Elbow - Evaluation Criteria

AP: Alternate Partial Flexion - Anatomy

Distal humerus is best visualized on "humerus parallel" projection, and proximal radius and ulna are best visualized on "forearm parallel" projection.

Distal humerus is best visualized on ______ projection, and proximal radius and ulna are best visualized on _______ projection.

Distal humerus is best visualized on *"humerus parallel" projection*, and proximal radius and ulna are best visualized on *"forearm parallel" projection.*

Acute Flexion Elbow (distal humerus)

1. Forearm and humerus should be directly superimposed. 2. Medial and lateral epicondyles and parts of trochlea, capitulum, and olecranon process all should be seen in profile. 3. Optimal exposure should visualize distal humerus and olecranon process through superimposed structures. 4. Soft tissue detail is not readily visible on either projection.

AP Elbow - Position

1. Long axis of arm should be aligned with long axis of IR. 2. No rotation evidenced by : The appearance of bilateral epicondyles seen in profile and radial, head, neck, and tubercles separated or only slightly superimposed by ulna. Olecranon process should be seated in the olecranon fossa with fully extended arm. Elbow joint space appears open with fully extended arm and proper CR centering. CR and center of collimation field should be to the mid-elbow joint.

AP Oblique: Lateral (external) Rotation - Position

1. Long axis of arm should be aligned with side border of IR. 2. Correct 45 degree lateral oblique should visualize radial head, neck, and tuberosity, free of superimposition by ulna. 3. Lateral epicondyle and capitulum should appear elongated and in profile. 4. CR and center of collimation field should be to mid-elbow joint.

AP Oblique: Medial (internal) Rotation - Position

1. Long axis of arm should be aligned with side border of IR. 2. Correct 45 degree medial oblique should visualize coronoid process of the ulna in profile. 3. Radial head and neck should be superimposed and centered over the proximal ulna. 4. Medial epicondyle and trochlea should appear elongated and in partial profile. 5. Olecranon process should appear seated in olecranon fossa and trochlear notch partially open and visualized with arm fully extended. 6. CR and center of collimation field should be at mid-elbow joint.

AP: Alternate Partial Flexion - Position

1. Long axis of arm should be aligned with side border of IR. 2. No rotation evidenced by: epicondyles seen in profile and radial head and neck separated or only slightly superimposed over ulna on forearm parallel projection. CR and center of collimation field should be to the mid-elbow joint.

Lateromedial Elbow - Position

1. Long axis of forearm should be aligned with long axis of IR, with the elbow joint flexed 90 degrees. 2. About 1/2 of radial head should be superimposed by the coronoid process, and olecranon process should be visualized in profile. 3. True lateral view is indicated by three concentric arcs of the trochlear sulcus, double ridges of the capitulum and trochlea, and the trochlear notch of the ulna. In addition, superimposition of the humeral epicondyles occurs. 4. CR and center of collimation field should be midpoint of the elbow joint.

Acute Flexion Elbow (proximal forearm)

1. Proximal ulna and radius, including outline of radial head and neck, should be visible through superimposed distal humerus. 2. Optimal exposure visualizes outlines of proximal ulna and radius superimposed over humerus.

Which are true about AP Oblique Lateral (external) elbow? All that apply: A. CR and center of collimation field should be to mid-elbow joint. B. Lateral epicondyle and capitulum should appear elongated and in profile. C. Long axis of arm should be aligned with side border of IR D. Correct 45 degree lateral oblique should visualize radial head, neck, and tuberosity superimposed.

A. CR and center of collimation field should be to mid-elbow joint. B. Lateral epicondyle and capitulum should appear elongated and in profile. C. Long axis of arm should be aligned with side border of IR ** D is in incorrect because 45 degree lateral oblique should visualize radial head, neck, and tuberosity, free of superimposition by ulna.

What anatomy do you want to see on AP elbow? All that apply: A. Distal humerus B. Distal radius and ulna C. Elbow joint space D. Proximal humerus

A. Distal humerus C. Elbow joint space (Distal humerus, elbow joint space, and proximal radius and ulna are visible.)

Which apply to lateromedial elbow evaluation criteria? All that apply: A. Elbow joint should be flexed 90 degrees B. About 1/2 of radial head should be superimposed by the coronoid process C. CR should be at midpoint of the humerus D. Superimposition of humeral epicondyles

A. Elbow joint should be flexed 90 degrees B. About 1/2 of radial head should be superimposed by the coronoid process D. Superimposition of humeral epicondyles **C is incorrect because CR and center of collimation field should be midpoint of the elbow joint.

Which apply for AP elbow evaluation criteria? All that apply: A. Long axis of arm should be aligned with long axis of IR B. Olecranon process is in the olecranon fossa C. Elbow joint spaces appear closed D. CR at mid-elbow joint

A. Long axis of arm should be aligned with long axis of IR B. Olecranon process is in the olecranon fossa D. CR at mid-elbow joint **C is incorrect because joint spaces should appear open

What anatomy should you see on a lateromedial elbow projection? All that apply: A. Proximal forearm B. Soft tissues and fat pads C. Olecranon Process D. Proximal humerus

A. Proximal forearm B. Soft tissues and fat pads C. Olecranon Process (Lateral projection of distal humerus and proximal forearm, olecranon process, and soft tissues and fat pads of the elbow joint are visible.)

What anatomy do you want to see on an AP oblique lateral (external) projection? All that apply: A. Lateral projection of radius and ulna B. Oblique distal humerus C. Proximal radius and ulna D. Entire humerus

B. Oblique distal humerus C. Proximal radius and ulna (Oblique projection of distal humerus and proximal radius and ulna is visible.)

What anatomy do you want to see on AP oblique medial (internal) projection? All that apply: A. Oblique view of proximal forearm B. Lateral radius and ulna C. Oblique view of distal humerus D. Proximal radius and ulna

C. Oblique view of distal humerus D. Proximal radius and ulna (Oblique view of distal humerus and proximal radius and ulna is visible.)

AP Elbow - Anatomy

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

Trauma Axial Lateromedial and Mediolateral Elbow (Coyle Method)- Coronoid Process

For Coronoid Process: 1. Anterior portion of the coronoid appears elongated but in profile. 2. joint space between coronoid process and trochlea should be open and clear. 3. Radial head and neck should be superimposed by ulna. 4. Optimal exposure factors should visualize clearly the coronoid process in profile. Bony margins of superimposed radial head and neck should be visualized faintly through proximal ulna.

Trauma Axial Lateromedial and Mediolateral Elbow (Coyle Method)- Radial Head

For Radial Head: 1. Joint space between radial head and capitulum should be open and clear. 2. Radial head, neck, and tuberosity should be in profile and free of superimposition except for a small part of the coronoid process. 3. Distal humerus and epicondyles appear distorted because of 45 degree angle.

Lateromedial Elbow - Anatomy

Lateral projection of distal humerus and proximal forearm, olecranon process, and soft tissues and fat pads of the elbow joint are visible.

AP Oblique: Lateral (external) Rotation - Anatomy

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

AP Oblique: Medial (internal) Rotation - Anatomy

Oblique view of distal humerus and proximal radius and ulna is visible.