Patella and PF Joint Projections PDF

# Patella ## Patella Projections ### PA Projection - Prone - Patella // IR - Heel rotated 5 to 10 laterally - Midpopliteal depression - Sharper detail than approach - VOID - Patella superimposed by Femur - **Bipartite Patella**: - Not a FX - Radiolucent line x-ray & CT ### Latera...

# Patella ## Patella Projections ### PA Projection - Prone - Patella // IR - Heel rotated 5 to 10 laterally - Midpopliteal depression - Sharper detail than approach - VOID - Patella superimposed by Femur - **Bipartite Patella**: - Not a FX - Radiolucent line x-ray & CT ### Lateral Projection: Medio-Lateral - Lat recumbent, flex knee - 5-10° (1) Flexion; - ↓ Patellofemoral jt-space - > 10° unhealed/new patellar fx - Patella I IR - Epicondyles superimposed - Mid Patellofemural jt. - Lat proj. - Patella Patellofemoral jt. open ### PA Oblique Projection: Medial Rotation - Prone; - Flex knee 5 to 10° - Medial Rot. Knee 45-55° - Patella - (Patella) Medial Portion; Free of Femur ## Patella Projections continued ### PA Oblique Projection: Lateral Rotation - Prone; - Knee flexed 5 to 10° - Knee lateral rotated - Patella - (Patella) Lateral Portion; Free of Femur - 45-55° ### KUCHENDORF method; PA axial oblique Projection: Lateral Rotation - Prone; - Hip elevated 2-3" - Knee flexed 10° (relax muscle) - Rotate knee laterally 35-40° - More comfortable; no pressure placed on injured patella. - Rest knee anteromedial side - 25-30° caudad - Jt space bin of patella 2 femur condyles - Majority of patella free of femur (except: Patellar outline) - To hold patella in lateral displacement position - Place index finger against patella - To press it laterally ## Patella & Patellofemoral Joint Projections ### Hughston method: Tangential Projection (Jaroschy) - Prone; - Ventral of cephalad - Knee on IR - Knee flexed 50-60° - Foot rest on collimator - 45° - Patellofemoral jt. - Patellofemoral jt. - Tangential image: - Sublaxation of Patella & Patellar FX - Assessment of femoral condyles. - Bony recorded detail: Patella & femoral condyles. ### Hughston (55°) - Both knees examined for comparison ### Laurin method - Knee flexed 20° - Patellar sublaxation ### Fodor-Malott & Weinberg wl Merchant et al - 45° knee flexion ### Merchant Method: Tangential Projection - Bilateral - Relaxation of the quadriceps muscles (for demo sublaxation of patella) - SID 6 ft - Supine; both knees flex 40-45° - (b/n 30-90° various Patellofemoral disorder) - Use of axial viewer device / adjustable viewer - Knee elevated 2° (femora // to tabletop) - 30° caudad from horizontal plane - b/n midway patellae @lvl of patellofemural jt. - - Skyline, sunrise, mountain view - Patella nondistorted slightly magnified - Open patellofemural jt. space - Femoral condyles intercondylar sulcus ### Quadriceps (not relaxed) - A sublaxed patella may be pulled back into intercondylar sulcus. (False normal appearance) - IR- 1 foot distal to patellae - Record angle knee flexion ## Settegast method: Tangential Projection - Supine/Prone - Knee extreme flexion 90° - Patella I IR - Jt I to IR - Patellofemoral Jt. - Patella PFJt. - Jt not I to IR 15 to 20° cephalad (depends on knee flexion) - Useful for demo vertical fx - Investigating articulate surfaces of patellofemural articulation ### Acute Flexion - First transverse fx of patella (lateral image) before doing this projection; acute flexion can cause fragment displacement ### SUNRISE method: Tangential Projection /Mountain/Skyline - Supine/Sitting - Knee flexed 40 to 45° - 30° caudad from horizontal - Patellofemoral Jt. - Patellofemoral Jt.