Positioning of the Forearm, Elbow and Humerus

AP Elbow Hand is supinated or pronated? The elbow must be _________ until humerus and radius/ulna are in the same plane The humeral epicondyles are _____ to IR CR perpendicular to which part of the elbow? Structures visualized?

AP Elbow Hand is supinated The elbow must be extended until the humerus and radius/ulna are in the same plane Epicondyles are parallel to the IR CR is perpendicular to mid elbow Distal humerus and proximal forearm

Transthoracic Lateral Humerus Patient is in what position? This is to see which part of the humerus? Which view will you get of the humerus? Their affected side is where? Unaffected side is where? Should you attempt to move the injured arm? CR is perpendicular to ____ through thorax Since the CR is entering the thorax first, what kind of technique needs to applied so we can see the proximal humerus? Structures visualized?

Transthoracic Lateral Humerus Patient is lateral. This is to see the proximal humerus and will get a AP view of the proximal humerus Their affected arm is closest to the IR and unaffected arm is above head, shoulder elevated as much as possible No CR is perpendicular to surgical neck through thorax Use a breathing technique Greater tubercle in profile

What parts of the arm should be in the same plane for a forearm and elbow radiographs?

Humerus, elbow, and forearm

AP Elbow (modification) This is only when the patient cant do what? The hand is what? How many views should be taken? Why and how are they taken? CR is perpendicular to what in each view? Structures visualized?

AP Elbow (modification) Only done when the patient cannot extend arm Hand is supinated Two views should be taken due to distortion when patient cannot fully extend arm: 1. Distal humerus is parallel to IR 2. Forearm is parallel to IR CR is centered on elbow Distal humerus and proximal forearm is visualized

AP Forearm What kind of view? Include articulation ends between? The hand must be supinated or pronated? Should the humerus be in the same plane as the radius/ulna? The _______ are parallel to the IR. Where is the CR centered to? Perpendicular or parallel? What are the structures visualized?

AP Forearm PA view Include the wrist and elbow Supinated Should be in the same plane. The epicondyles are parallel to the IR CR is perpendicular to middle of the forearm Elbow joint, radius, ulna, and proximal rows of carpals

AP Humerus Humeral epicondyles are ___ to IR CR is ____ to mid-humerus Should include? (2) Structures visualized?

AP Humerus Humeral epicondyles are parallel to IR CR is perpendicular to mid-humerus Should include shoulder and elbow Greater tubercle in profile, Humeral head and anatomical and surgical necks

AP Lateral (external) Oblique Elbow Elbow is ____ and hand is ______ The arm is rotated ______ 45 degrees (also known as?) CR is perpendicular to? Structures visualized?

AP Lateral Oblique Elbow Elbow is extended and the hand is supinated The arm is rotated laterally (externally rotated) CR perpendicular to elbow joint See radial head free of superimposition of the ulna

AP Medial Oblique (Internal rotation) Hand is supinated or pronated? Elbow should form a ___ angle, what does this allow? CR is perpendicular to? Structures visualized?

AP Medial Oblique Hand is pronated and elbow should form a 45 degree angle to get the radial head out of the way CR is perpendicular to elbow joint Coronoid process projected free of superimposition

Axial Lateral for radial head (Radial head view) If patient cannot rotate their arm _______ , this is a modification Elbow is flexed or not? Epicondyles are _______ to the IR, thumb side is down? Humerus not in the same plane as radius/ulna? Is the CR going to be angled? Towards? Structures visualized? Due to the angling of the tube, will there be distortion?

Axial Lateral for radial head (Radial head view) Cannot rotate arm laterally Elbow is flexed at 90 degrees Epicondyles are perpendicular to the IR, thumb side up Humerus should be in the same plane CR is going to be angled 45 degrees toward the shoulder to get the radial head out of superimposition Radial head free of superimposition Yes

Lateral Elbow Elbow is flexed at? Humeral ______ perpendicular to IR. Thumb side is down or up? Humerus same plane as radius/ulna? CR is parallel to epicondyles? Structures visualized?

Lateral Elbow Flexed at 90 degrees Humeral epicondyles perpendicular to IR. Thumb side is up Yes they are in the same plane Not parallel -----> perpendicular Olecranon process in profile (best view to see this) Radial tuberosity directed anteriorly

Lateral Forearm Include articulation ends between? Elbow must be flexed at what angle? Where is the thumb? Is the humerus the same plane as the radius/ulna? Where is the CR perpendicular to? What are the structures visualized?

Lateral Forearm Include the wrist and elbow Elbow must be flexed at 90 degrees and the thumb side hand up Yes CR perpendicular to middle of forearm Distal radius and ulna superimposed Radial head superimposed with coronoid process

Lateral Humerus (Can do patient facing IR or away, stretcher) Humeral epicondyles are ________ to IR CR is _______ to mid-humerus Should include the ____ and ______ Structures visualized? Ice cream cone? Abduct the humerus from?

Lateral Humerus Humeral epicondyles are perpendicular to IR CR is perpendicular to mid-humerus Should include shoulder and elbow Humeral epicondyles are superimposed and can see humeral head and surgical neck Should see a perfect one Abduct from body

When do you use a grid?

Only for humerus and shoulder

At a minimum, how many views do you need if severe trauma for accurate evaluation of potential fractures?

Two views, 90 degrees apart.