Elbow Projection PDF
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Summary
This document provides detailed instructions on various radiographic projections for the elbow, focusing on different suspected injuries, and alternative methods. It outlines procedures for acute flexion, distal humerus, proximal forearm, and radial head injuries, as well as demonstrating coronoid and trochlea visualization.
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# Elbow Projection ## Elbow Projection - **AP Projection**: Hand supinated, elbow extended. Humeral epicondyle // IR. - **Lateral Projection**: Elbow flexed 90 degrees, hand in lateral position, humeral epicondyle to IR. - **Suspected injury soft tissue Elbow**: Elbow flexed 30-35 degrees (partia...
# Elbow Projection ## Elbow Projection - **AP Projection**: Hand supinated, elbow extended. Humeral epicondyle // IR. - **Lateral Projection**: Elbow flexed 90 degrees, hand in lateral position, humeral epicondyle to IR. - **Suspected injury soft tissue Elbow**: Elbow flexed 30-35 degrees (partial flexion). - **FX + D of elbow**: Elevated/displaced fat pads. - **Posterior Fat pads seen**: FX Jerced elbow (nursemaid) - **AP Oblique Projection (medial rotation)**: Hand pronated, elbow fully extended, medially rotated 45 degrees from IR. - **Coronoid Process**: (ulna) Free of radial head. - **Trochlea**: (humerus) (medial side) - **AP Oblique Projection (lateral rotation)**: Hand supinated, elbow fully extended. Rotate elbow 45 degrees laterally to IR. Thumb and index finger touching the table (1st or 2nd digit). - **Radial Head** - Neck (lateral). - **Capitulum**: (humerus). ## Alternatives - **Lateral Elbow**. - **AP Projection (partial flexion)**: Distal humerus. - **AP projection (Partial flexion)**: Proximal forearm. ## Pt can't fully Extend Elbow: ### Distal Humerus - **AP Projection (Partial flexion)**: Hand supinated, elbow partially flexed, distal humerus placed on IR. ### Proximal Forearm - **AP Projection (Partial flexion)**: Dorsal surface of forearm placed on IR. Hand supinated, elbow partially flexed. ### Acute Flexion - FOR FX & moderate Dislocation of Elbow ### Distal Humerus - **Jones Method (Acute flexion)**: Elbow fully flexed. - **1. AP projection**: Superimposed (AP arm, PA forearm). - **2. PA projection**: Superimposed bones of arm and forearm. - **Olecranon process**: More open elbow joint. ### Proximal Forearm - **2. PA projection (Acute flexion)**: Elbow fully flexed. ### Radial Head Series - **Lateral Projection (latero-medial)**: Flexed elbow 90 degrees, elbow in lateral position. - **1. Hand supinated**. - **2. Hand in lateral**. - **3. Hand pronated**. - **4. Hand internally rotated**. - **Radial Head**: 1 inch distal to Lateral epi. ### Radial Head Varying Degrees Of Rotation - **Radial head facing Anteriorly**: Supinated lateral. - **Radial Head Facing Posteriorly**: Pronated, internally rotated. ### Radial Head Clearly Projected -> Elbow Trauma - **Greenspan Norman Method**: 45 degrees medially toward the shoulder. - **Radial Head Holly Method**: AP Projection of radial head. ## Trauma Axial Lateral Projection Elbow - **COYLE Method (axiolateral projection)**: Seated - Hand pronated, radial head, elbow flexed 90 degrees. - **Radial-Lateral**: 45 degrees toward the shoulder. - **Mid-elbow joint**: 45 degrees cephalad, coronoid process medial. - **Supine**: - **IR vertical**: Humeral epicondyles // to IR - Hand facing anteriorly, coronal process, 80 degrees to elbow. - **Radial Head** - 90 degrees to elbow. - **45 degrees cephalad**: Coronoid process, 45 degrees caudad. ## CR UT - **Seated** - Seat: 45 degrees toward shoulder. - Lateral: 90 degrees flexion. - Medial: 80 degrees flexion. - Radial head: 90 degrees to elbow. - Coronoid process: 90 degrees to elbow. - **Supine**: - Sup: -45 degrees to CR. - -45 degrees to CR. ## Pt Can't Fully Extend Elbow For AP Med / Lal Oblique Traumatic Elbow Injury ### Distal Humerus - **PA Axial Projection (distal humerus)**: Seated, arm rested vertically against IR. Rest forearm // IR, hand supinated. - **Humerus, 75 degrees, forearm 15 degrees to CR.** - **Ulnar Sulcus**: groove b/n medial epicondyle & trochlea - **Rafert Long**: AP oblique projection (distal humerus) - Demo of ulnar sulcus for ulnar nerve. - **Demo of**: Epicondyles, trochlea, ulnar sulcus, olecranon fossa (humerus posterior). - **For Radiohumeral bursitis (Tennis Elbow)**: Lateral epicondylitic. - **To detect obscured calcifications in the ulnar sulcus**. ### Olecranon Process (proximal vina) - **PA Axial Projection (proximal forearm)**: Seated, rest forearm // to IR. - **Humerus (arm):** 45-50 degrees from forearm. - **Hand supinated**: 20 degrees toward the wrist. - **Dorsum of olecranon process**: Curved extremity and articular margin of the olecranon process. ## Best Ways to Demonstrate Coronoid (ulna) & Trochlea: - **AP Oblique Projection (Internal Rotation)**: (medial rotation). ## Best Way to Demonstrate Radial Head, Neck & Capitulum: - **AP Oblique Projection (external rotation)**: (lateral rotation).
