30 Questions
What is the primary issue with the radiograph in the example?
The soft tissue of the palm is obstructing the view of the first CMC joint
What modification would be beneficial to show the joint in this patient?
Long-Rafert or Lewis modification of the central ray
What is the significance of the arrow in the radiograph example?
It highlights the soft tissue of the palm
What is the main goal of modifying the central ray in this case?
To improve the visibility of the first CMC joint
What is the primary advantage of using the Long-Rafert or Lewis modification?
It allows for better visualization of the first CMC joint
What is the name of the method used for the AP Oblique Projection?
Norgaard Method
In which direction is the wrist positioned for the PA Axial Projection using the Rafert-Long method?
Ulnar deviation
What is the name of the series used for the PA and PA Axial wrist projections?
Rafert-Long Series
What is the type of projection used for the Stecher Method?
PA Axial Projection
What is the name of the bone being projected in the given images?
Scaphoid
What is the primary purpose of adjusting the central ray angle in the radiographic examination of the wrist?
To achieve a more direct view of the wrist bones
What is the primary difference between radiographs (A) and (B)?
The angle of the central ray
What is the primary purpose of the Folio method in radiology?
To diagnose ulnar collateral ligament (UCL) tears in the MCP joint
What is the purpose of using a 10-degree cephalad angle in radiograph (B)?
To reduce the distortion of the wrist bones on the radiograph
What is the significance of the 13-degree difference in the MCP joint angle between the left and right sides?
It is a sign of UCL tear
What is the significance of the radiographs being from the same patient?
It ensures that the radiographic images are not affected by patient variables
What is the primary advantage of using a PA axial view in radiograph (B)?
It provides a more accurate representation of the wrist bones
What is the purpose of the PA Oblique projection in hand radiology?
To evaluate the MCP joint
What is the importance of the marker on the radiograph?
To identify the radiographic view
What is the significance of the metacarpal index in hand radiology?
It assesses the length of the metacarpal bones
What is the role of the flexible strip in the Folio method?
To hold the hand in place
What is the purpose of the Lateral projection in hand radiology?
To assess the lateral aspect of the hand
What is the significance of the 20-degree angle measurement in the UCL tear?
It indicates the severity of the tear
What is the importance of the hand position in the PA projection?
It should be placed on the flat surface
What is the role of the radiographic markers in the evaluation of hand anatomy?
To identify the radiographic view
What is the name of the projection method used to visualize the carpal canal?
Gaynor-Hart method
What is the orientation of the central ray in a tangential carpal canal projection?
Inferosuperior
What is the purpose of modifying the central ray in a carpal canal projection?
To demonstrate the carpal canal
What is the name of the anatomical structure visualized in a tangential carpal canal projection?
Carpal canal
What is the benefit of using a tangential projection for the carpal canal?
It provides a unique view of the carpal canal
Study Notes
Radiograph Projections
- A typical repeat radiograph may obscure the first CMC joint, which can be improved by using the Long-Rafert or Lewis modification of the central ray.
Axial CT Scan
- An axial CT scan through the distal carpals can help well visualize the CMC joint.
Folio Method
- The Folio method is used to diagnose a tear in the ulnar collateral ligament (UCL) of the first metacarpophalangeal (MCP) joint, also known as "skier's thumb".
- Key points to note in this projection include:
- Evidence of proper alignment and the presence of a marker without anatomy.
- The hand in a PA projection without rotation.
- The first metacarpal and first MCP joint.
- The ulnar side of the wrist and the soft tissues around it.
- The thumb in the center of the image.
- Trabecular bone details and surrounding soft tissues.
Hand PA Projection
- Evaluation criteria for a hand PA projection include:
- Evidence of proper alignment and the presence of a marker without anatomy.
- Anatomy from the fingertips to the distal radius and ulna.
- Fingers slightly separated without soft tissue overlap.
- No hand rotation.
- The MCP and IP joints are open, indicating that the hand is placed on the receiver flat.
- Trabecular bone details and surrounding soft tissues.
PA Oblique Projection
- No specific details mentioned.
Lateral Projection
- No specific details mentioned.
Lateromedial in Flexion
- No specific details mentioned.
AP Oblique Projection (Norgaard Method)
- No specific details mentioned.
Scaphoid PA Axial Projection (Stecher Method)
- No specific details mentioned.
Rafert-Long Method Scaphoid Series
- PA and PA axial wrist in ulnar deviation are used in this series.
- Radiographs are all from the same patient.
Carpal Bridge Tangential Projection
- No specific details mentioned.
Carpal Canal Tangential Projection (Gaynor-Hart Method)
- No specific details mentioned.
This quiz is about radiography techniques, specifically the use of Long-Rafert or Lewis modification to visualize the first CMC joint on a radiograph.
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