RAD 100 Positioning: Elbow

patient position for PA proximal forearm (acute flexion)

center the flexed elbow joint to the center of the IR

patient position for lateral (radial head) projection (4 position series)

flex the elbow 90 degrees, center the joint to the IR and place it in a lateral position

lateral elbow, radius with hand internally rotated x-ray

hand is in extreme internal rotation

lateral elbow, radius with hand lateral x-ray

hand is lateral

lateral elbow, radius with hand pronated x-ray

hand is pronated

lateral elbow, radius with hand supinated as much as possible x-ray

hand is supinated as much as possible

-forearm and humerus superimposed -proximal radius & ulna

what structures should be shown in the image of a PA proximal forearm (acute flexion)?

open elbow joint with olecranon process seen in profile; superimposed humeral epicondyles; soft tissue

what structures should be shown in the image of a lateral elbow projection?

-olecranon process and the distal humerus -soft tissue

what structures should be shown in the image of an AP elbow distal humerus (acute flexion) projection?

-distal humerus without distortion -closed elbow joint

what structures should be shown in the image of an AP elbow distal humerus (partial flexion) projection?

distal humerus, proximal forearm, elbow joint open, soft tissue

what structures should be shown in the image of an AP elbow projection?

-elbow joint opened partially -proximal forearm

what structures should be shown in the image of an AP elbow proximal forearm (partial flexion) projection?

*radial head and neck projected free of superimposition -open elbow joint -soft tissue

what structures should be shown in the image of an AP oblique (lateral rotation) elbow projection?

*coronoid process projected free of superimposition -ulna superimposed by radius -olecranon process in fossa -soft tissue

what structures should be shown in the image of an AP oblique (medial rotation) elbow projection?

perpendicular to the elbow joint

where should the central ray be centered on a AP elbow projection?

perpendicular to the elbow joint

where should the central ray be centered on a AP oblique (lateral rotation) elbow projection?

perpendicular to the elbow joint

where should the central ray be centered on a AP oblique (medial rotation) elbow projection?

perpendicular to the flexed forearm, entering approximately 2" distal to the olecranon process

where should the central ray be centered on a PA proximal forearm (acute flexion)?

perpendicular to the elbow joint

where should the central ray be centered on a lateral elbow projection?

perpendicular to the humerus, approximately 2" superior to the olecranon process

where should the central ray be centered on an AP elbow distal humerus (acute flexion) projection?

perpendicular to the elbow joint

where should the central ray be centered on an AP elbow distal humerus (partial flexion) projection?

perpendicular to the elbow joint

where should the central ray be centered on an AP elbow proximal forearm (partial flexion) projection?

lateral elbow, radius with hand internally rotated

identify the image

lateral elbow, radius with hand lateral

identify the image

lateral elbow, radius with hand pronated

identify the image

lateral elbow, radius with hand supinated as much as possible

identify the image

patient position for AP oblique (medial rotation) elbow

1. center the elbow to the image receptor 2. supinate the hand and place the forearm and humerus on the same plane 3. medially rotate or pronate the hand so the elbow is at an angle of 45 degrees

patient position for AP acute flexion (distal humerus) (Jones Method)

1. center the image receptor to the epicondylar area of the humerus 2. flex the elbow completely, with no rotation

patient position for AP elbow

1. extend the elbow, supinate the hand and adjust the forearm and humerus on one plane 2. place the elbow joint in the center of the image receptor *3. humeral epicondyles are parallel to the image receptor*

patient position for lateral (lateromedial) elbow

1. flex the elbow 90 degrees and place the humerus and forearm in the same plane. 2. center the elbow joint to the middle of the image receptor *3. humeral epicodyles are perpendicular to the image receptor*

patient position for AP elbow distal humerus (partial flexion)

1. place the elbow in an AP position with the hand supinated 2. place the humerus on the IR 3. center the IR on the condyle area

patient position for AP elbow proximal forearm (partial flexion)

1. rest the forearm on the IR w/ the *hand supinated* and the *elbow* in an AP 2. center the image receptor to the elbow joint

patient position for AP oblique (lateral rotation) elbow

1. supinate the hand, place the forearm and humerus on the same plane 2. rotate the hand and forearm laterally 45 degrees; try to have the patients thumb and second digit touch the table

routine projections for elbow

AP Lateral AP Oblique (medial rotation) AP Oblique (lateral rotation) AP (partial flexion) (distal humerus) AP (partial flexion) (proximal forearm) AP Acute flexion (Jones Method) (distal humerus) PA Proximal forearm (Acute flexion)