Positioning Review of Upper and Lower Extremities
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Transcript of Positioning Review of Upper and Lower Extremities
Positioning Review of Positioning Review of Upper and LowerUpper and Lower
ExtremitiesExtremities
ReferenceReferenceImages in this presentation are from:Images in this presentation are from:
Merrill’s Atlas of Radiographic Positioning and Merrill’s Atlas of Radiographic Positioning and Procedures.Procedures.
Eugene Frank, Bruce Long, Barbara SmithEugene Frank, Bruce Long, Barbara Smith
FingersFingersPAPA
Third Digit
Fifth Digit
Fourth Digit
Second Digit
CR - PIP
LateralLateral
Third DigitSecond Digit
Fourth Digit
Fifth Digit
ThumbThumbAPAP
CR – MCP
LateralLateral
HandHandAPAP
CR – 3rd MCP
PA ObliquePA Oblique
LateralLateral
Extension Lateral
Fan Lateral
WristWrist PA PA
CR – Mid Carpal
1. Scaphoid = Navicular 2. Lunate= Semilunar3. Triquetrum = Triquetral, Triangular4. Pisiform
5. Trapezium = Greater
Multangular6. Trapezoid = Lesser Multangular7. Capitate = Os Magnum8. Hamate = Unciform
LateralLateral
PA ObliquePA Oblique
AP ObliqueAP Oblique
Ulna Deviation – Ulna Ulna Deviation – Ulna FlexionFlexion
Stecher Method – Cassette Stecher Method – Cassette raised raised
Stecher Method – Tube Stecher Method – Tube angledangled
Carpal Tunnel (Tangential Carpal Tunnel (Tangential Projection) - Gaynor-Hart Projection) - Gaynor-Hart
MethodMethod
ForearmForearmAPAP
Lateral Lateral
ElbowElbowAP AP
Epicondyles are parallel to the IR
LateralLateral
Epicondyles are perpendicular to the IR
Medial (Internal) Rotation Medial (Internal) Rotation ObliqueOblique
Lateral (External) Rotation Lateral (External) Rotation ObliqueOblique
Distal Humerus – Partial Distal Humerus – Partial FlexionFlexion
APAP
Proximal Forearm – Partial Proximal Forearm – Partial FlexionFlexion
APAP
HumerusHumerusAPAP
LateralLateral
Transthoracic LateralTransthoracic Lateral
Lower ExtremityLower Extremity
ToesToes AP – Perpendicular CR AP – Perpendicular CR
CR - 3rd MTP
AP AxialAP Axial
AP Oblique – Medial AP Oblique – Medial RotationRotation
FootFoot AP AxialAP Axial
CR - Base of 3rd metatarsal
AP Oblique – Medial AP Oblique – Medial RotationRotation
Lateral - MediolateralLateral - Mediolateral
AnkleAnkleAPAP
Lateral - MediolateralLateral - Mediolateral
Medial Rotation (Internal) Medial Rotation (Internal) ObliqueOblique
for bony structuresfor bony structures
15-20 degree Medial Rotation 15-20 degree Medial Rotation for Ankle Mortise Jointfor Ankle Mortise Joint
Lateral (External) Rotation Lateral (External) Rotation ObliqueOblique
Stress MethodStress Method
Inversion StressEverson Stress
For verification of ligament tear
CalcaneusCalcaneus Axial – PlantodorsalAxial – Plantodorsal
CR - base of 3rd metatarsal
Lateral CalcaneusLateral Calcaneus
CR - 1” distal to medial malleoulus
Lower LegLower Leg AP AP
LateralLateral
KneeKneeAP – Sthenic PatientAP – Sthenic Patient
CR - 1/2” distal to apex of patella
AP - Hypersthenic PatientAP - Hypersthenic Patient
AP - Asthenic PatientAP - Asthenic Patient
LateralLateral
AP Oblique - Lateral (External) AP Oblique - Lateral (External) RotationRotation
AP Oblique – Medial (Internal) AP Oblique – Medial (Internal) Rotation Rotation
Bilateral knees – weight- Bilateral knees – weight- bearingbearing
Patella Patella PAPA
CR - mid patella
Lateral PatellaLateral Patella
Settegast Method for PatellaSettegast Method for Patella“Sunrise or Skyline View”“Sunrise or Skyline View”
Typical tube angle is 15-20 degrees
Hughston Method for PatellaHughston Method for Patella
Lower leg forms 50-60 degree angle from table
Intercondylar Fossa - PA Axial Intercondylar Fossa - PA Axial Projection (Holmblad Method)Projection (Holmblad Method)
Femur is at 20 degree angle
“Tunnel” projection
Camp-Coventry MethodCamp-Coventry Method
If knee is flexed 40 degrees, the tube is angled 40
FemurFemur
AP Projection (for distal femur)AP Projection (for distal femur)
AP Projection (for proximal femur)AP Projection (for proximal femur)
Lateral femur to include kneeLateral femur to include knee
Lateral Projection (for proximal Lateral Projection (for proximal femur)femur)