IR SIZE (AP PROJECTION FOREARM)
Lengthwise 7 x 17 in. or 14 x 17 in. divided
Position Part (AP PROJECTION FOREARM)
-supinate hand, extend elbow
-adjust IR so that the long axis is parallel with forearm
-have patient lean laterally
-palpate and adjust humeral epicondyles to be equidistant from IR
Central Ray (AP PROJECTION FOREARM)
perpendicular to midpoint forearm
Structures Shown (AP PROJECTION FOREARM)
-elbow joint, radius and ulna, and proximal row of slightly distorted carpal bones
Evaluation Criteria (AP PROJECTION FOREARM)
wrist and distal humerus
slight superimposition of radial head, neck, and tuberosity of proximal ulna
no elongation or foreshortening of the humeral epicondyles
partially open shoulder joint
IR SIZE (LATERAL PROJECTION FOREARM)
lengthwise 7 x 17 and 14 x 17 divided
Position of Patient (LATERAL PROJECTION FOREARM)
entire limb same plane
flex elbow 90 degrees
center forearm over unmasked half of IR and parallel with long axis of forearm
thumb side up
Central Ray (LATERAL PROJECTION FOREARM)
perpendicular midpoint of forearm
Structures Shown (LATERAL PROJECTION FOREARM)
bones of the forearm, elbow joint, proximal row of carpal bones
Evaluation Criteria (LATERAL PROJECTION FOREARM)
wrist and distal humerus
superimposition of radius and ulna at their distal end
superimposition by the radial head over coronoid process
radial tuberosity facing anteriorly
superimposed humeral epicondyles
elbow flexed 90 degrees
soft tissue and bony trabeculation along entire length of radial and ulnar shafts
Upper Portion of the Ulna has two processes called
1. olecranon process (proximal portion of trochlear notch)
2. coronoid process (distal, lower portion of trochlear notch)
Distal end of humerus is called
Two smooth elevations of the humeral condyle that articulate with the forearm are?
trochlea (medial)
capitulum (lateral)
Cornoid Fossa (Humerus) is?
shallow depression anterior surface above trochlea (receives coronoid process when elbow is flexed)
lateral to the coronoid fossa and proximal to capitulum receives the radial head when elbow is flexed
deep
depression behind the coronoid fossa on posterior surface and accomodates the olecranon process when elbow is extended
covers the largest area and lies within the olecranon fossa of the posterior humerus
lie in the coronoid & radial fossae of the anterior humerus
anterior to and parallel with the anterior aspect of
proximal radius
IR SIZE (AP PROJECTION ELBOW)
Position Part (AP PROJECTION ELBOW)
extend elbow
supinate hand
center IR and parallel with long axis
lean laterally
anterior surface & humeral epicondyles parallel to IR
Central Ray (AP PROJECTION ELBOW)
perpendicular to elbow joint
Structures Shown (AP PROJECTION ELBOW)
AP projection of elbow joint
distal arm
proximal forearm
Evaluation Criteria (AP PROJECTION ELBOW)
radial head, neck, and tuberosity slightly superimposed over proximal ulna
open elbow joint
NO ROTATION OF EPICONDYLES
What is the purpose of an AP elbow with wide latitude exposure?
GRISWOLD two reasons for flexing the elbow 90 degrees
1. olecranon process can be seen in profile
2. elbow fat pads are least compressed
IR SIZE (LATERAL PROJECTION ELBOW)
Position of Patient (LATERAL PROJECTION ELBOW)
near end of the table and low enough to place the humerus and elbow joint in same plane
Position of Part (LATERAL PROJECTION ELBOW)
flex elbow 90 degrees
center IR to elbow joint with long axis of the forearm parallel with long axis of IR
hand in lateral position
humeral epicondyles are perpendicular
Central Ray
(LATERAL PROJECTION ELBOW)
Structures Shown (LATERAL PROJECTION ELBOW)
elbow joint
distal arm and proximal forearm
Evaluation Criteria (LATERAL PROJECTION ELBOW)
open joint
flexed elbow 90 degrees
superimposed humeral epicondyles
radial tuberosity facing anteriorly
radial head slightly superimposing the coronoid process
olecranon process in profile
IR Size (AP OBLIQUE ELBOW MEDIAL)
Position of Part (AP OBLIQUE ELBOW MEDIAL)
center elbow joint to midpoint of IR
rotate internally to pronate the hand
Central Ray (AP OBLIQUE ELBOW MEDIAL)
Structures Shown (AP OBLIQUE ELBOW MEDIAL)
coronoid process projected free of
superimposition
Evaluation Criteria (AP OBLIQUE ELBOW MEDIAL)
coronoid process in profile
elongated medial humeral epicondyles
ULNA SUPERIMPOSED BY RADIAL HEAD AND NECK
OLECRANON PROCRESS WITHIN OLECRANON FOSSA
soft tissue and bony trabeculation
Position of Patient (AP OBLIQUE ELBOW LATERAL)
end of the table with arm extended and in contact with the table
Position of Part (AP OBLIQUE ELBOW LATERAL)
externally rotate to place anterior surface at 45 degree obliquity+
PATIENTS FIRST TWO DIGITS SHOULD TOUCH THE TABLE
Central Ray (AP OBLIQUE ELBOW LATERAL)
perpendicular to elbow joint
Structures Shown (AP OBLIQUE ELBOW LATERAL)
oblique projection of the elbow joint
with radial head and neck free superimposing of the ulna
Evaluation Criteria (AP OBLIQUE ELBOW LATERAL)
radial head, neck, and tuberosity projected free the ulna
open elbow joint
soft tissue and bony trabeculation
Why is there partial
flexion for a distal humerus ?
Patient can't completely extend elbow
Two AP projections must be obtained to avoid distortion
What views are needed when the patient can't extend the elbow?
(AP DISTAL HUMERUS)
(AP PROXIMAL FOREARM)
IR SIZE (AP DISTAL HUMERUS PARTIAL FLEXION)
Position of Patient (AP DISTAL HUMERUS PARTIAL FLEXION)
seat patient low enough to place entire humerus in same plane.
support elevated forearm
Position Part (AP DISTAL HUMERUS PARTIAL FLEXION)
supinate hand if possible
put humerus in same plane
support elevated forearm
Central Ray (AP DISTAL HUMERUS PARTIAL FLEXION)
Perpendicular to humerus
depending of the flexion, angle ray distally into the joint
Structures Shown (AP DISTAL HUMERUS PARTIAL FLEXION)
Evaluation Criteria (AP DISTAL HUMERUS PARTIAL FLEXION)
Distal Humerus without rotation or distortion
proximal radius superimposed over the ulna
closed elbow joint
greatly foreshortened proximal forearm
trabeculation detail on the distal humerus
Position Patient (AP PROXIMAL FOREARM PARTIAL FLEXION)
seat patient at the end of the table with hand supinated
Position of Part (AP DISTAL HUMERUS PARTIAL FLEXION)
seat patient high
enough to permit DORSAL surface of the forearm to rest on the table
Central Ray (AP PROXIMAL FOREARM PARTIAL FLEXION)
perpendicular to elbow joint and long axis of forearm
Structures Shown (AP PROXIMAL FOREARM PARTIAL FLEXION)
IR
SIZE (AP HUMERUS UPRIGHT)
Position of Part (AP HUMERUS UPRIGHT)
1.5 inches above humeral head
slightly abduct arm and supinate hand
coronal plane passing through the epicondyles and parallel with IR
Central Ray (AP HUMERUS UPRIGHT)
perpendicular to midportion of humerus and center to IR
Structures Shown (AP HUMERUS UPRIGHT)
AP projection of entire length of humerus
accuracy shown by epicondyles
Evaluation Criteria (AP HUMERUS UPRIGHT)
elbow and shoulder joint
maximum visibility of epicondyles without rotation
humeral head and greater tubercle in profile
outline of lesser tubercle
beam divergence possibly partially closing the elbow joint
no great variation in radiographic densities of proximal and distal humerus
IR Size (Lateromedial Projection Humerus
Upright)
Position of Part (Lateromedial Projection Humerus Upright)
IR 1.5 inches above humeral head
internally rotate arm if patient arm
flex elbow 90 degrees and place patient anterior hand on hip
coronal plane passes through the epicondyles should be perpendicular to IR
`
Central Ray (Lateromedial Projection Humerus Upright)
Perpendicular to midportion of humerus and center to IR
Structures Shown (Lateromedial Projection Humerus Upright)
entire length of humerus. accuracy of position is confirmed by
superimposed epicondyles
Evaluation Criteria (Lateromedial Projection Humerus Upright)
elbow and shoulder joint
superimposed epicondyles
LESSER TUBERCLE IN PROFILE
greater tubercle superimposed over humeral head
NO GREAT VARIATION in radiographic densities of proximal and distal humerus
IR Size (AP HUMERUS RECUMBENT)
Position of Part (AP HUMERUS RECUMBENT)
IR 1.5 inches above humeral head
elevate the opposite shoulder on a sandbag to place the affect arm in contact with the IR or elevate the arm and IR on sandbags
supinate hand if you can and adjust the limb to place epicondyles parallel with the plane of the IR
Position of Part (AP HUMERUS RECUMBENT LATEROMEDIAL)
rotate the forearm medially to place EPICONDYLES PERPENDICULAR to the plane of the IR
rest posterior aspect of hand against patient's side
this movement turns the epicondyles in lateral position without flexing the elbow
Structures Shown (AP HUMERUS RECUMBENT LATEROMEDIAL)
Central Ray (AP HUMERUS RECUMBENT LATEROMEDIAL)
center of IR of distal humerus
Arm is made up of one bone called the...
The upper portion of the ULNA has two processes called
olecranon process (more proximal)
coronoid process (more distal)
Distal End of the Humerus is called the
TWO SMOOTH ELEVATIONS
(OF THE HUMERALCONDYLE) THAT ARTICULATE WITH FOREARM ARE AS
TROCHLEA (MEDIAL SIDE)
CAPITULUM (LATERAL SIDE)
SHALLOWDEPRESSION ANTERIOR SURFACE ABOVE TROCHLEA IS THE
What is LATERALTO THE CORONOID FOSSA AND PROXIMAL TO CAPITULUM RECEIVES THE RADIAL HEAD WHENELBOW IS FLEXED.?
DEEP DEPRESSION BEHIND THE CORONOID FOSSA ON POSTERIORSURFACE AND ACCOMODATES THE OLECRANON PROCESS WHEN ELBOW IS EXTENDED.
OF THE PROXIMALHUMERUS: WHAT IS THE LARGE, SMOOTH,ROUNDED AND LIES IN AN OBLIGUE PLANE ON SUPEROMEDIAL SIDE.
WHAT PART IS LYING IN SAME PLANE AS HEAD OF THE HUMERUS?
OF THE PROXIMAL HUMERUS CONSTRICTION OF BODY BELOW THE TUBERCLES (SITE FOR MANY FRACTURES).
Of the proximal humerus what is the ANTERIOR SURFACE IMMEDIATELY BELOW ANATOMIC NECK.
LATERAL SURFACE JUST BELOW THE ANATOMIC NECK OF THE HUMERUS IS
DISTAL AND PROXIMAL RADIOULNAR ARTICULATIONS ARE
Pronation of the
Hand does what?
RADIUSTURNS MEDIALLY AND CROSSES OVER ULNA AT ITS “UPPER THIRD”
THE ULNA MAKES ASLIGHT COUNTER ROTATION THAT ROTATES THE HUMERUS MEDIALLY.
What fat pad COVERS THE LARGEST AREA AND LIES WITHIN THE OLECRANON FOSSA OF THE POSTERIOR HUMERUS?
What fat pad LIES IN THE CORONOID & RADIAL FOSSAE OF THE ANTERIOR HUMERUS?
What fat pad is ANTERIOR TO AND PARALLEL WITH THE ANTERIOR ASPECT OF PROXIMAL RADIUS?