Elbow

Ir

10x12

How much and in which direction should the central Ray be angled for the trauma axial lateral projection (coyle method) involving the coronoid process?

45° away from shoulder

How much is the upper limb rotated for a lateral (rotation) oblique projection of the elbow?

45° laterally

How much and in which direction should the central Ray be angles for the trauma axial lateral projection ( coyle method) involving the radial head?

45° toward shoulder

Special projections of the elbow

Acute flexion Trauma axial lateral (coyle method) Radial head projections

The trauma lateral

Aka radial head capitulum view Elbow in a true lateral position Cr angles 25° towards the head along the long axis of the humerus. Elbow in 90° flexion epicondyles superimposed and perpendicular to the image receptor

Ap elbow fully extended

Epicondyles parallel to ir Cr to mid elbow joint Demonstrates well penetrated bone architecture.

True false: lead (gonadal) shielding is not required for upper limb radiographs of the patient can sit upright for these exams

False

Cr

Perpendicular to ir directed to midelbow joint which is approx 2 cm distal to midpoint of a line between epicondyles

Which special projections of the elbow should be performed instead of the routine ap if the patients elbow is tightly flexed and cannot be extended at all?

Two projections-cr perpendicular to humerus and cr perpendicular to forearm

Radial head lateromedial projections

1.Hand supinated maximum external rotation 2.hand lateral 3.hand pronated 4.hand internal rotation -maximum internal rotation Cr perpendicular to ir directed to radial head

Sid

40 inches

Analog

60-70 kv

Digital

70-75 kv

What is the amount of elbow flexion required for the trauma lateral projection (coyle method) to demonstrate the coronoid process?

80° of flexion

Projections of the elbow

Ap Oblique -Lateral (external) - Medial (internal) Lateral

Which routine projection of the elbow best demonstrates the radial head, neck, and tuberosity with slight (if any) superimposition of the ulna?

Ap oblique with 45° lateral rotation

Which projection of the elbow best demonstrates the coronoid process in profile?

Ap oblique with 45° medial rotation

Trauma axial lateromedial projections (coyle method)

Cr 45° away shoulder 80° flexion For coronoid process

Trauma axial lateromedial projections (coyle method)

Cr 45° to shoulder 90° flexion For radial head

Acute flexion

Cr perpendicular to humerus Cr perpendicular to forearm

Ap medial oblique projection

Demonstrates the coronoid process, trochlear notch and medial trochlea in profile. The limb is rotated medially (internal) 45 degrees the hand is pronated

Lateral elbow

Elbow flexed 90° humerus and forearm parallel to ir Three concentric arcs visible Olecranon process in profile

The best position to evaluate the posterior fat pads of the elbow joint is

Lateral flexed 90°

Ap lateral oblique projection

Purpose is to demonstrate the radial head and radial neck free of superimposition, and an unobstructed view of the radioulnar joint 45° external rotation Shows tuberosity lateral epicondyle and capitulum in profile

What is the only difference among the four radial head lateral projections of the elbow ?

The rotational position of hand and wrist

Funny bone

Ulnar nerve Largest unprotected nerve in the body Only place on the arm where the nerve is not protected On the elbow (runs along the back of the elbow) Directly connected to the little finger and half of the ring finger Supplies the palmar side of the afore mentioned fingers