4Chapter_Positioning_Forearm_RADR1311_Accessible_Summer2020_SC (2).pdf

Forearm Positioning Essential Projections Routine Projections AP Lateral Clinical Indications for Forearm Fractures Dislocations Osteoarthritis Osteomyelitis General Positioning Guidelines Patient Position Seated at the end of the table, facing RT(R) Part Position Place the part in the center of the...

Forearm Positioning Essential Projections Routine Projections AP Lateral Clinical Indications for Forearm Fractures Dislocations Osteoarthritis Osteomyelitis General Positioning Guidelines Patient Position Seated at the end of the table, facing RT(R) Part Position Place the part in the center of the IR Entire upper limb positioned in the to be in same plane Forearm parallel to the long axis of the IR General Positioning Guidelines CR Perpendicular to IR Perpendicular to part Collimation 4 sided to include anatomy of interest Includes bony detail and soft tissue Marker Placed at most narrow part of anatomy (wrist) AP: Forearm Part Position Supinate hand and fully extend arm Drop shoulder to place the entire upper limb in the same horizontal plane Center mid-forearm to the IR Align the long axis of the forearm to be parallel to the long axis of the IR Position humeral epicondyles parallel and equidistant from the IR CR Perpendicular Enters at mid-forearm Collimation Entire radius and ulna Proximal row of carpals Distal humerus AP Forearm: Positioning Error Extending the arm and keeping the hand pronated In pronation the radius and ulna are crossed The hand must be supinated for the AP forearm projection to demonstrate the radius and ulnar shafts free or superimposition from one another Evaluation Criteria AP Forearm Entire radius and ulna Proximal carpal Elbow Distal humerus No motion Optimal density and contrast Soft tissue Bony trabeculation Radiographic Anatomy AP Forearm Lateral: Forearm Part Position Flex upper limb to a 90 degree angle, resting on the ulnar surface Drop shoulder to place the entire upper limb in the same horizontal plane Center mid-forearm to the IR Align the long axis of the forearm to be parallel to the long axis of the IR Position humeral epicondyles and wrist in a true lateral position Humeral condyle superimposed Radial and ulnar styloid superimposed CR Perpendicular Enters at mid-forearm Collimation Entire radius and ulna Proximal row of carpals Distal humerus Evaluation Criteria Lateral Forearm Lateral projection of entire radius and ulna Proximal carpal Elbow (flexed to 90 degrees) Head of ulna superimposed over radius Distal humerus No motion Optimal density and contrast Soft tissue Bony trabeculation Radiographic Anatomy Lateral Forearm Alternative/Special Projections Wrist Trauma Protocol – 2 views PA “As Is” projection – when patient is unable to supinate or fully extend arm due to injury X-table Lateral Trauma Protocol – 2 views PA “As Is” projection – when patient is unable to supinate or fully extend arm due to injury X-table Lateral Trauma Protocol – 2 views PA projection – when patient is unable to supinate or fully extend arm due to injury X-table Lateral