Radiology Techniques: Toe Projections
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What is the minimum SID required for lateral-mediolateral or lateromedial projections of the toes?

  • 40 inches (correct)
  • 30 inches
  • 60 inches
  • 50 inches

    • In which clinical indications would lateromedial projections be particularly useful?

  • Spinal disc herniation
  • Ligament tears in the knee
  • Rotator cuff injuries
  • Fractures of the phalanges of the toes (correct)

    • Where should the CR be directed for the first digit during the projection?

  • To the interphalangeal joint (correct)
  • To the metatarsophalangeal joint
  • To the distal phalanx
  • To the proximal interphalangeal joint

    • What adjustment is necessary for collimation during the examination?

    <p>Collimate closely on four sides to the affected digit</p> Signup and view all the answers

    What positioning adjustment should be made for the fourth and fifth digits?

    <p>Rotate the foot laterally</p> Signup and view all the answers

    What feature indicates optimal exposure in the radiographic images?

    <p>Sharp cortical margins of bone</p> Signup and view all the answers

    In evaluating the positioning of the digit, what should be aligned with the long axis of the image receptor?

    <p>The long axis of the digit</p> Signup and view all the answers

    What is the recommended kVp range for taking lateral-mediolateral or lateromedial projections of the toes?

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

    What is the minimum Source-Image Distance (SID) required for an AP projection of the foot?

    <p>40 inches (100 cm)</p> Signup and view all the answers

    Which part of the patient's position is NOT required for the AP projection of the foot?

    <p>Flex the opposite knee</p> Signup and view all the answers

    What angle should the Central Ray (CR) be directed for the AP projection of the foot?

    <p>10° posteriorly toward the heel</p> Signup and view all the answers

    Which of the following is a clinical indication for performing an AP projection of the foot?

    <p>Locating soft tissue effusions</p> Signup and view all the answers

    What is the recommended IR size for the AP projection of the foot?

    <p>10 x 12 inches (24 x 30 cm)</p> Signup and view all the answers

    Which criterion is essential for evaluating the AP projection of the foot?

    <p>Visibility of the intertarsal joint space</p> Signup and view all the answers

    What should be done for a high arch when performing the AP projection of the foot?

    <p>Increase the CR angle to 15°</p> Signup and view all the answers

    What is the primary purpose of shielding during the AP projection of the foot?

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

    What is the minimum SID recommended for an AP projection of the toes?

    <p>40 inches (100 cm)</p> Signup and view all the answers

    Which pathologies are specifically mentioned for the AP projection of toes?

    <p>Osteoarthritis and gouty arthritis</p> Signup and view all the answers

    How should the CR be angled for the AP projection of the toes?

    <p>10° to 15° toward the calcaneus</p> Signup and view all the answers

    What is the primary reason for using the tangential projection of the toes?

    <p>To evaluate the extent of injury to the sesamoid bones</p> Signup and view all the answers

    What should be included in the collimation for the AP projection of a toe?

    <p>Part of one digit on each side of the digit in question</p> Signup and view all the answers

    Which aspect is evaluated to ensure no rotation in the AP projection of the toes?

    <p>The shafts of the phalanges appearing equally concave on both sides</p> Signup and view all the answers

    What is the minimum required source-to-image distance (SID) for this projection?

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

    What is the recommended Image receptor (IR) size for the AP projection of the toes?

    <p>8 x 10 inches (18 x 24 cm)</p> Signup and view all the answers

    What patient position is recommended for the tangential projection?

    <p>Prone with a towel under the lower leg</p> Signup and view all the answers

    What should the evaluation criteria indicate about joint spaces in the AP projection?

    <p>IP and MTP joint spaces should be open</p> Signup and view all the answers

    Which of the following describes the correct angulation of the central ray (CR) for the tangential projection?

    <p>Perpendicular to the IR and directed tangentially to the posterior aspect of the MTP joint</p> Signup and view all the answers

    Why is close collimation important in digital radiography for the AP projection of the toes?

    <p>To prevent fogging from scatter radiation</p> Signup and view all the answers

    What angle should the plantar surface of the foot form relative to the vertical during positioning?

    <p>15° to 20°</p> Signup and view all the answers

    Which of the following should be visible in the evaluation criteria for the tangential projection?

    <p>Sesamoids free of superimposition</p> Signup and view all the answers

    What condition is noted regarding the pain experienced by the patient during positioning?

    <p>It is often uncomfortable and may be painful</p> Signup and view all the answers

    If a patient cannot tolerate the prone position, what alternative projection can be used?

    <p>Supine reverse projection</p> Signup and view all the answers

    What size should the imaging receptor (IR) be for the tangential projection?

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

    Which of the following factors should be ensured for optimal exposure during the tangential projection?

    <p>Optimal contrast and density with sharp bony margins</p> Signup and view all the answers

    What is the minimum source-to-image distance (SID) for an AP oblique projection of the toes?

    <p>40 inches (100 cm)</p> Signup and view all the answers

    Which digit requires medial rotation for optimal positioning in an AP oblique projection?

    <p>First digit</p> Signup and view all the answers

    What should be the alignment of the long axis of the digit in relation to the IR?

    <p>Aligned to the long axis of the IR</p> Signup and view all the answers

    Which of the following is NOT a clinical indication for an AP oblique projection of the toes?

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

    What is the recommended collimation for the AP oblique projection of the toes?

    <p>Include phalanges and a minimum of the distal half of metatarsals</p> Signup and view all the answers

    What angle is recommended for lateral rotation of the foot for the fourth and fifth digits?

    <p>30° to 45°</p> Signup and view all the answers

    Which of the following indicates that motion is present during the examination?

    <p>Blurry soft tissue details</p> Signup and view all the answers

    What should be used to prevent motion during the AP oblique projection?

    <p>A 45° radiolucent support under the elevated portion of the foot</p> Signup and view all the answers

    Which imaging modality is primarily used to evaluate soft tissue injuries in the lower limbs?

    <p>Magnetic Resonance Imaging (MRI)</p> Signup and view all the answers

    What condition is characterized by cartilage softening under the patella, leading to pain and tenderness?

    <p>Chondromalacia Patellae</p> Signup and view all the answers

    Which of the following is primarily used to measure bone density in patients?

    <p>Bone Densitometry</p> Signup and view all the answers

    What is a common feature of Ewing Sarcoma as detected on radiographs?

    <p>Onion peel appearance</p> Signup and view all the answers

    What benign tumor typically appears in small bones of the hands and feet in adolescents and young adults?

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

    Which condition is known to cause inflammation of the bone and cartilage affecting the anterior proximal tibia?

    <p>Osgood-Schlatter Disease</p> Signup and view all the answers

    What imaging method is helpful for detecting osteomyelitis and metastatic bone lesions?

    <p>Nuclear Medicine (NM)</p> Signup and view all the answers

    Which of the following conditions involves the accumulation of fluid in the joint cavity?

    <p>Joint Effusions</p> Signup and view all the answers

    Which type of bone tumor is more common in individuals aged 40-70 arising from plasma cells?

    <p>Multiple Myeloma</p> Signup and view all the answers

    What condition involves excessive uric acid in the blood and commonly affects the first metatarsophalangeal joint?

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

    What condition is characterized by bone softening due to a lack of mineralization?

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

    What is a common radiographic appearance of Paget's disease?

    <p>Mixed areas of sclerotic and lytic lesions</p> Signup and view all the answers

    Which of the following conditions leads to excessive production of soft but dense bone?

    <p>Paget's disease</p> Signup and view all the answers

    What is a common radiographic examination for osteomalacia?

    <p>AP and lateral of the affected limb</p> Signup and view all the answers

    What exposure factor adjustment is often required for osteomalacia?

    <p>Decrease (-)</p> Signup and view all the answers

    Which of the following best describes Ewing sarcoma on imaging?

    <p>Ill-defined area of bone destruction with an 'onion peel' appearance</p> Signup and view all the answers

    Which condition shows a classic 'sunburst' pattern in imaging?

    <p>Osteogenic sarcoma</p> Signup and view all the answers

    Which condition is NOT typically associated with bone loss or destruction?

    <p>Exostosis (osteochondroma)</p> Signup and view all the answers

    In which condition are uric acid deposits typically found in the joint space?

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

    What is a characteristic of osteoclastoma as seen on radiograph?

    <p>Large radiolucent lesions with thin strips of bone</p> Signup and view all the answers

    What is the recommended source-image receptor distance (SID) for lower limb radiography?

    <p>40 inches (100 cm)</p> Signup and view all the answers

    Which practice is essential when radiographing the lower limb to protect sensitive regions?

    <p>Implementing lead shielding over gonadal areas</p> Signup and view all the answers

    What should be done to maintain constant SID when using IRs directly on the tabletop?

    <p>Increase the tube height by 3-4 inches (8-10 cm)</p> Signup and view all the answers

    Which position should the long axis of the part being radiographed generally be in relation to the IR?

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

    Why is collimation important in lower limb radiography?

    <p>To limit scatter radiation and ensure centering accuracy</p> Signup and view all the answers

    What is the recommended practice for images on a single digital imaging plate?

    <p>Avoid multiple exposures whenever possible</p> Signup and view all the answers

    What should be done to prevent distortion in lower limb radiography?

    <p>Keep the part parallel to the IR and correctly center the CR</p> Signup and view all the answers

    When are grids generally used in lower limb radiography?

    <p>For body parts measuring 10 cm or more</p> Signup and view all the answers

    What is a common exposure factor for lower limb radiographs?

    <p>Short exposure time</p> Signup and view all the answers

    Which imaging plate is commonly used for examinations distal to the knee?

    <p>IRs without grids</p> Signup and view all the answers

    What adjustment should be made for pediatric patients due to their tissue characteristics?

    <p>Decrease exposure factors due to reduced tissue quantity and density.</p> Signup and view all the answers

    Which position-related concern is crucial when treating geriatric patients?

    <p>Decreased joint flexibility may affect routine positioning techniques.</p> Signup and view all the answers

    What element is essential for obtaining radiographic quality in bariatric patients?

    <p>Properly dressing the patient before imaging.</p> Signup and view all the answers

    When imaging a lower limb with a cast, what is the recommended increase in exposure for a large plaster cast?

    <p>Increase 8 to 10 kVp.</p> Signup and view all the answers

    What classification of joint is the distal tibiofibular joint?

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

    What is the purpose of using grids in digital imaging for thicker anatomy?

    <p>To enhance the image quality by reducing scatter radiation.</p> Signup and view all the answers

    Which surface of the foot is referred to as the dorsum?

    <p>The top surface</p> Signup and view all the answers

    What is the minimum kVp value recommended for most digital imaging cases?

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

    What type of movement does plantar flexion involve?

    <p>Pointing the foot and toes downward</p> Signup and view all the answers

    Which is a recommended practice when using four-sided collimation for radiography?

    <p>Collimate to the region of interest using at least two parallel borders.</p> Signup and view all the answers

    What does the ALARA principle emphasize in radiographic imaging?

    <p>As low as reasonably achievable exposure factors.</p> Signup and view all the answers

    Which joint type does the ankle joint represent?

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

    What should be considered when imaging knees in bariatric patients?

    <p>Increased cephalad CR angles may be necessary for visualization.</p> Signup and view all the answers

    What type of movements do intertarsal joints primarily provide?

    <p>Gliding movements with some rotation</p> Signup and view all the answers

    Which of the following describes dorsiflexion?

    <p>Bending the foot upwards towards the leg</p> Signup and view all the answers

    Which aids can be used to enhance patient comfort during imaging?

    <p>Positioning aids and supports.</p> Signup and view all the answers

    Which statement is true about the interphalangeal joints?

    <p>They are hinge joints permitting flexion and extension.</p> Signup and view all the answers

    What is the function of the fibrous capsule in synovial joints?

    <p>To contain synovial fluid for lubrication</p> Signup and view all the answers

    Which motions are not allowed by the tibiofibular joint?

    <p>Side-to-side movements</p> Signup and view all the answers

    What are the primary movements that the ankle joint permits?

    <p>Dorsiflexion and plantar flexion</p> Signup and view all the answers

    Study Notes

    Clinical Indications

    • Fractures or dislocations of the phalanges of the digits in question
    • Pathologies such as osteoarthritis and gouty arthritis (gout), especially in the first digit

    Technical Factors

    • Minimum SID—40 inches (100 cm)
    • IR size—8 × 10 inches (18 × 24 cm)
    • Landscape
    • Kvp range: 50-60

    Shielding

    • Shield radio-sensitive tissues outside region of interest.

    Patient Position

    • Place patient supine or seated on table; knee should be flexed with plantar surface of foot resting on IR

    Part Position

    • Center and align long axis of digit to CR and long axis of portion of IR being exposed.
    • Ensure that MTP joint of digit in question is centered to CR.
    • Rotate the leg and foot 30° to 45° medially for the first, second, and third digits (Fig. 6.43) and laterally for the fourth and fifth digits (Fig. 6.44).
    • Use 45° radiolucent support under elevated portion of foot to obviate.

    CR

    • CR perpendicular to IR, directed to MTP joint in question
    • Colliate closely to area of interest.
    • Include at least the first, second, and third distal metatarsals for possible sesamoids but CR at first MTP joint.

    Computed Radiography or Digital Radiography

    • Close collimation is important over unexposed portions of IR to prevent fogging from scatter radiation.

    Evaluation Criteria

    • Anatomy Demonstrated: Digits in question and distal half of metatarsals should be included without overlap (superimposition).
    • Position: Long axis of foot aligned to long axis of portion of IR being exposed. 
    • No rotation: Rotation is present if shafts of the phalanges and distal metatarsals appear equally concave on both sides.
    • Correct obliquity: Side with increased concavity has been rolled away from IR.
    • No motion: as evidenced by sharply defined cortical margins of bone and detailed bony trabeculae.
    • Exposure: Optimal contrast and density (brightness) allow visualization of bony cortical margins and trabeculae and soft tissue structures.

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    Description

    This quiz focuses on the essential techniques for lateral-mediolateral and lateromedial projections of the toes. It covers minimum SID requirements, clinical indications, CR direction, collimation adjustments, and optimal exposure criteria. Test your knowledge on best practices for toe radiographic examinations.

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