Which projection and position of the elbow demonstrates the radial head and capitulum without superimposition?

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Citation:

Murphy, A., Fahrenhorst-Jones, T. Elbow (internal oblique view). Reference article, Radiopaedia.org. (accessed on 13 Sep 2022) https://doi.org/10.53347/rID-59930

The elbow internal oblique view is a specialized projection, utilized to demonstrate both the coronoid process in profile and the olecranon process sitting within the olecranon fossa of the humerus. The affected limb is pronated.

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The medial oblique view is not a standard projection of the elbow, however helpful when occult fractures of the coronoid process are suspected.

• the patient is seated alongside the table
• fully extended arm and forearm, in a pronated position 
• ensure the anterior portion of the elbow is roughly 45 degrees from the IR 

• anteroposterior medial oblique projection
• centering point
  • mid elbow joint
• collimation
  • superior to the distal third of the humerus
  • inferior to include one-third of the proximal radius and ulna
  • lateral to include the skin margin 
  • medial to include medial skin margin 
• orientation  
  • portrait
• detector size
  • 18 cm x 24 cm
• exposure
  • 50-60 kVp
  • 2-5 mAs
• SID
  • 100 cm
• grid
  • no 

• the coronoid process should be seen in profile 
• a clear visualization of the olecranon sitting in the olecranon fossa  
• the radial head and proximal ulna are superimposed

Keep in mind patient comfort when performing this examination. 

References

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