Knee Intercondylar Fossa Projections Quiz
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Questions and Answers

What are the basic projections of the knee (intercondylar fossa)?

  • Lateral view
  • Oblique projection
  • PA axial...camp coventry method (correct)
  • AP axial...beclere method

    • What are the special projections of the knee (intercondylar fossa)?

  • Lateral view
  • PA axial...camp coventry method
  • AP axial...beclere method (correct)
  • Oblique projection

    • Intercondylar fossa, femoral condyles, tibial plateaus, and intercondylar eminence should be demonstrated and are part of the?

    clinical indications

    Evidence of bony or cartilaginous pathology, osteochondral defects or narrowing of the joint space should be seen and are part of the?

    <p>clinical indications</p> Signup and view all the answers

    What are the loose bodies in the knee joint called?

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

    What is the minimum SID (source to image distance)?

    <p>40</p> Signup and view all the answers

    What is the IR size used?

    <p>8 x 10</p> Signup and view all the answers

    What is the KV range for the knee imaging?

    <p>70 to 85</p> Signup and view all the answers

    The IR should be oriented lengthwise for knee imaging.

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

    What tissues should be shielded during knee imaging?

    <p>radiosensitive tissues</p> Signup and view all the answers

    Recommended collimation should cover?

    <p>all 4 sides to knee joint</p> Signup and view all the answers

    How is the patient positioned for the Camp Coventry method?

    <p>prone with no rotation</p> Signup and view all the answers

    How is the knee positioned for the Camp Coventry?

    <p>Flex the knee 40 to 50 degrees resting foot on a suitable device</p> Signup and view all the answers

    Center the IR to the _____

    <p>knee joint considering CR angle</p> Signup and view all the answers

    CR is _____

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

    CR is perpendicular to the _____ (popliteal depression)

    <p>long axis of lower leg and centered to knee joint</p> Signup and view all the answers

    Tube is angled _____, when the knee is flexed 40 degrees.

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

    Tube is angled _____, when the knee is flexed 50 degrees.

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

    The PA axial is also known as?

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

    The PA axial was first described _____

    <p>by Holmblad in 1937</p> Signup and view all the answers

    The patient assumes a kneeling position on the radiographic table, which describes the?

    <p>tunnel aka PA axial</p> Signup and view all the answers

    In _____, the Holmblad method was modified so that if the patient's condition is allowed, a standing position could be used.

    <p>1983</p> Signup and view all the answers

    For the Holmblad method, the CR is?

    <p>perpendicular to IR and lower leg</p> Signup and view all the answers

    Where is the CR directed for the Holmblad method?

    <p>midpopliteal crease</p> Signup and view all the answers

    What anatomy should be demonstrated with both the Camp Coventry and the Holmblad method?

    <p>intercondylar fossa, tibial plateaus (articular facets), knee joint space</p> Signup and view all the answers

    The intercondylar fossa should be _____ without _____

    <p>open without superimposition by patella</p> Signup and view all the answers

    Symmetric appearance of distal posterior femoral condyles are evidence of?

    <p>no rotation</p> Signup and view all the answers

    Superimposition of half of fibular head by tibia is evidence of?

    <p>no rotation</p> Signup and view all the answers

    Articular facets and intercondylar eminence well visualized without superimposition is evidence of?

    <p>no rotation</p> Signup and view all the answers

    How is the part positioned?

    <p>IR is placed against anterior surface of knee</p> Signup and view all the answers

    Where is the IR centered?

    <p>apex of patella</p> Signup and view all the answers

    From full extension, the knee is flexed _____ (Holmblad method)

    <p>60 to 70 degrees</p> Signup and view all the answers

    If the patient cannot flex the knee 60 to 70 degrees, what should they do (Holmblad method)?

    <p>lean forward 20 to 30 degrees</p> Signup and view all the answers

    How is the patient positioned for the Holmblad method?

    <p>kneeling on x-ray table or partially standing straddling x-ray tube or partially standing with affected leg on stool or chair</p> Signup and view all the answers

    How many positions can the patient be placed in for the Holmblad method?

    <p>3</p> Signup and view all the answers

    Optimal density is seen by?

    <p>soft tissue visualized and outline of patella through the femur</p> Signup and view all the answers

    No motion is seen by?

    <p>trabecular markings of femoral condyles and proximal tibia appear sharp and clear</p> Signup and view all the answers

    Why is the AP axial (Beclere method) not a preferred projection?

    <p>increase OID if curved cassette is not available and increase exposure to gonads</p> Signup and view all the answers

    Shielding for Beclere method?

    <p>place shield over pelvic area, extending to midfemur</p> Signup and view all the answers

    How is the patient positioned for the Beclere method?

    <p>supine with no rotation of leg with support for the partially flexed knee</p> Signup and view all the answers

    The knee is flexed _____ for the Beclere method.

    <p>40 to 45 degrees</p> Signup and view all the answers

    For the Beclere method, the IR is adjusted and centered to?

    <p>mid-knee joint area</p> Signup and view all the answers

    What is placed under the IR as needed to ensure it is firmly against posterior thigh?

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

    The CR for the Beclere method is?

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

    The CR is perpendicular to the lower leg _____ degrees for the Beclere method.

    <p>40 to 45 cephalad</p> Signup and view all the answers

    The CR is directed to a point _____

    <p>1 inch distal to apex of patella</p> Signup and view all the answers

    Collimation for the Beclere method?

    <p>4 sides of knee joint</p> Signup and view all the answers

    Symmetric appearance of distal posterior femoral condyles is evidence of?

    <p>no rotation</p> Signup and view all the answers

    Superimposition of half of fibular head by tibia is evidence of?

    <p>no rotation</p> Signup and view all the answers

    Articular facets and intercondylar eminence well visualized without superimposition are evidence of?

    <p>no rotation</p> Signup and view all the answers

    Study Notes

    Knee - Intercondylar Fossa Projections

    • Basic projections: PA axial (Camp Coventry method) and Holmblad method.
    • Special projection: AP axial (Beclere method).

    Clinical Indications

    • Visualize intercondylar fossa, femoral condyles, tibial plateaus, and intercondylar eminence.
    • Detect bony or cartilaginous pathology, osteochondrial defects, or joint space narrowing.

    Terminology

    • Loose bodies in knee joint referred to as "joint mice."
    • Minimum SID (Source-to-Image Distance) is 40 inches.
    • Image receptor (IR) size is 8 x 10 inches.

    Exposure Parameters

    • Kilovolt (KV) range for knee imaging is 70 to 85.
    • IR should be positioned lengthwise.
    • Shielding should cover radiosensitive tissues.
    • Recommended collimation includes all four sides of the knee joint.

    Positioning for Camp Coventry Method

    • Patient lies prone with no rotation.
    • Knee flexed 40 to 50 degrees, foot resting on a suitable device.
    • Center the IR to the knee joint, considering the central ray (CR) angle.
    • CR is perpendicular to the lower leg's long axis and centered to the knee joint.
    • Tube angle adjustments: 40 degrees when knee is 40 degrees flexed, 50 degrees when flexed at 50 degrees.

    History and Method Variations

    • PA axial projection also known as the tunnel view.
    • Holmblad method first described by Holmblad in 1937; modified in 1983 to allow a standing position if patient's condition permits.

    CR and Visualization

    • For Holmblad, CR is perpendicular to both IR and lower leg, directed at the midpopliteal crease.
    • Aim to demonstrate intercondylar fossa, tibial plateaus, and knee joint space without superimposition by the patella.

    Evidence of Proper Technique

    • Symmetric distal posterior femoral condyles indicate no rotation.
    • Superimposition of fibular head by tibia also confirms no rotation.
    • Clear visualization of articular facets and intercondylar eminence signifies accurate positioning.

    Optimal Imaging Conditions

    • IR placed against the anterior surface of the knee and centered at the apex of the patella.
    • For Holmblad method, knee flexed 60 to 70 degrees; if unable, patient should lean forward 20 to 30 degrees.
    • For both methods, a maximum of three patient positions are possible.

    Density and Clarity in Imaging

    • Optimal density demonstrates soft tissue and patella outline clearly.
    • No motion is indicated when trabecular markings are sharp and clear.

    Beclere Method Specifics

    • Not preferred due to increased object-to-image distance (OID) and potential exposure to gonads.
    • Shielding technique involves covering pelvic area to mid-femur.
    • Patient positioned supine with leg support during partial knee flexion of 40 to 45 degrees.
    • For Beclere method, CR is perpendicular at a 40 to 45-degree angle cephalad, directed 1 inch distal to the apex of the patella.

    Collimation and Visualization Evidence

    • Collimation for Beclere method should encompass all four sides of the knee joint.
    • Evidence of no rotation is again confirmed by symmetric appearance of distal femoral condyles, half of fibular head superimposition, and clear visibility of articular facets and intercondylar eminence.

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    Description

    Test your knowledge on the various projections of the knee, specifically focusing on the intercondylar fossa. This quiz covers both basic and special projection methods, including the Camp Coventry and Holmblad methods, as well as the Beclere method. Perfect for students learning radiographic techniques.

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