Questions and Answers
What is the recommended collimation for a forearm x-ray?
Collimate both lateral borders to the actual forearm area
What is the minimum source-to-image distance (SID) for a forearm x-ray?
40 inches (102 cm)
How should the patient be positioned for a lateral forearm x-ray?
Seat patient at end of table, with elbow flexed 90°
What is the ideal direction of the central ray (CR) for a lateral forearm x-ray?
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What is the recommended minimum source-to-image receptor distance (SID) for this imaging procedure?
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For analog imaging, what is the recommended kilovoltage (kV) range?
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How should the patient be positioned for the wrist imaging?
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What is the recommended central ray (CR) angle for the PA axial wrist (scaphoid) with ulnar deviation?
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Which anatomy should be clearly demonstrated in the wrist imaging?
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What is the purpose of collimation in this imaging procedure?
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What might obscure fractures of the scaphoid require in this imaging procedure?
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What should be evident in the wrist imaging to show ulnar deviation?
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What are the clinical indications for forearm imaging?
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What is the recommended collimation for forearm imaging?
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What projection is used for calcification or pathology of the dorsal aspect of carpal bones?
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What is the purpose of PA and PA axial scaphoid with ulnar deviation?
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What may be required for nondisplaced fractures of the scaphoid?
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What should be used to protect radiosensitive tissues outside the region of interest during upper limb imaging?
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What is the recommended patient positioning for forearm imaging?
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What is the purpose of the carpal bridge tangential projection?
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What is the recommended collimation to avoid cutting off anatomy at either joint during forearm imaging?
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What is the purpose of PA and PA axial scaphoid with ulnar deviation?
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What may be required for nondisplaced fractures of the scaphoid?
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What should be used to protect radiosensitive tissues outside the region of interest during upper limb imaging?
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Study Notes
Radiographic Imaging of Upper Limb
- Forearm routine involves AP and lateral projections to demonstrate radius, ulna, carpal bones, elbow, and humerus, with specific positioning and exposure instructions
- Clinical indications for forearm imaging include fractures, dislocations, and pathologic processes like osteomyelitis or arthritis
- Technical factors for forearm imaging include minimum SID, IR size, and kV range for analog and digital systems
- Patient positioning for forearm imaging includes fully extending the arm, dropping the shoulder, and aligning the forearm with the IR
- Collimation for forearm imaging should be focused on the actual forearm area with minimal collimation at both ends to avoid cutting off anatomy at either joint
- Carpal bridge tangential projection is used for calcification or pathology of the dorsal aspect of carpal bones, with specific technical factors and patient positioning
- Evaluation criteria for carpal bridge tangential projection include the visualization of specific carpal bones and the position and exposure requirements
- PA and PA axial scaphoid with ulnar deviation is used for possible scaphoid fractures, with a warning not to attempt the position before ruling out possible fractures
- Nondisplaced fractures of the scaphoid may require additional projections or a CT scan of the wrist
- The text provides specific technical factors and patient positioning for wrist imaging, including scaphoid views, radial deviation, and carpal canal imaging
- Shielding should be used to protect radiosensitive tissues outside the region of interest during upper limb imaging
- The text emphasizes the importance of considering beam divergence and ensuring the inclusion of a minimum distance distal to wrist and elbow joints on the image receptor.
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