Forearm Radiography

Position CR Demonstrates

AP Projection(Forearm)

 CR is perpendicular to IR, directed to mid-forearm

 AP projection of the entire radius and ulna is shown, with a minimum of proximal row carpals and

distal humerus and pertinent soft tissues such as fat pads and stripes of the wrist and elbow joints

Lateral/ lateromedial Projection (Forearm)

 CR is perpendicular to IR, directed to mid-forearm

Lateral projection of entire radius and ulna, proximal row of carpal bones, elbow, and distal end of the humerus are visible as well as pertinent soft tissue, such as fat pads and stripes of the wrist and

elbow joints 

   

   

Elbow Radiography

Position CR Demonstrates

AP Projection (Elbow fully extended)

 CR is perpendicular to IR, directed to mid-elbow joint, which is approximately 2 cm distal to midpoint

of a line between epicondyles

Distal humerus, elbow joint space, and proximal radius and ulna are visible

AP Projection (Elbow cannot

be fully extended)

 CR is perpendicular to IR, directed to mid-elbow joint, which is approximately 2 cm distal to midpoint

of a line between epicondyles 

Distal humerus is best visualized on “humerus parallel” projection and proximal radius and ulna

are best visualized on “forearm parallel” projection

AP Oblique Projection/

Lateral (external rotation)

CR is perpendicular to IR, directed to mid-elbow joint, which is approximately 2 cm distal to midpoint of a line between epicondyles as viewed from the x-

ray tube 

Oblique projection of distal humerus and proximal radius and ulna is visible

AP Oblique Projection/

Medial (internal rotation)

CR is perpendicular to IR, directed to mid-elbow joint, which is approximately 2 cm distal to midpoint of a line between epicondyles as viewed from the x-

ray tube 

Oblique projection of distal humerus and proximal radius and ulna is visible 

 Lateral/ Lateromedial

Projection

CR is perpendicular to IR, directed to mid-elbow joint, which is approximately 4 cm medial to easily palpated posterior surface of olecranon process

Lateral projection of distal humerus and proximal forearm, olecranon process, and soft tissues and

fat pads of the elbow joint are visible

 Acute Flexion Projection

Distal humerus: CR perpendicular to IR and humerus, directed to a point midway between

epicondyles. Proximal forearm: CR perpendicular to forearm

(angling CR as needed), directed to a point approx 2 inches proximal or superior to olecranon process

Proximal humerus: Forearm and humerus should be directly superimposed. Medial and lateral

epicondyles and parts of trochlea, capitulum, and olecranon process all should be seen in profile.

Optimal exposure should visualize distal humerus and olecranon process through superimposed

structures. Soft tissue detail is not readily visible on either projection

Distal forearm: proximal ulna and radius, including outline of radial head and neck, should be visible through superimposed distal humerus. Optimal

exposure visualizes outlines of proximal ulna and radius superimposed over humerus

 Trama Axial Laterals/ Axial lateromedial projections

(Coyle Method)

Radial Head: CR angled 45 degrees toward shoulder, centered to radial head

Coronoid Process: CR angled 45 degrees from shoulder into midelbow joint

Radial Head: joint space between radial head and capitulum should be open and clear. Radial head,

neck, and tuberosity should be in profile and free of superimposition except for a small part of the

coronoid process. Coronoid Process: Distal portion of the coronoid

appears elongated but in profile. Joint space between coronoid process and trochlea should be

open and clearRadial Head

Laterals/ Lateromedial

projection 

CR is perpendicular to IR, directed to radial head (approx 2 to 3 cm distal to lateral epicondyle)

Radial head and neck should be partially superimposed by ulna but completely visualized in

profile in various projectons. Radial tuberosity should be visualized.