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Positioning Review of Upper and Lower Extremities

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Presentation on theme: "Positioning Review of Upper and Lower Extremities"— Presentation transcript:

1 Positioning Review of Upper and Lower Extremities
Reference Images in this presentation are from: Merrill’s Atlas of Radiographic Positioning and Procedures. Eugene Frank, Bruce Long, Barbara Smith

2 Fingers PA Fifth Digit Second Digit Third Digit Fourth Digit CR - PIP

3 Lateral Fifth Digit Second Digit Third Digit Fourth Digit

4 Thumb AP CR – MCP

5 Lateral

6 Hand AP CR – 3rd MCP

7 PA Oblique

8 Lateral Fan Lateral Extension Lateral

9 Wrist PA CR – Mid Carpal 1. Scaphoid = Navicular 2. Lunate= Semilunar
3. Triquetrum = Triquetral, Triangular 4. Pisiform 5. Trapezium = Greater Multangular 6. Trapezoid = Lesser Multangular 7. Capitate = Os Magnum 8. Hamate = Unciform CR – Mid Carpal

10 Lateral

11 PA Oblique

12 AP Oblique

13 Ulna Deviation – Ulna Flexion

14 Stecher Method – Cassette raised

15 Stecher Method – Tube angled

16 Carpal Tunnel (Tangential Projection) - Gaynor-Hart Method

17 Forearm AP

18 Lateral

19 Elbow AP Epicondyles are parallel to the IR

20 Lateral Epicondyles are perpendicular to the IR

21 Medial (Internal) Rotation Oblique

22 Lateral (External) Rotation Oblique

23 Distal Humerus – Partial Flexion AP
Patient may be unable to extend elbow due to dislocation or injury. 2 views are needed in this case, one for distal humerus and one for proximal forearm. Distal humerus: humerus is on table in same plane may need to support forearm Supinate hand Proximal Forearm: Patient may be standing or may have to elevate cassette under arm forearm is on cassette CR is perpendicular to elbow jt.

24 Proximal Forearm – Partial Flexion AP

25 Humerus AP

26 Lateral

27 Transthoracic Lateral

28 Lower Extremity

29 Toes AP – Perpendicular CR
CR - 3rd MTP

30 AP Axial

31 AP Oblique – Medial Rotation

32 Foot AP Axial CR - Base of 3rd metatarsal

33 AP Oblique – Medial Rotation

34 Lateral - Mediolateral

35 Ankle AP

36 Lateral - Mediolateral

37 Medial Rotation (Internal) Oblique for bony structures

38 15-20 degree Medial Rotation for Ankle Mortise Joint

39 Lateral (External) Rotation Oblique

40 Stress Method Inversion Stress Everson Stress
For verification of ligament tear Inversion Stress Everson Stress

41 Calcaneus Axial – Plantodorsal
CR - base of 3rd metatarsal

42 Lateral Calcaneus CR - 1” distal to medial malleoulus

43 Lower Leg AP

44 Lateral

45 Knee AP – Sthenic Patient
CR - 1/2” distal to apex of patella

46 AP - Hypersthenic Patient

47 AP - Asthenic Patient

48 Lateral

49 AP Oblique - Lateral (External) Rotation

50 AP Oblique – Medial (Internal) Rotation

51 Bilateral knees – weight- bearing

52 Patella PA CR - mid patella

53 Lateral Patella

54 Settegast Method for Patella “Sunrise or Skyline View”
Typical tube angle is degrees

55 Hughston Method for Patella
Lower leg forms degree angle from table

56 Intercondylar Fossa - PA Axial Projection (Holmblad Method)
Femur is at 20 degree angle “Tunnel” projection

57 Camp-Coventry Method If knee is flexed 40 degrees, the tube is angled 40

58 Femur AP Projection (for distal femur)

59 AP Projection (for proximal femur)

60 Lateral femur to include knee

61 Lateral Projection (for proximal femur)

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