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