IR?

    <p>Parallel</p> Signup and view all the answers

    What anatomy is demonstrated by the central ray directed to the shoulder joint in the Grashey Method?

    <p>Glenohumeral joint space</p> Signup and view all the answers

    Which structure does the Tangential projection (Carpal Bridge) primarily help to identify?

    <p>Hamate's hamulus</p> Signup and view all the answers

    What is the primary purpose of performing the PA with Radial Flexion/deviation?

    <p>To view the medial side carpal spaces</p> Signup and view all the answers

    Which of the following projections requires the hand to be in a pronated position?

    <p>AP Oblique (Medial Rotation)</p> Signup and view all the answers

    For the true AP projection of the elbow, which anatomical structures should be superimposed?

    <p>Radial Head, Neck, and Tuberosity over the Ulna</p> Signup and view all the answers

    Which projection method specifically visualizes the radial head and involves lateromedial rotation?

    <p>Lateral Projection (Lateromedial rot.)</p> Signup and view all the answers

    In the AP Partial Flexion projection, what anatomical regions are primarily focused upon?

    <p>Distal Humerus and Proximal Forearm</p> Signup and view all the answers

    What is the positioning requirement for performing the AP Oblique (Medial Rotation) projection of the elbow?

    <p>Elbow should be at 45 degrees to the film</p> Signup and view all the answers

    What is the arm positioning required for the Inferosuperior Axial Projection?

    <p>Arm abducted at 90 degrees, forearm hanging downward</p> Signup and view all the answers

    In the PA Oblique (Scapular Y) projection, what is the recommended position for the affected side?

    <p>Affected side in contact with the film</p> Signup and view all the answers

    For the Superoinferior Axial Projection using the Cleaves method, what is the angle recommended towards the elbow?

    <p>5-15 degrees</p> Signup and view all the answers

    What position should the arm be in for the AP Axial Projection using the Stryker ‘Notch’ method?

    <p>Flexed and abducted forwardly beyond 90 degrees</p> Signup and view all the answers

    What is the central ray (C.R.) orientation for the Inferosuperior Axial Projection?

    <p>Horizontally to the midcoronal with 25 degrees medial angulation</p> Signup and view all the answers

    What is the recommended angle for the central ray in the Settegast method when performing an inferosuperior projection?

    <p>15-20 degrees cephalad</p> Signup and view all the answers

    During the lateral projection of the proximal femur, how should the body be positioned?

    <p>Rotate toward the affected side</p> Signup and view all the answers

    What is the degree of knee flexion needed for the lateral positioning of the knee?

    <p>Flex at 45 degrees</p> Signup and view all the answers

    Which key anatomical feature helps determine the rotation needed for an AP projection of the femorotibial joint?

    <p>Interepicondylar line</p> Signup and view all the answers

    What is the rotation angle for the knee during the PA Oblique projection?

    <p>45-55 degrees</p> Signup and view all the answers

    During a lateral projection, what is the maximum degree of flexion recommended for the knee?

    <p>100 degrees</p> Signup and view all the answers

    In the Kuchendorf Method for PA Axial Oblique Projection, what is the required flexion of the knee to relax the muscle?

    <p>100 degrees</p> Signup and view all the answers

    What is the central ray angle required for the Tangential Projection (Hughston Method)?

    <p>45 degrees</p> Signup and view all the answers

    Which projection method utilizes the term 'mountain view'?

    <p>Merchant Method</p> Signup and view all the answers

    What is the recommended angle for the central ray (CR) during the Merchant Method tangential projection?

    <p>40 degrees from horizontal</p> Signup and view all the answers

    Which projection is associated with demonstrating patellar subluxation and femoral condyles?

    <p>Tangential Projection (Hughston Method)</p> Signup and view all the answers

    How is the knee positioned for the PA Axial Oblique Projection (Kuchendorf Method)?

    <p>Laterally rotated</p> Signup and view all the answers

    What is the correct CR orientation for the AP Axial Projection of the clavicle?

    <p>Perpendicular to the midshaft</p> Signup and view all the answers

    What is the purpose of the Tangential Projection in the context of multiple injuries?

    <p>To provide specific views of the clavicle</p> Signup and view all the answers

    For the Tangential Projection (Tarrant), what is the central ray angle adjustment if the medial third of the clavicle is in question?

    <p>Add 15-25 degrees laterally</p> Signup and view all the answers

    In the Tangential Projection method, what is the primary reason for using an angle during imaging?

    <p>To avoid superimposition of structures</p> Signup and view all the answers

    Study Notes

    AP Projection

    • Rotate the leg 3-50 degrees internally until the interepicondylar line is parallel to the image receptor.
    • The central ray (CR) is directed 1/2 inch below the apex of the patella.
    • The angle of the CR is 5-70 degrees.
    • The structure being imaged is the distal femur and proximal leg.

    VARIATION- ASIS TO TABLETOP (PA PROJECTION)

    • The central ray is directed 50 degrees caudad.
    • The central ray is parallel to the tibial plateau because the tibia and fibula are slightly inclined.

    Lateral Projection (Mediolateral)

    • The patient should turn toward the affected side
    • Flex the knee between 20-30 degrees to relax the muscles and show the maximum volume of the joint cavity.
    • The central ray is directed 5 - 7 degrees cephalad.

    AP Oblique Internal Rotation

    • Rotate the leg 45 degrees internally.

    AP Weight Bearing (AHLBACK)

    • This projection is used to assess Degenerative Joint Disease (DJD), knee joint spaces, varus and valgus deformity and narrowing of the joint space.

    AP Oblique Lateral Rotation

    • Rotate the leg 45 degrees externally.

    PA Projection

    • Rotate the heel 5-10 degrees laterally.
    • The CR is directed to the midpopliteal depression.

    PA Oblique - Medial & Lateral Rotation

    • Rotate the knee 45-55 degrees.

    Lateral Projection

    • Flex the knee no more than 10 degrees to prevent fragment separation in new or unhealed patellar fractures.
    • Demonstrates the patella, patellofemoral joint, and tibiofemoral joint.

    PA Axial Oblique Projection (Kuchendorf Method)

    • The patient should be prone.
    • Rotate the knee laterally so the patella and medial condyle both rest on the table (35-40 degrees).
    • Flex the knee by 10 degrees to relax the muscles.
    • The central ray is directed 25-30 degrees towards the patella.
    • This projection demonstrates most of the patella free of superimposition.

    Tangential Projection (Hughston Method)

    • Also known as Tangential Projection (Merchant Method).
    • The patient should be prone with the leg elevated resting on the tube.
    • Flex the knee 50-60 degrees.
    • The central ray is directed 45 degrees.
    • This projection demonstrates the patellofemoral joint and patellar subluxation and femoral condyles.

    Tangential Projection (Merchant Method)

    • Also known as Mountain View.
    • The patient can be sitting or supine with the knee flexed 40 degrees.
    • The central ray is directed 30 degrees from horizontal.
    • This projection demonstrates patello femoral disorders, patellar subluxation and uses an axial viewer device.

    Tangential Projection (Settegast Method)

    • The patient should be prone.
    • Flex the knee to place the femur at an angle of 45 degrees.
    • The central ray is perpendicular to the leg/CR 10 degrees.

    PA Proj, Weight Bearing (Rosenberg )

    • This projection demonstrates the intercondyloid fossa.

    PA Axial Projection (Camp-Coventry Method)

    • The patient should be prone with the knee flexed 40-50 degrees.
    • The central ray is perpendicular to the long axis of the leg entering the popliteal.
    • This projection demonstrates the knee joint space and reveals loose bodies within the joint.

    PA Axial Projection (Holmblad Method)

    • This projection demonstrates the intercondylar fossa.
    • There are 3 positions:
      • Standing with the knee resting on a stool.
      • Standing with the knee on a vertically placed cassette.
      • Kneeling.
    • The femur should be 70 degrees to the long axis of the leg.
    • The central ray is perpendicular to the long axis of the leg entering the popliteal.

    AP Axial Projection (Beclere Method)

    • The patient is supine with the image receptor under the popliteal.
    • The knee is flexed so the femur forms 60 degrees to the long axis of the leg.
    • The central ray is perpendicular to the long axis of the leg entering the knee.

    PATELLA

    • The patella is the knee cap and the biggest sesamoid bone.

    Shoulder AP Neutral

    • Hand rotated internally
    • Palm of the hand against the hip
    • Epicondyles should be perpendicular to IR
    • Epicondylar plane is 45 degrees to the plane of the film
    • Humerus in true lateral
    • To demonstrate lesser tuberosity
    • Greater tubercle partially superimposes the humeral head

    Shoulder Transthoracic Lateral Projection (Lawrence Method)

    • External rotation - insertion site of supraspinatus tendon
    • Neutral rotation - profiles small calcific deposit
    • Internal rotation - insertion site of subscapularis tendon

    Shoulder Inferosuperior Axial / Lawrence

    • Supine
    • Abduct the arm 90 degrees
    • Arm external rotation
    • CR: horizontally through the axilla to the AC jt. of 15 degrees

    Shoulder Inferosuperior Axial Proj.(Rafert Mod)

    • Exaggerated external rotation, thumb pointing downward & posteriorly 45 degrees
    • Best for hill sachs
    • CR same but medial angulation

    Shoulder Inferosuperior Axial Projection / West point

    • Reduce magnification & improve recorded detail
    • CR ┴ to the midshaft
    • SS: entire clavicle with slight superimposition

    Shoulder AP Axial Projection

    • Lordotic position
    • 0-15 degrees if upright
    • 15- 30 degrees if supine
    • Exact axial image of the clavicle is seen

    Shoulder Tangential

    • Supine
    • IR supported to stand slantedly touching the affected shoulder
    • CR: passing bet.Clavicle and chest wall ┴ to IR
    • 25-40 degrees from the horizontal
    • Note: add 15-25 degrees laterally If medial third is in question

    Shoulder PA Axial Projection

    • Prone
    • 15-30 deg. to the supraclavicular region

    Shoulder Tangential Projection (Tarrant)

    • Useful in pt. who have multiple injuries and can’t assume the lordotic or recumbent
    • CR: 25-35 degrees Anterior & inferior midclavicle

    Scapula Procedures

    • AP Projection
    • Lateral Projection(RAO/LAO)
    • PA Oblique Projection (RAO/LAO) (Lorenz and Lilienfield Method)

    Scapula Lateral Projection

    • (RAO/LAO) affected side in contact
    • SS: posterior articulation

    Ankle Procedures

    • Malleolus
    • AP
    • Oblique
    • Mortise View

    Malleolus

    • Plantar surface at right angle to IR
    • Rotate the leg and foot medially 45 degrees

    Ankle AP

    • Plantar surface vertically positioned
    • CR: ⊥ to ankle joint to a point midway between malleoli
    • SS: distal tib.fib.and proximal talus

    Ankle Oblique

    • AP Projection
    • Femorotibial jt
    • Patellofemoral jt

    Ankle Mortise View

    • Plantar surface vertically positioned
    • Rotate 3-5 degrees internally until the interepicondylar line is parallel to IR
    • ½“ below the apex of the patella
    • 5-7 degrees
    • SS: distal femur, proximal leg

    Knee Radiographic Positioning Procedures

    • AP
    • Lateral
    • AP Oblique Internal Rotation
    • AP Oblique Lateral Rotation
    • AP Weight Bearing (AHLBACK)
    • PA Proj, weight bearing (Rosenberg)
    • Intercondyloid Fossa
    • PA Axial Projection (Camp-Coventry Method)
    • AP Axial Projection (Beclere Method)
    • Patella

    Knee AP

    • Plantar surface vertically positioned
    • CR: ⊥ to ankle joint to a point midway between malleoli
    • SS: distal tib.fib.and proximal talus

    Knee Lateral

    • Turn toward the affected side
    • Flexion 20-30 degrees relaxes the muscle and show the maximum volume of the joint cavity
    • CR 5-7 degrees cephalad

    Knee AP Oblique Internal Rotation

    • Rotate the leg 45 degrees internally

    Knee AP Oblique Lateral Rotation

    • Rotate the leg 45 degrees externally

    ** Knee AP Weight Bearing (AHLBACK)**

    • DJD, knee joint spaces, varus and valgus deformity
    • Narrowing of the joints space

    Knee PA Proj, weight bearing (Rosenberg)

    • Flex knee to place the femur at angle of 45 degrees
    • dCR:⊥ to leg/CR 100 degrees

    Knee Intercondyloid Fossa

    • PA Axial Projection (Camp-Coventry Method)
    • Intercondyloid fossa
    • Prone
    • Flex knee 40-50 degrees
    • CR: ⊥ to long axis of leg entering popliteal
    • To demonstrate the knee joint space and reveal a LOOSE BODY within the joint
    • Femur must be 70 degrees to the long axis of leg

    Knee AP Axial Projection (Beclere Method)

    • Supine, IR under popliteal
    • Knee is flexed so that femur forms 60 degrees to the long axis of leg
    • CR: ⊥ to long axis of Leg entering knee

    Knee Patella

    • Knee cap
    • Biggest sesamoid bone

    Talocalcaneal Joint

    • Isherwood method
    • Lateromedial Oblique Projection (Medial Rotation Foot)
    • AP Axial Oblique Proj.(Medial Rotation Ankle)
    • AP Axial Oblique Proj.(Lateral Rotation Ankle)

    Talocalcaneal Joint Isherwood method

    • Method used to demons. 3 articulation of the talocalcaneal joint separately

    Talocalcaneal Joint Lateromedial Oblique Projection (Medial Rotation Foot)

    • Plantar flat on IR, then rotate 45 degrees medially
    • CR: ⊥ 1 DA to the lateral malleolus
    • SS: anterior subtalar joint

    Talocalcaneal Joint AP Axial Oblique Proj.(Medial Rotation Ankle)

    • From plantar right angle to IR, rotate 30 degrees medially
    • CR: 100 1 DA to lateral malleolus
    • SS: middle subtalar joint

    Talocalcaneal Joint AP Axial Oblique Proj.(Lateral Rotation Ankle)

    • From plantar right angle to IR, rotate 30 degrees laterally
    • CR: 100 1 D to medial malleolus
    • SS: posterior subtalar joint

    ASIS to Tabletop PA Projection

    • CR: 50 caudad
    • Because tibia & fibula are slightly inclined, CR will be parallel to tibial plateau

    AP Oblique (Lateral Rotation)

    • Used for trauma patients
    • Similar to elbow lateral but hands in prone position
    • For radial head:
      • Flex elbow 90 degrees
      • Rotate 45 degrees toward the shoulder
    • For coronoid process:
      • Flex elbow 80 degrees
      • Rotate 45 degrees away from the shoulder

    AP Partial Flexion (distal humerus)

    • Used for trauma patients
    • Perpendicular to the humerus, traversing the elbow joint

    AP Partial Flexion (Proximal Forearm)

    • Center ray perpendicular to the forearm

    AP Acute Flexion (Jones Method)

    • Used for trauma patients
    • Two inches superior or distal to the olecranon process

    Lateral Projection (Lateromedial Rotation)

    • Four position series
    • Flex elbow 90 degrees
    • Supinate hand and rotate externally
    • Place hand in true lateral position (Thumbs up)
    • Pronate hand
    • Rotate hand internally(Thumbs down)

    PA Axial Projection (distal humerus)

    • Rest elbow on image receptor with supinated forearm
    • Flex elbow 75 degrees
    • Center ray perpendicular to the midshaft

    PA Axial Projection (olecranon process)

    • Flex elbow 45-50 degrees
    • Center ray perpendicular to the olecranon process
    • Lordotic positioning
      • 0-15 degrees if upright
      • 15-30 degrees if supine
    • Exact axial image of the clavicle is seen

    Tangential Projection

    • Supine position
    • Image receptor supported to stand slantingly touching the affected shoulder
    • Center ray passing between the clavicle and chest wall perpendicular to the image receptor
    • 25-40 degrees from the horizontal
    • Add 15-25 degrees laterally if the medial third is in question

    PA Axial Projection

    • Prone position
    • 15-30 degrees to the supraclavicular region
    • Center ray perpendicular to the image receptor

    Tangential Projection (Tarrant)

    • Useful for patients with multiple injuries
    • Center ray 25-35 degrees anterior and inferior to the midclavicle

    Bony Structure

    • Plantar surface vertically positioned
    • Rotate leg and foot 45 degrees medially
    • Center ray perpendicular midway between the malleoli

    Lateral Projection (RAO/LAO)

    • Affected side in contact with the image receptor
    • Rotate leg and foot 15-20 degrees medially
    • Center ray perpendicular to the ankle joint

    Lateral (mediolateral)

    • Center ray perpendicular to the ankle joint entering the medial malleolus
    • Articulation (joint space) between the talus and fibula is not demonstrated

    AP stressed studies

    • Used to evaluate the joint separation and ligament tear or rupture

    Leg

    • Tibia: shin bone (anterior crest or border)
    • Fibula: calf bone

    AP Projection (Leg)

    • Center ray perpendicular to the midshaft

    Lateral Projection (Leg)

    • Center ray perpendicular to the midshaft

    AP Oblique (knee)

    • Medial rotation: 45 degrees
      • Opens the proximal tibiofibular joint
    • Lateral rotation: 45 degrees
      • Superimposes the tibia and fibula
    • Center ray perpendicular to the midshaft

    Knee joint

    • Flex knee to place the femur at an angle of 45 degrees
    • Center ray perpendicular to the leg/ 10 degrees

    PA Projection, weight bearing (Rosenberg)

    • Center ray 10 degrees

    PA Axial Projection (Holmblad Method)

    • Intercondylar fossa
    • Three positions:
      • Standing, knee resting on a stool
      • Standing, knee on a vertically placed cassette
      • Kneeling
    • Femur must be 70 degrees to the long axis of the leg
    • Center ray perpendicular to the long axis of the leg entering the popliteal

    PA Axial Projection (Camp-Coventry Method)

    • Intercondyloid Fossa
    • Prone positioning
    • Flex knee 40-50 degrees
    • Center ray perpendicular to the long axis of the leg entering the popliteal
    • Demonstrates the knee joint space and reveals loose bodies within the joint.

    AP Axial Projection (Beclere Method)

    • Supine positioning, with image receptor under the popliteal
    • Flex knee so that the femur forms 60 degrees to the long axis of the leg
    • Center ray perpendicular to the long axis of the leg entering the knee

    Patella

    • Kneecap
    • Biggest sesamoid bone

    PA Projection (Patella)

    • Heel rotated 5-10 degrees laterally
    • Mid-popliteal depression

    Lateral Projection (Patella)

    • Flex knee no more than 10 degrees
    • Demonstrates the patella, patellofemoral joint and tibio-femoral joint

    PA Axial Oblique Projection (Kuchendorf Method)

    • Prone positioning
    • Rotate the knee laterally so that the patella and medial condyle rest on the table
    • Flex knee 10 degrees to relax the muscle
    • Center ray 25-30 degrees on the patella

    Tangential Projection (Hughston Method)

    • Also known as Tangential Projection (Merchant Method)
    • Prone positioning
    • Leg elevated resting on the tube
    • Flex the knee 50-60 degrees
    • Center ray 45 degrees
    • Demonstrates the patellofemoral joint
    • Demonstrates patellar subluxation and femoral condyles

    Tangential Projection (Settegast Method)

    • Prone positioning

    Tangential Projection (Merchant Method)

    • Also known as Mountain view
    • Sitting or supine positions
    • Flex knee 40 degrees
    • Center ray 30 degrees from the horizontal
    • Demonstrates the patellofemoral disorders
    • Uses Axial viewer device.

    PA Oblique (Medial and Lateral Rotation)

    • Rotate the knee 45-55 degrees
    • Demonstrates most of the patella free of superimposition

    PA Oblique

    • Demonstrates the lateral and medial aspects of the carpal bones
    • Utilizes positioning to create an oblique angle with the X-ray beam
    • Lateral side view: Trapezium and Scaphoid
    • Medial side view: Entire pisiform, Triquetrum, and Hamate

    Scaphoid Series (Rafert-Long Method)

    • Ulnar deviation with four shots
    • PA Axial (Stecher)
      • Cassette inclined
      • CR angulation 0-10-20-30 deg toward elbow
      • Clenched fist
      • Prevents self-superimposition

    Carpal Canal - Gaynor-Hart

    • Tangential projection (inferosuperior)
    • Hyper-extend the wrist
    • CR directed 25-30 deg along the long axis of the hand
    • Demonstrates fractures of the hamate’s hamulus
    • Rules out abnormal calcification in the carpal sulcus
    • Detects carpal tunnel syndrome

    Carpal Bridge Projection - Tangential

    • Also known as the Lentino method
    • Utilizes tangential projection, particularly useful for:
      • Fractures of the scaphoid
      • Lunate dislocation
      • Calcification and foreign bodies
      • Chip fractures in the dorsal aspect of carpals
    • CR directed 45 deg caudally to the wrist

    Clements Nakayama Method

    • PA Oblique with Ulnar Flexion
    • CR directed 45 degrees distally
    • Demonstrates the trapezium and its articulations
    • If ulnar flexion is impossible, deviate the long axis of the hand 20 degrees away from the CR's axis

    Forearm Radiography

    • Two standard views:
      • AP
      • Lateral
    • True AP view superimposes the radial head, neck, and tuberosity over the ulna

    Elbow Radiography

    • Standard views:
      • AP
      • Lateral
      • AP Oblique (Medial Rotation)
      • AP Oblique (Lateral Rotation)
      • AP Partial Flexion (proximal forearm and distal humerus)
      • AP Acute Flexion/Jones method
      • Lateral (Lateromedial rot.) Radial Head
      • Coyle method (coronoid and radial head)

    Shoulder Radiography

    • AP
      • Lean laterally to reduce strain
      • True AP view superimposes the radial head, neck, and tuberosity over the ulna
    • Lateral
      • Griswold technique: Elbow flexed at 90 degrees
        • Demonstrates the lateral epicondyles
        • Demonstrates the olecranon process
        • Demonstrates the fat pads, signifying soft tissue injury
    • AP Oblique (Medial Rotation)
      • Hand pronated
      • Demonstrates the coronoid process and elbow joint
      • AP Neutral
      • Palm of the hand against the hip
      • Epicondylar plane is 45 degrees to the plane of the film
      • Greater tubercle partially superimposes the humeral head
    • Coyle Method - Axial Lateromedial Projection
      • Hand rotated internally
      • Epicondyles perpendicular to the Image Receptor
      • Humerus placed in true lateral position
      • Demonstrates the lesser tuberosity
    • Transthoracic Lateral Projection (Lawrence Method)
      • CR 1 inch inferior to coracoid process
      • External rotation: Demonstrates insertion site of the supraspinatus tendon
      • Neutral rotation: Profiles small calcific deposits
      • Internal rotation: Demonstrates insertion site of the subscapularis tendon

    Shoulder - Inferosuperior Axial Projections

    • Inferosuperior Axial / Lawrence - Patient supine - Arm abducted 90 degrees - Arm externally rotated - CR directed horizontally through the axilla to the AC joint at 15 degrees
      • Inferosuperior Axial Proj.(Rafert Mod)
        • Exaggerated external rotation
        • Thumb pointing downwards and posteroinferiorly at 45 degrees
        • Best view for Hill-Sachs lesions
        • CR directed medially

    Shoulder - Additional Views

    • Inferosuperior Axial Projection / West point
    • Subacromial & subcoracoid dislocation
    • Neer Method - Tangential Projection

    Supraspinatus Outlet

    • RAO/LAO
      • Affected side in contact with IR
      • Body rotated 45-60 degrees
      • CR 10-15 degrees caudally passing superior margin of humeral head
    • SS: coracoacromial arch demonstrating the supraspinatus outlet region

    Blacket-Healy Method

    • Tangential projection (Fisk Method)
      • Standing
      • Elbow flexed
      • Cassette placed over the supinated forearm
      • Lean forward to place the humerus 10-15 degrees from vertical
      • CR is perpendicular to the head of the humerus
    • Teres minor insertion (PA projection)
      • Prone
      • Elbow flexed
      • Forearm resting on back
      • CR perpendicular to the head of the humerus

    Glenoid Cavity

    • Subscapularis Insertion (AP projection)
      • Two exposures (without and with weights)
      • Equal weights (5-8 lbs)
      • Demonstrates dislocation/separation of joints

    Glenoid Cavity - Axial Projection

    • AP Oblique Proj.(Alexander Method)
      • Affected side in contact with IR
      • Body rotated 45-60 degrees
      • Arm across chest
      • CR directed 15 degrees superiorly to the coracoid process
    • AP Axial Projection (Alexander Method)
      • 15 degrees superiorly to the coracoid process
      • AC joint projected superiorly

    Clavicle and Collarbone Radiography

    • Standard views include:
      • AP Projection
      • PA Projection
      • AP Axial (Tangential Projection)
      • PA Axial Projection
      • Tangential (Tarrant)

    Clavicle - Additional Views

    • AP Projection
      • Used to prevent additional injury
      • CR: Midshaft

    Hand - PA Oblique

    • Demonstrates lateral and medial carpal bones
    • Lateral side includes the trapezium and scaphoid
    • Medial side includes the entire pisiform, triquetrum, and hamate

    Scaphoid series (Rafert-Long Method)

    • Ulnar Deviation with four shots
    • CR: 0, 10, 20 and 30 degrees towards the elbow
    • Cassette is always inclined
    • Clenched fist
    • Used to prevent self-superimposition

    Hand - PA Axial (Stecher)

    • Clenched fist
    • CR angulation
    • Cassette inclined
    • Used to prevent self-superimposition

    Hand - Gaynor-Hart (Carpal Canal)

    • Tangential projection (inferosuperior)
    • Wrist is hyperextended
    • 250-300 long axis of the hand
    • Best view to demonstrate fx of the hamate’s hamulus
    • Rule out abnormal calcification
    • Carpal tunnel syndrome
    • CR: 45 degrees caudally to the wrist

    Hand - Tangential Projection (Carpal Bridge)

    • Also known as the Lentino method
    • Demonstrates fractures of the scaphoid
    • Demonstrates lunate dislocation
    • Demonstrates calcification and foreign bodies
    • Demonstrates chip fractures in the dorsal aspect of the carpals

    Hand - Clements Nakayama Method

    • PA Oblique with Ulnar Flexion
    • CR: 45 degrees distally
    • Demonstrates trapezium and its articulations

    Forearm (Antebrachium)

    • Hand rotated internally
    • Epicondyles are perpendicular to IR
    • Humerus in true lateral
    • Demonstrates lesser tuberosity
    • Greater tubercle partially superimposes the humeral head
    • Palm of the hand against the hip

    Shoulder - AP Neutral

    • Epicondylar plane is 45 degrees to the plane of the film
    • CR: 1 inch inferior to the coracoid process, enter 1 inch inferior and medial to the coracoid process
    • External rotation demonstrates insertion site of supraspinatus tendon
    • Neutral rotation demonstrates the profile of small calcific deposits
    • Internal rotation demonstrates insertion site of subscapularis tendon

    Shoulder - Transthoracic Lateral Projection (Lawrence Method)

    • Demonstrates the insertion site of the supraspinatus, infraspinatus and teres minor tendons
    • Demonstrates the insertion site of the subscapularis tendon

    Shoulder - Inferosuperior Axial (Lawrence Method)

    • Supine
    • Arm abducted 90 degrees
    • Arm externally rotated
    • CR: Horizontally through the axilla to the AC joint with 15 degrees cephalic angulation
    • Best view to demonstrate a Hill-Sach lesion

    Shoulder - Inferosuperior Axial Projection (Rafert Mod)

    • Exaggerated external rotation, thumb pointing downwards and posteriorly 45 degrees
    • CR is same as Lawrence Method with medial 15 degree angulation
    • Best for Hill-Sach lesion

    Shoulder - Inferosuperior Axial Projection (West Point)

    • Supine
    • Arm is slightly abducted
    • Forearm is internally rotated
    • Dorsum touches the hip
    • CR perpendicular to the shoulder joint, entering the coracoid process

    Shoulder - Grashey Method

    • Rotate the patients body 35 to 45 degrees towards the affected side (when standing)
    • Scapula parallel to the IR
    • Abduct the arm slightly using internal rotation
    • Palm of the hand is placed in the abdomen
    • CR: Perpendicular to the shoulder joint, entering the coracoid process

    Shoulder - AP Oblique Projection (Apple Method)

    • Similar to the Grashey method
    • Weighted abduction
    • Demonstrates loss of articular cartilage in the shoulder joint

    Shoulder - AP Axial Oblique (Garth Method)

    • For acute shoulder trauma
    • Demonstrates posterior dislocation of shoulder
    • Demonstrates Hill-Sach defect
    • Apical view
    • Rotate body 45 degrees towards affected side
    • Flex the elbow and place the arm across the chest
    • CR: 45 degrees to the shoulder joint

    AC Joint - Bilateral AP Projection (Pearson Method)

    • Two exposures without weights and with weights
    • Equal weights (5-8 pounds)
    • Demonstrates dislocation or separation of AC joint
    • Weights make shoulder muscle contract

    AC Joint - AP Axial Projection (Alexander Method)

    • 15 degrees cephalic to the coracoid process
    • AC joint projected superiorly

    AC Joint - PA Axial Oblique Projection (RAO/LAO) (Alexander Method)

    • Affected side in contact
    • Body rotated 45-60 degrees
    • Arm across chest
    • 15 degrees cephalic to the AC joint

    Clavicle / Collar Bone

    • AP projection
    • PA projection
    • AP Axial (Tangential Projection)
    • PA Axial Projection
    • Tangential (Tarrant)

    Clavicle - AP Projection

    • Used to prevent further injury
    • CR: Midshaft of clavicle

    Clavicle - PA Projection

    • Flex the knee and position femur at a 45 degree angle
    • CR perpendicular to leg or 10 degrees cephalic

    Clavicle - PA Projection, Weight Bearing (Rosenberg)

    • Used to assess stability of the clavicle with weight bearing

    Intercondyloid Fossa

    • PA Axial Projection (Camp-Coventry Method)
    • Prone, knee flexed 40-50 degrees
    • Demonstrates the knee joint space and loose bodies
    • CR: Perpendicular to the long axis of the leg, entering the popliteal

    Intercondyloid Fossa - PA Axial Projection (Holmblad method)

    • Demonstrates the intercondyloid fossa
    • Three positions with femur in contact with the table:
      • Standing, knee resting on a stool
      • Standing, knee on a vertically placed cassette
      • Kneeling
    • Femur must be 70 degrees to the long axis of the leg
    • CR: Perpendicular to the long axis of the leg, entering the popliteal fossa

    Intercondyloid Fossa - AP Axial Projection (Beclere Method)

    • Supine, IR under the popliteal
    • Knee is flexed
    • Femur forms 60 degrees to the long axis of the leg
    • CR: Perpendicular to the long axis of the leg, entering the knee

    Patella

    • Knee cap
    • Largest sesamoid bone.

    Elbow Positioning

    • AP
      • Lean the patient laterally for less strain
      • True AP makes the radial head, neck and tuberosity superimposed over the ulna
    • Lateral
      • Griswold 90 degrees flexion
      • Lateral epicondyles
      • Demonstrates the olecranon process, fat pads

    Elbow Positions

    • AP Oblique (Medial Rotation)
      • Hand pronated
      • Demonstrates the coronoid process and elbow joint
    • AP Oblique (Lateral Rotation)
      • Hand supinated
      • Demonstrates the radial head and elbow joint
    • AP Partial Flexion
      • Demonstrates the proximal forearm and distal humerus
    • AP Acute Flexion (Jones method)
      • Demonstrates the olecranon process in a true AP
    • Lateral (Lateromedial Rot.) Radial Head
      • Demonstrates the radial head, coronoid process with minimal superimposition of the ulna
    • Coyle Method
      • Axial lateromedial
      • Patient lies laterally on the unaffected side
      • Affected arm is abducted at 90 degrees pointing to the ceiling with the forearm horizontal and the CR 5-150 medially
      • Demonstrates the coronoid process and radial head

    Additional Elbow Positions

    • Inferosuperior Axial Projection
      • Patient prone with arm abducted at 90 degrees and hanging downwards pointing the CR 25 AM towards the elbow
      • Demonstrates the articulation of the proximal and distal humerus
    • Superoinferior Axial Projection
      • Extend the shoulder and flex the elbow at 90 degrees
      • CR 5-150 towards the elbow
      • Demonstrates the relationship of the proximal end of the humerus and the glenoid cavity

    Clavicle Positioning

    • AP Projection
      • CR perpendicular to the midshaft
      • Demonstrates the entire clavicle with slight superimposition
    • **AP Axial Projection “Stryker Notch Method” **
      • Patient in lordotic position
      • 0-15 degrees for upright and 15-30 degrees for supine
      • Flex and abduct the arm forwardly beyond 90 degrees and place the hand on top of the head
      • Demonstrates the exact axial image of the clavicle
      • Useful in identifying the cause of shoulder dislocation
    • PA Axial Projection
      • Patient prone and 15-30 degrees to the supraclavicular region
      • CR 25-400 from horizontal
      • Demonstrates the entire clavicle
    • Tangential Projection
      • Patient supine
      • IR is supported to stand slantedly touching the affected shoulder
      • CR passing between the clavicle and chest wall perpendicular to the IR
      • 25-400 from the horizontal
      • Add 15-250 laterally if the medial third is in question

    Scapula Positioning

    • AP Projection
      • Demonstrates the scapula
    • Lateral Projection (RAO and LAO)
      • Affected side in contact with the IR
      • Heel rotated 5-100 laterally
      • Midpopliteal depression
      • Demonstrates the scapula
    • PA Oblique Projection (RAO and LAO)
      • Demonstrates the scapula - Lorenz and Lilienfield method

    Knee Positioning

    • AP Projection
      • No rotation for distal femur
      • 10-150 internal rotation for proximal femur
      • Demonstrates the entire femur
    • Lateral Projection
      • For distal femur, patient lateral with affected side on the IR and draw the unaffected thigh forward
      • For proximal femur, patient supine with body rotated towards affected side and pelvis adjusted 10-150 posteriorly to prevent superimposition
      • Flex affected knee 45 degrees
      • Demonstrates the femur
    • PA Axial Oblique Projection (Kuchendorf Method)
      • Patient prone
      • Rotate the knee laterally so that the patella and medial condyle rest on the table (35-400)
      • Flex knee by 10 degrees
      • CR 25-300 patella
      • Demonstrates the patella without superimposition
    • Tangential Projection (Hughston Method)
      • Patient prone
      • Leg elevated resting on the tube and knee flexed 50-60 degrees
      • CR 45 degrees
      • Demonstrates the patellofemoral joint
      • Demonstrates patellar subluxation and femoral condyles
    • Tangential Projection (Merchant Method)
      • Patient sitting or supine
      • Flex knee 40 degrees
      • CR 30 degrees from horizontal
      • Demonstrates the patellofemoral joint
      • Demonstrates patellofemoral disorders
    • Tangential Projection (Settegast Method)
      • Patient prone
      • Acute flexion (greater than 90 degrees)
      • CR perpendicular to the joint space and 15-20 degrees cephalad
      • Demonstrates vertical fractures
    • Settegast Method (Inferosuperior)
      • Patient sitting or supine
      • Flex knee 40-45 degrees
      • CR 10-15 degrees from the lower leg
      • Demonstrates the patellofemoral joint

    Pelvis Positioning

    • AP Projection
      • Demonstrates the entire pelvis

    Pelvis Shapes

    • Android
    • Gynecoid
    • Platypelloid
    • Anthrapoid
    • Iliac crest:*
    • Android: Wider flair
    • Gynecoid: Narrower
    • Coccyx:*
    • Android: More straight
    • Gynecoid: More curved
    • Pubic arch:*
    • Android: Greater than 90 degrees
    • Gynecoid: Less than 90 degrees

    Pelvis Measurements

    • Iliopectineal line:
      • Male: 8.5-11.5 cm
      • Female: 8-10.5 cm
    • Bischop's line:
      • Male: 6-8 cm
      • Female: 5.5-7 cm
    • Baudelocque's diameter:
      • Male: 18-20 cm
      • Female: 18-19 cm
    • Sacral promontory to symphysis pubis:
      • Male: 10-12 cm
      • Female: 10-11 cm
    • Lateral diameter:
      • Male: 12-14 cm
      • Female: 10-13 cm
    • True conjugate:
      • Male: 11-13 cm
      • Female: 11-12.5 cm
    • Obstetric conjugate:
      • Male: 9-11 cm
      • Female: 9-11 cm
    • Diagonal conjugate:
      • Male: 11.5-13 cm
      • Female: 11.5-13 cm

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    Related Documents

    Radiographic Positioning PDF

    Description

    Test your knowledge on various knee imaging techniques including AP projection, PA projection, and lateral projection. This quiz covers the positioning, central ray directions, and specific angles necessary for effective imaging of the knee joint. Perfect for students in medical imaging or radiography courses.

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