RAD-111 Chapter 4: G

AP Elbow (Fig. C4-162)

1. All essential anatomic structures included. 2. Elbow is rotate laterally, evident by slight separation of proximal radius and ulna . 3. No collimation borders evident; central ray centering excellent for elbow. 4. Optimal exposure factors. 5. No anatomic side marker evident on this projection. Repeatable error(s): 2 (rotation) and 5 (unless markers are visible elsewhere on radiograph)

Lateral elbow (Fig. C4-165)

1. All pertinent anatomic structures demonstrated. 2. Elbow overflexed (beyond 90 degrees) and not true lateral; too much distance between parts of concentric circles 1 and 2; trochlear notch space not open. 3. Satisfactory collimation (i.e., collimation that is evident); central ray centering slightly off center to the elbow joint. 4. Acceptable exposure factors. 5. Anatomic side marker partially off radiograph and unacceptable (unless it is demonstrated on the actual radiograph). Repeatable error(s): 2 (part positioning) and 5 (unless marker is more visible on actual radiograph).

Lateral wrist (Fig. C4-161)

1. All pertinent anatomic structures included. 2. Upper limb rotated slightly; radius and ulna not directly superimposed; metacarpals not all superimposed. 3. No collimation evident on this printed radiograph; centering slightly off; central ray centered to the distal carpal region; includes too much forearm. 4. Acceptable selected exposure factors. 5. Anatomic side marker evident on this projection. Repeatable error(s); 2 (rotation) and 3 (centering)

PA foreman--pediatric (Fig. C4-164).

1. All pertinent anatomic structures not included because of PA projection being performed over AP. 2. Poor part positioning because proximal radius crossing over ulna as a result of PA projection being performed. 3. No collimation evident on this printed radiograph; acceptable central ray centering. 4. Exposure factors are satisfactory. 5. Anatomic side marker evident. Repeatable error(s): 1 (anatomy demonstrated) and 2 (Note: Individual who is immobilizing infant's hand should wear lead glove or use mechanical restraint.)

PA wrist with ulnar deviation (Fig. C4-163). Note: This demonstrates a radial deviation for the ulnar side carpals (the opposite of the ulnar deviation for scaphoid).

1. Aspect of pisiform cut off laterally. 2. Excellent part positioning with good radial deviation. 3. Central ray centering error--central ray centered over scaphoid and medial carpals; would have excellent collimation if central ray were centered correctly. 4. Excellent exposure factors. 5. Evidence of satisfactory anatomic marker. Repeatable error(s): 1 (anatomy demonstrated) and 3 (centering).

PA hand (Fig. C4-160)

1. Because of rotation and flexion, the anatomy of hand is distorted and the joints are not open. 2. Fingers flexed preventing clear assessment of joint spaces. Medial rotation of hand distorts the proximal phalanges and metacarpals. 3. No collimation evident on this printed radiograph centering satisfactory for hand 4. Exposure factors are acceptable 5. No anatomic side marker Repeatable error(s): 1 (anatomy demonstrated) and 2 (part positioning)