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Questions and Answers
What is the kVp setting recommended for an AP oblique projection of the elbow joint?
What is the kVp setting recommended for an AP oblique projection of the elbow joint?
What is the correct mAs for the lateral elbow projection?
What is the correct mAs for the lateral elbow projection?
Where should the central ray be directed for the lateral elbow projection?
Where should the central ray be directed for the lateral elbow projection?
What is the distance required for the lateral elbow projection?
What is the distance required for the lateral elbow projection?
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During the AP oblique elbow positioning, which structure should be slightly superimposed over the proximal ulna?
During the AP oblique elbow positioning, which structure should be slightly superimposed over the proximal ulna?
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What is the required collimation for both elbow projections?
What is the required collimation for both elbow projections?
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Which positioning aspect is crucial for the lateral elbow view?
Which positioning aspect is crucial for the lateral elbow view?
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What is the main purpose of removing artifacts in the field of view during the imaging process?
What is the main purpose of removing artifacts in the field of view during the imaging process?
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What is the central ray location for the lateral knee view?
What is the central ray location for the lateral knee view?
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What is the recommended kVp range for lateral knee imaging?
What is the recommended kVp range for lateral knee imaging?
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What should be the mAs setting for a lateral knee view?
What should be the mAs setting for a lateral knee view?
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In the intercondylar view, how should the tube be angled?
In the intercondylar view, how should the tube be angled?
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What is the distance recommended for knee imaging?
What is the distance recommended for knee imaging?
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What is the correct central ray position when performing an intercondylar view?
What is the correct central ray position when performing an intercondylar view?
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What anatomical structures should be included in the collimation for the lateral knee view?
What anatomical structures should be included in the collimation for the lateral knee view?
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What indicates the proper positioning of the femoral condyles in the lateral knee view?
What indicates the proper positioning of the femoral condyles in the lateral knee view?
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What is the central ray positioning for the AP Rosenberg view?
What is the central ray positioning for the AP Rosenberg view?
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What is the kVp setting recommended for the Horizontal Beam Lateral Knee view?
What is the kVp setting recommended for the Horizontal Beam Lateral Knee view?
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In the AP Rosenberg view, what range of mAs is recommended?
In the AP Rosenberg view, what range of mAs is recommended?
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What is the positioned angle of the tube for the Horizontal Beam Lateral Knee view?
What is the positioned angle of the tube for the Horizontal Beam Lateral Knee view?
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Which statement describes the collimation criteria for the PA Rosenberg view?
Which statement describes the collimation criteria for the PA Rosenberg view?
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What is the appropriate distance for both the AP Rosenberg and Horizontal Beam Lateral Knee views?
What is the appropriate distance for both the AP Rosenberg and Horizontal Beam Lateral Knee views?
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What should be included in the collimation for the Horizontal Beam Lateral view?
What should be included in the collimation for the Horizontal Beam Lateral view?
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In the PA Rosenberg criteria, what is noted about the tibial plateau alignment?
In the PA Rosenberg criteria, what is noted about the tibial plateau alignment?
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Study Notes
Lateral Knee View
- Positioning: Patient lies on their side with their knee flexed at 30 degrees. The unaffected leg can be positioned in front to provide stability.
- Tube Angle: 5-7 degrees cephalic angle
- Central Ray: Centered on the medial aspect of the knee joint, 2.5cm distal to the medial epicondyle of the femur.
- Distance: 100-110cm
- Collimation: Four sides of collimation should be visible to include the anatomy of interest.
- kVp: 60-70kVp
- mAs: 7-10mAs
- Grid: No grid is required.
- Instructions: The patient must hold still during the procedure.
- Notes: Remove any artifacts in the field of view, such as clothing.
Lateral Knee Criteria
- Collimation: Should include all required anatomy, including skin edges.
- Alignment: Both condyles of the femur should be superimposed. The patello-femoral joint space should be open, and the tibial plateau should be in profile.
- Anatomy: The distal femur, patella, and proximal tibia/fibula should be included.
- Density: The cortical outline and bony trabecular pattern should be adequately demonstrated.
- Contrast: Both soft tissues and bony interfaces should be visualized.
- Markers: Side marker should be evident.
- Identity: The image should have appropriate identification or be deliberately anonymized.
Intercondylar View
- Positioning: AP (seated) is preferred. The patient kneels on a stool or sits with their knee bent at 60 degrees.
- Tube Angle: Angled to be parallel to the tibial plateau, a cephalic angle is also required to match the tibial angle.
- Central Ray: Is angled cephalically to match the tibial angle.
- Distance: 100-110cm
- Collimation: Four sides of collimation should be visible to include the anatomy of interest
- kVp: 60-70kVp
- mAs: 7-10mAs
- Grid: No grid is required.
- Instructions: The patient must hold still during the procedure.
- Notes: Remove any artifacts in the field of view, such as clothing.
Intercondylar Criteria
- Collimation: Should include all required anatomy including skin edges.
- Alignment: Femoral condyles should be symmetrical.
AP (External) Oblique Elbow
- Collimation: Include all required anatomy, including skin edges.
- Alignment: The elbow joint should be open and centered to the central ray. The radial head, neck, and tuberosity should be slightly superimposed over the proximal ulna. No rotation of humeral epicondyles, the coronoid and olecranon fossae should be approximately equidistant to the epicondyles.
- Anatomy: An AP oblique projection of the elbow joint, distal arm, and proximal forearm with the radial head and neck free from superimposition.
- Density: The cortical outline and bony trabecular pattern should be adequately demonstrated.
- Contrast: Soft tissue and bony interfaces should be visualized.
- Markers: Side marker should be evident.
- Identity: The image should have appropriate identification or be deliberately anonymized.
Lateral Elbow
- Positioning: Seated with their arm bent at 90 degrees, the shoulder, elbow, and wrist should be in the same plane. Patient seated at the end of the xray table. The entire arm should be in the same plane to open the joint spaces. The hand/wrist should be lateral to superimpose the radius/ulna.
- Tube Angle: The tube should be straight.
- Central Ray: Perpendicular to the mid elbow joint.
- Distance: 100-110cm
- Collimation: Four sides of collimation should be visible to include the skin edges of the elbow including 5cm of the distal humerus and proximal forearm.
- kVp: 60kVp
- mAs: 5mAs
- Grid: No grid is required
- Instructions: The patient must hold still during the procedure.
- Notes: Remove any artifacts in the field of view, such as clothing.
Lateral Elbow Criteria
- Collimation: Should include all required anatomy including skin edges.
- Alignment: The olecranon process and trochlea notch should be in profile. Humeral epicondyles should be superimposed. The elbow should be flexed at 90 degrees. The radial head should be slightly superimposed on the coronoid process of the ulna.
- Anatomy: The proximal radius/ulna should be demonstrated, including the region of joint fat pads.
- Density: The cortical outline and bony trabecular pattern should be adequately demonstrated.
- Contrast: Soft tissues and bony interfaces should be visualized.
PA Rosenberg
- Collimation: Should include all required anatomy including skin edges.
- Alignment: No rotation of the femur or tibia. The tibial plateau should be in profile, meaning the anterior and posterior margins are superimposed.
- Anatomy: The distal femur, proximal tibia, and fibula should be demonstrated. The femoro-tibial joint spaces should be open and the intercondylar fossa should be visualized.
- Density: The cortical outline and bony trabecular pattern should be adequately demonstrated.
- Contrast: Soft tissues and bony interfaces should be visualized.
- Markers: Side marker should be evident. Label as "Wt Bearing Rosenberg".
- Identity: The image should have appropriate identification or be deliberately anonymized.
- Note: Typically requested to demonstrate osteoarthritis. Use clear instructions for the patient as this is an uncomfortable position. Be quick!
Horizontal Beam Lateral Knee View
- Positioning: The patient is supine on the bed with their knee extended. The image plate is resting between the patient’s knees.
- Tube Angle: The tube is angled perpendicular to the long axis of the knee. The central ray is typically angled about 5 degrees caudally.
- Central Ray: Enters at the distal portion of the lateral condyle. The aim is to superimpose the femoral condyles (the medial femoral condyle is larger than the lateral femoral condyle).
- Distance: 100-110cm
- Collimation: Four sides of collimation should be visible to include the anatomy of interest.
- kVp: 60
- mAs: 12mAs (dependant on the thickness of the knee)
- Grid: No grid is required.
Horizontal Beam Lateral Criteria
- Collimation: Should include all required anatomy including skin edges.
- Alignment: Femoral condyles should be superimposed. True lateral.
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Description
This quiz covers the detailed procedure for performing a lateral knee X-ray, including patient positioning and technical factors. It also evaluates the criteria for proper alignment and collimation necessary for capturing clear images of the knee anatomy.
