Exam 5 Chapter 7
Concerning IR placement/collimated field location , (a) to what level on the patient should the upper border of an IR or collimated field be placed when demonstrating the proximal femur (b) to what level of the patient should the lower border of the IR or collimated field be placed when demonstrating the distal femur?
(a) At the level of the ASIS (b) 2 inches below the knee
Concerning the placement of the unaffected (uppermost) limb, (a) where should it be placed when demonstrating the proximal femur (b) Where should it be placed when demonstrating the distal femur
(a) posterior to the affected thigh (b) anterior of the affected thigh
What is the CR orientation and entrance point for the AP projection of the knee joint?
-according to ASIS to tabletop measurement-enters 1/2 in below patellar apex-19 cm: 3 to 5 degrees cuadad-19 to 24 cm: perpendicular-24 cm: 3 to 5 degrees cephalad
How many degrees and in what direction should the CR be directed if the patient measures between 7 1/2 and 10 inches (19 and 24 cm) from the ASIS to the table top?
0 degrees ( perpendicular)
The placement of the top border of the IR should extend atleast___inches (___cm ) above the knee joint to avoid being projected off by beam divergence.
1 to 1 1/2 and 2.5 to 3.8 cm
For the following three situations, choose the CR angulation that best demonstrates the joint space based on the anterior superior iliac spine (ASIS) to tabletop measurement. 1. Less than 7 1/2 inches (19 CM) 2. Between 7 1/2 and 10 inches (19 cm- 24 cm) 3. More than 10 inches (24 cm)
1. 3 to 5degrees caudad 2. Perpendicular 3. 3 to 5 degrees cephalad
Describe 3 ways the patient can be positioned on a radiographic table in the tangential projection (settegast method)
1. The patient can be placed in the prone position with the knee flexed and centered over the IR. 2. The patient can be lateral recumbent with a VERTICALLY oriented IR placed against the ANTERIOR surface of the distal thigh. 3. The patient can be sitting with his/her feet off the placed against the anterior surface of the lower thigh
Describe the three ways patients can positioned?
1. The patient can be standing with the affected knee flexed and resting on a horizontally oriented IR that is placed on a stool. 2. The patient can be standing with the affected knee flexed and placed in contact with a vertically oriented IR 3. The patient can be kneeling on the radiographic table with the affected knee over the IR.
With reference to the knee, where is the centering point used for positioning the IR or centering the collimated field to the knee?
1/2 inch below the apex of the patella
Where on the knee should the CR enter?
1/2 inch inferior to the patellar apex
The knee should be flexed no more than___? degrees
10
When a new or healing fracture is present the knee should be flexed no more than __ ? degrees
10
How many degrees and in which direction should the lower limb be rotated to demonstrate the proximal femur?
10 to 15 degrees medially
Oblique ankle can be done with ________ medial rotation
15 or 45 degrees
From the supine position, how many degrees should the lower limb and foot be rotated to position the ankle for this projection? (demonstrate the ankle mortise?)
15 to 20 degrees
The knee should be flexed ___? degrees
20 to 30
How many degrees and in what direction should the central ray be directed if the patient measures less than 7 1/2 inches (19cm) from the ASIS to the table top?
3 to 5 degrees caudal
How many degrees and in what direction should the CR be directed if the patient measures more than 10 inches (24 cm) from the ASIS to the table top?
3 to 5 degrees cephalic
AP medial oblique foot is at Foot angle of ______
30 degrees
How many degrees and in what direction should the central ray be directed?
40 degrees caudad (when the knee is flexed 40 degrees) or 50 degrees caudad (when the knee is flexed 50 degrees)
How many degrees and in which direction should the central ray be directed for the axial (plantodorsal) projection? (CALCANEUS)
40 degrees cephalad
How many degrees and in what direction should the leg and foot be rotated?
40 degrees medially
Approximately how many degrees should the knee be flexed?
40 or 50 degrees
How many degrees should the leg be rotated?
45 degrees
When demonstrating the distal femur and including the knee, how many degrees should the knee be flexed?
45 degrees
Which individual toes are best demonstrated using the AP oblique projection with the foot rotated laterally?
4th and 5th toes (and sometimes 3rd)
Lateral Knee with _____ cephalic angle
5 degrees
***How many degrees and in what direction should the CR be directed?
5 to 7 degrees cephalad
What angle should be formed between the femur and the pane of the IR when the patient is correctly positioned?
70 degrees
What might occur if the patient flexes the knee more than the recommended number of degrees?
A reduction in the femoropatellar joint space
From the following list, what structures and articulation should be demonstrated in the image of an AP oblique ankle. a. Talus b. cuboid c. calcaneus d. distal tibia e. distal fibula f. tibifibuluar articulation g. femorotibial articulation i. Talofibular articulation
A. Talus D. Distal tibia E. Distal fibula F. Tibiofibular articulation (joint)
What are the essential projections for the femur?
AP and lateral
What are the essential projections for the leg?
AP and lateral
What projection shows the joint spaces of the toes?
AP axial 15 degree angle
What projection shows the joints spaces the best with the foot?
AP axial foot with 10 degree angle
What are the essentials projections of the foot?
AP, AP axial, AP oblique, and lateral
What is the essential projections for the toes?
AP, AP axial, AP oblique, and lateral
What are the essential projections of the ankle?
AP, lateral, AP oblique-medial rotation, AP oblique-medial rotation for mortise joint, and AP-stress
What are the essential projections for the knee joint?
AP, lateral, AP standing (weight-bearing), AP oblique in lateral rotation position, and AP oblique in medial rotation position
Describe how the IR should be placed for a knee projection?
Against the anterior surface of the knee and centered to the patellar apex
How do images indicate that a patient has a torn ligament affecting the ankle?
An increase in the joint space on the side of the injury indicates a torn ligament
What is the CR orientation and entrance point for the AP axial projections of the foot?
Angled 10 degrees; enters based of third metatarsal
What is the CR orientation and entrance point of the AP axial projection of the toes?
Angled 15 degrees posteriorly; enters third MTP joint
What is the CR orientation and entrance point for the plantodoral axial projection of the calcaneus
Angled 40 degrees cephalic; enters base of third metatarsal
Where on the medial surface of the foot should the central ray enter the calcaneus for the lateral projection?
At the midportion of the calcaneus (1 inch distal to the medial malleolus).
write M if the statement refers to the medial oblique, L if the statement refer to the lateral oblique projection, or B if the statement refers to both oblique projection. Knee joint should be seen and open
Both
write M if the statement refers to the medial oblique, L if the statement refer to the lateral oblique projection, or B if the statement refers to both oblique projection. Soft tissue around the knee should be seen
Both
write M if the statement refers to the medial oblique, L if the statement refer to the lateral oblique projection, or B if the statement refers to both oblique projection. Tibial plateaus should be visualized
Both
write M if the statement refers to the medial oblique, L if the statement refer to the lateral oblique projection, or B if the statement refers to both oblique projection. bony trabecular detail of the distal femur and proximal tibia should be demonstrated
Both
What are the size of collimate field for the essentials projections of the foot?
Collimate 1 inch on all sides including 1 inch beyond calcaneus and distal tips of toes
What is the size of collimated field for the plantodoral axial projection of the calcaneus?
Collimate to 1 inch on three sides of the calcaneus shadow
What is the size of collimated field for the lateral projection of the calcaneus?
Collimate to 1 inch past posterior and inferior heel shadow; include medial malleolus and 5th metatarsal bas
What are the size of collimated field for the essential projections for the knee joint?
Collimate to 10x12 inches
What is the collimated field for the lateral projection for the patella and patellofemoral joint?
Collimate to 4x4 inches
What is the collimated field for the PA projection for the patella and patellofemoral joint?
Collimate to 6x6 inches
On an image of a correctly positioned AP projection of the knee, the patella should be demonstrated ?
Completely superimposed on the femur
What is the anatomic landmarks and relation to IR for the AP oblique-medial rotation projection for the ankle?
Coronal plane of lower extremity and malleoli at 45 degree angle with IR
What is the anatomic landmarks and relation to IR for the AP oblique-medial rotation for mortise joint projection for the ankle?
Coronal plane of lower extremity at 15 to 20 degree angle with IR; intermalleolar plane parallel with IR
With reference to the lower leg, how should the foot be positioned for the lateral projection?
Dorsiflex the foot to form a 90 degree angle with the lower leg.
True or false The bases of metatarsals should be included within the image for AP oblique projections.
False
True or false the foot should be plantar flexed to place the long axis of the foot parallel with the IR.
False
What is the anatomic landmarks and landmarks relation to IR for the lateral projection of the leg?
Femoral condyles and patella perpendicular to IR
What is the anatomic landmarks and landmarks relation to IR for the AP projection of the leg?
Femoral condyles parallel to IR
What is the anatomic landmarks and relation to IR for the AP oblique lateral rotation position projection of the knee joint?
Femoral condyles superimposed and perpendicular to IR; patella perpendicular to IR
What two metatarsal bases appear overlapped in the image of the AP oblique projection medial rotation?
First and second metatarsal
Which positioning maneuver relaxes the muscles and shows the maximum volume of the joint cavity?
Flexing the knee 20 to 30 degrees
Both PA axial projections (the holmblad method and the camp coventry method) produce similar results and have identical evaluation criteria. From the following list, circle the seven evaluation citeria that refer to both projections.
Fossa should be open and visualized. Apex of the patella should not superimpose the fossa. Soft tissue in the fossa and interspaces should be seen. Intercondylar eminences and knee joint space should be seen. No rotation is evident by slight tibiofibular overlap being seen. Posteroinferior surface of the femoral condyles should be demonstrated. Bony trabecular detail on the tibial eminences, distal femur, and proximal tibia should be demonstrated.
How should the pelvis be positioned to demonstrate the proximal femur?
From true lateral, the pelvis should be rolled posteriorly about 10 to 15 degrees
When the patient is placed in the prone position and is unable to maintain a steady lower leg after flexing the knee, what can be done to help the patient hold the position?
Instruct the patient to hold his/her shoulder over the ends of a long strip of bandage that is looped around the ankle and foot
AP knee showing the femorotibial joint and AP knee with femorotibial joint space not fully open. Lets say both are the same patient describe how you believe the central ray was directed to produce the image? Explain why?
It was directed perpendicularly or some angulaion other than 3 to 5 degrees cephalad; the femorotibial joint space is not well shown
Assuming that the ASIS to tabletop measurement for the patient is greater than 10 inches describe how you believe the central ray was directed to produce the image explain why?
It was probably angled 3 to 5 degrees cephalad, the femorotibial joint space is demonstrated open
write M if the statement refers to the medial oblique, L if the statement refer to the lateral oblique projection, or B if the statement refers to both oblique projection. Medial femoral and tibial condyles should be demonstrated
Lateral oblique projection
The CR should be directed perpendicular to the long axis of the ?
Leg (tibia)
What is the anatomic landmarks and relation to IR for the lateral projection of the calcaneus
Long axis of calcaneus aligned with long axis of IR
What is the key patient/part positioning points for the lateral projection of the leg?
Lying on affected side with leg extended; leg resting on lateral surface; knee may be slightly flexed
What is the patient/part positioning points for the lateral projection of the knee joint?
Lying on affected side with opposite extremity on table for support; normal knee flexed 20 to 30 degrees; flexed knee resting on lateral side; ankle supported to lie in same plane, if neccessary
What is the anatomic landmarks and relation to IR for the AP- stress projection for the ankle?
Malleoli in anatomic position; foot inverted and everted
What is the anatomic landmarks and relation to IR for the AP projection for the ankle?
Malleoli in anatomic position; plantar surface of foot positioned vertical
What is the anatomic landmarks and relation to IR for the plantodoral axial projection of the calcaneus
Malleoli parallel with plane of IR; plantar surface vertical
What is the anatomic landmarks and relation to IR for the lateral projection for the ankle?
Malleoli superimposed and perpendicular to IR
The CR should enter the patient 1 inch distal to the ?
Medial epicondyle
How should the femoral neck appear in the AP projection of the proximal femur?
Not foreshortened in profile
What are the essential projections for the intercondylar fossa?
PA axial (Homblad Method) PA axial (Camp-Coventry Method)
Why is the PA projection preferred over the AP projection?
PA projections provide better recorded detail because of a closer object to image distance than the AP projection.
What is the essential projections for the patella and patellofemoral joint?
PA, lateral, and Tangential (Settegast method)
What procedure should the radiographer perform if the patient is unable to turn from the supine position toward the affected side to position a fractured leg on the IR for the lateral projection?
Perform a cross table lateral projection by placing an IR vertically between the patients legs and directing a horizontal CR to the leg.
What should the radiographer do if the leg is too long to demonstrate the knee and the ankle joint with the same exposure?
Perform two AP projections to ensure that the entire lower limb is demonstrated
With reference to the plane of the IR, the patella should be___? (parallel or perpendicular)
Perpendicular
What is the CR orientation and entrance point of the Lateral projection of the toes?
Perpendicular to IR of great toe; PIP joint of toes 2 to 5
What is the CR orientation and entrance point for the AP projections of the foot?
Perpendicular to base of third metatarsal
What is the CR orientation and entrance point for the AP projection of the leg?
Perpendicular to center of leg
What is the CR orientation and entrance point for the PA axial (Camp-Coventry Method) projection of the intercondylar fossa?
Perpendicular to lower leg; angled 40 degrees caudad with 40 degree knee flexion; 50 degrees with 50 degree knee flexion; enters knee joint and IR center
What is the CR orientation and entrance point for the lateral projection of the leg?
Perpendicular to midpoint of leg
What is the CR orientation and entrance point for the AP projection for the patella and patellofemoral joint?
Perpendicular to midpopliteal are; exits patella
Describe how and where the CR should be directed? (Tangential projection settegast)
Perpendicular to the patellofemoral joint space (CR angulation is typically 15 to 20 degrees)
Describe how and where the CR should be directed for a knee projection?
Perpendicular to the tibia-fibula at the center of the IR, entering the posterior surface of the knees
What is the CR orientation and entrance point of the AP oblique projection of the toes?
Perpendicular to third MTP joint
What is the CR orientation and entrance point of the AP projection of the toes?
Perpendicular to third MTP joint
What is the CR orientation and entrance point for the lateral projection of the calcaneus
Perpendicular; enters 1 inch distal to medial malleolus
What is the CR orientation and entrance point for the AP-stress projection for the ankle?
Perpendicular; enters ankle joint midway between the malleoli
What is the CR orientation and entrance point for the lateral projection for the ankle?
Perpendicular; enters medial malleolus
What is the anatomic landmarks and relation to IR for the lateral projections of the foot?
Plane of MTP joints and plantar surface perpendicular to plane of IR; long axis of foot aligned with long axis of IR
What is the anatomic landmarks and relation to IR of the AP oblique projection of the toes?
Plane of MTP joints at 30 to 45 degree angle from plane of IR
What is the anatomic landmarks and relation to IR of the AP axial projection of the toes?
Plane of MTP joints parallel with plane of IR
What is the anatomic landmarks and relation to IR for the AP axial projections of the foot?
Plane of MTP joints parallel with plane of IR; long axis of foot aligned with long axis of IR
What is the anatomic landmarks and relation to IR for the AP projections of the foot?
Plane of MTP joints parallel with plane of IR; long axis of foot aligned with long axis of IR
What is the anatomic landmarks and relation to IR of the AP projection of the toes?
Plane of MTP joints parallel with plane of IR; long axis of foot aligned with long axis of IR
What is the anatomic landmarks and relation to IR of the Lateral projection of the toes?
Plane of MTP joints perpendicular to IR
What is the anatomic landmarks and relation to IR for the AP oblique projections of the foot?
Plane of MTP joints rotated 30 degrees medially from plane of IR; long axis of foot aligned with long axis of IR
What are the essentials projections of the calcaneus?
Plantodoral axial and lateral
What is the key patient/part positioning points for the AP projection for the patella and patellofemoral joint?
Prone; patella parallel to IR; heel rotated laterally 5 to 10 degrees
For lateral projections of the lesser toes, the central ray should enter at the ______ joint?
Proximal interphalangeal
What should the radiographer do to make maintaining the proper flexion of the knee more comfortable for the patient?
Rest the patients foot on a support
How should the lower limb be adjusted to place the patella parallel with the IR
Rotate the heel 5 to 10 degrees laterally.
What is the key patient/part positioning point of the Lateral projection of the toes?
Seat or supine with knee flexed and lateral side of foot on IR; leg and foot rotated laterally for toes 3 to 5 medially for toes 1 to 2 to place in lateral position
What is the key patient/part positioning point of the AP axial projection of the toes?
Seat or supine with knee flexed and plantar surface of foot resting on IR; leg vertical; plantar surface of foot resting on IR; toes centered
What is the key patient/part positioning point of the AP projection of the toes?
Seat or supine with knee flexed and plantar surface of foot resting on IR; leg vertical; plantar surface of foot resting on IR; toes centered to collimated field
What is the key patient/part positioning point of the AP oblique projection of the toes?
Seat or supine with knee flexed; foot resting on IR; foot and leg medially rotated to place plantar surface of foot at 30 to 45 degree angle from IR
What is the key patient/part positioning points for the AP-stress projection for the ankle?
Seated or supine with knee extended; ankle in anatomic position wile foot is forcibly held in inversion and eversion stress for two separate exposures
What is the key patient/part positioning points for the AP projection for the ankle?
Seated or supine with knee extended; dorsal surface of ankle centered to IR/collimated field; ankle in anatomic position; foot dorsiflexed to right angle
What is the key patient/part positioning points for the AP oblique- medial rotation for mortise joint projection for the ankle?
Seated or supine with knee extended; lower extremity rotated medially 15 to 20 degrees; ankle centered to IR; foot dorsiflexed
What is the key patient/part positioning points for the AP oblique-medial rotation projection for the ankle?
Seated or supine with knee extended; lower extremity rotated medially 45 degrees; ankle centered to IR; foot dorsiflexed
What is the key patient/part positioning points for the lateral projection of the calcaneus
Seated or supine with knee flexed and lateral surface of calcaneus centered to collimated field; leg rotated laterally to place plantar surface of calcaneus perpendicular to IR
What is the key patient/part positioning points for the AP oblique projections of the foot?
Seated or supine with knee flexed and plantar surface of foot resting on IR; leg and plantar surface of foot medially rotated 30 degrees from IR
What is the key patient/part positioning points for the lateral projections of the foot?
Seated or supine with knee flexed and plantar surface of foot resting on IR; leg rotated laterally to place plantar surface of foot perpendicular to IR; foot dorsiflexed to 90 degrees
What is the key patient/part positioning points for the AP axial projections of the foot?
Seated or supine with knee flexed and plantar surface of foot resting on IR; leg vertical, plantar surface of foot resting on IR
What is the key patient/part positioning points for the AP projections of the foot?
Seated or supine with knee flexed and plantar surface of foot resting on IR; leg vertical, plantar surface of foot resting on IR
What is the collimated field for the Tangential (settegast method) projection for the patella and patellofemoral joint?
Single-collimate 4x4 inches bilateral- 4x10 inches
Where is the patella located on a correctly positioned AP projection of the knee?
Slightly off center to the medial side of the femur
What is the patient/part positioning points for the AP projection of the knee joint?
Supine or seated with knee extended; knee extended; 1/2 inch below patellar apex in center of IR/collimated field
What is the key patient/part positioning points for the AP projection of the leg?
Supine or seated with knee extended; knee extended; ankle and foot dorsiflexed
What is the patient/part positioning points for the AP oblique in lateral rotation position projection of the knee joint?
Supine; knee extended; lower extremity externally rotated 45 degrees
For the lateral projections of the toes, what can be done to prevent the superimposition of toes?
Tape all toes above the affected toe into a flexed position.
What factor determines the number of degrees the central ray should be angled with a knee projection?
The amount of knee flexion
How do the positioning procedures most likely differ to produce these images?
The angulation of the CR was different
What determines the number of degrees the CR is angled for a knee projection?
The degree of flexion of the knee
Where should the distal fibula be seen in images of the lateral projection of the foot?
The distal fibula should overlap the posterior portion of the tibia.
What portion of an ORTHOPEDIC appliance should be demonstrated on the image?
The entire orthopedic appliance should be demonstrated
What can occur if a patient with a healing fracture flexes the knee more than recommended number of degrees?
The fracture may separate, causing a fragment to be displaced
What structures of the knee are demonstrated with the tunnel projection?
The intercondylar fossa is primarily demonstrated but the intercondylar tubercles, the femoral condyles, and the tibial plateaus can also be seen.
With reference to the position of the patients leg and foot during the procedure, how is it determined that the leg has been rotated the correct number of degrees?
The intermalleolar plane should be parallel with the IR.
Why is preferable to place the patient in the prone position for the tangential projection?
The knee can usually be flexed to a greater degree, and immobilization is easier
What projection of the patella should be performed before a tangential projection is attempted?
The lateral projection of the patella, To rule out a transverse fracture
Describe how the lesser trochanter should appear in the AP projection of the proximal femur?
The lesser trochanter should not be seen beyond the medial border of the femur, or only a very small portion of the lesser trochanter should be seen.
IF a radiographer positions the lower limb very carefully to ensure that the femoral condyles are physically superimposed, by they do not appear to be well superimposed on the image, what could have caused the image to appear that way?
The natural divergence of the beam may prevent the femoral condyles from appearing superimposed
from the following list, the 4 evaluation criteria that indicate the femur was correctly positioned when including the knee in a lateral projection of the distal femur a. The patella should be seen in profile. b. The patella should superimpose the femur. c. The patellofemoral joint space should be open. d. The greater trochanter should be seen in profile. e. The anterior surface of the femoral condyles should be superimposed. f. The inferior surface of the femoral condyles should not be superimposed.
The patella should be seen in profile The patellofemoral joint space should be open The anterior surface of the femoral condyles should be superimposed The inferior surface of the femoral condyles should not be superimposed
How can the patient hold the foot in the stress position during the Ap stress studies?
The patient may be instructed to pull on a strip of bandage that is looped around the foot.
List three factors that should be considered when deciding whether or not to use a grid for AP projections?
The size of the patients knee The preference of the radiologists The preference of the radiographer
To what level of the patient should the IR or collimated field be centered for the knee?
To 1/2 inch below the level of the patellar apices
Why should the lower limb be rotated?
To place it in true anatomic profile and to place the femoral neck in profile
Why is dorsiflexion of the foot required for the lateral (mediolateral) projection?
To prevent lateral rotation of the ankle
**Why is the CR angled cephalad for the lateral projection?
To prevent the joint space from being obscured by the magnified shadow of the femoral condyle.
State the purpose of performing AP stress studies of the ankle.
To verify the presence of ligamentous tear.
How many degrees of rotation are best demonstrated using the AP oblique projection with the foot rotated laterally?
Toes rotated 30 to 45 degrees
True or false All phalanges should be seen in the AP image.
True
True or false for the lateral projection of the great toe, the patient should lie in the lateral recumbent position on the unaffected side.
True
True or false the tibiotalar joint must be seen in the lateral projection of the foot.
True
How should the pelvis be positioned to demonstrate the distal femur?
True lateral
What is the key patient/part positioning points for the lateral projection for the ankle?
Turned on affected side until ankle is resting on lateral surface; ankle resting on lateral surface and centered to IR/collimated field; foot dorsiflexed and lateral
When performing the axial (plantodorsal) projection what should the radiographer do to demonstrate a complete calcaneus if the anterior portion of the calcaneus is not seen in the image with the same brightness as the posterior portion?
Two images should be performed to demonstrate the entire calcaneus completely.
What can be done to alleviate the pressure on the patella caused by the patients weight?
Use supports under the patients thigh and leg to remove pressure from the patella
How should the CR be directed to demonstrate toes when the plantar surface of the affected foot is in contact with a foam wedge, which should be inclined 15 degrees so that the toes are elevated above a horizontally placed IR? a. perpendicular b. 15 degrees posteriorly (toward the heel) c. 15 degrees anteriorly (away from the heel)
a
In which direction should the foot be rotated for the AP oblique projection for best demonstration of the cuboid and its related articulations? a. medially b. laterally
a
The AP projection should demonstrate the joint space between the medial malleolus and the talus without any overlapping structures. a. true b. false
a
The AP projection should demonstrate the lateral and medial malleoli. a. true b. false
a
The lateral (mediolaterla) projection should demonstrate the fibula over the posterior half of the tibia. a. true b. false
a
What projection of the foot best demonstrates the lateral tarsals with the least superimposition of structures? a. AP oblique projection (medial rotation) b. AP oblique projection (lateral rotation) c. AP axial projection d. AP projection
a
Which of the following projections (AP or AP axial projections) for toes normally does not demonstrate open interphalangeal joints? a. AP projection of the toes with the central ray directed perpendicularly b. AP axial projection of the toes with a central ray angulation of 15 degrees c. AP axial projection of the toes with a 15 degree foam wedge and the central ray directed perpendicularly
a
What is the CR orientation and entrance point for the AP oblique lateral rotation position projection of the knee joint?
according to ASIS to tabletop measurement; enters 1/2 in below patellar apex
What is the CR orientation and entrance point for the AP oblique medial rotation position projection of the knee joint?
according to ASIS to tabletop measurements; enters 1/2 in below patellar apex
What is the CR orientation and entrance point for the Tangential (settegast method) projection for the patella and patellofemoral joint?
angled 15 to 20 degree cephalic to enter perpendicular to patellofemoral joint space
What is the CR orientation and entrance point for the lateral projection of the knee joint?
angled 5 to 7 degrees cephalad, centers 1 in distal to medial epicondyle
conical projection at the head of the fibula
apex
Which physical condition affecting knees is often the reason that weight bearing AP projections are performed?
arthritis
An image of the lateral (mediolateral) projection should demonstrate the lateral malleolus free from superimposition by the talus. a. true b. false
b
For the lateral projection of the 5th toes, the patient should lie in the lateral recumbent position on the unaffected side. a. true b. false
b
The AP projection should demonstrate the distal third of the fibula without superimposition with the talus or tibia. a. true b. false
b
The CR should enter the dorsal surface of the foot for the axial (plantodorsal) projection of the calcaneus .a. true b false
b
The plantar surface of the foot should be in contact with the IR for the axial (plantodorsal) projection of the calcaneus. a. true b. false
b
What is the central ray orientation if the joint space of the toes (Ap axial projection) are of primary interest? a. perpendicular b. 15 degrees posteriorly (toward the heel) c. 15 degrees anteriorly (away from the heel)
b
which projection of the calcaneus best demonstrates the sinus tarsi? a. plantodorsal axial b. lateral
b
For the AP oblique projection of the foot, the leg should be rotated medially until the plantar surface of the foot forms an angle of with the IR. a. 10 degrees b. 20 degrees c. 30 degrees d. 40 degrees
c
In terms of the foot, how should the CR be directed for best demonstration of tarsometatarsal joints with a dorsoplantar projection? a. perpendicular b. 10 degrees anteriorly (away from the heel) c. 10 degrees posteriorly (toward the heel)
c
In terms of the foot, what other projection term refers to the AP projections? a. axial b. plantodorsal c. dorsoplantar
c
What are the size of collimated field for the essential projections for the ankle?
collimate 1 inch on all sides of the ankle and 8 inches long to include the heel Lateral- include heel and 5th metatarsal base
What is the size of collimated field for the projections of the leg?
collimate to 1 inch on all sides and 1.5 inches beyond ankle and knee joint
What is the collimated field for the essential projections for the femur?
collimate to 1 inch on all sides of the femur and 17 inches long
What is the size of collimated field for the toes projections?
collimate to 1 inch on all sides; including 1 inch proximal to MTP joints
What is the size of the collimated field for the essential projections for the intercondylar fossa?
collimate to 8x10 inches
two large eminences on the distal end
condyles
two prominent processes on the proximal end of the tibia
condyles
Distal posterior femur demonstrating _______________
condyles and intercondyler fossa
known as the anterior border of the tibia
crest
In terms of the foot, toward what point of the foot should the CR be directed for AP and AP axial projections? a. the base of the fifth metatarsal b. the head of the third metatarsal c. the head of the fifth metatarsal d. the base of the third metatarsal
d
True or false the ap projection of the leg should demonstrate the fibula without any overlapping with the tibia.
false
True or false the lateral projection demonstrates the patella with slight overlapping with the femoral condyles.
false
True or false the patient should slightly flex both knees to maximize the knee joint space
false
true or false the patellofemoral articulation is seen in slight overlap with the anterior surfaces of the femoral condyles
false
true or false gonadal shielding should not be used because it may superimpose the femoral head.
false
What is the anatomic landmarks and relation to IR for the PA axial (Camp-Coventry Method) projection of the intercondylar fossa?
femoral and tibial condyles parallel to IR
What is the anatomic landmarks and relation to IR for the PA axial (Homblad Method) projection of the intercondylar fossa?
femoral and tibial condyles parallel to IR plane
What is the anatomic landmarks and relation to IR for the lateral projection for the patella and patellofemoral joint?
femoral condyle superimposed and patella perpendicular
What is the anatomic landmarks and relation to IR for the AP projection of the knee joint?
femoral condyles parallel to IR
What is the anatomic landmarks and relation to IR for the lateral projection of the knee joint?
femoral condyles superimposed and perpendicular to IR; patella perpendicular to IR
What is the anatomic landmarks and relation to IR for the AP projection for the femur?
femoral neck parallel to IR; ASIS at top of exposure field
What is the anatomic landmarks and relation to IR for the lateral projection for the femur?
femur in lateral
lateral bone of the leg
fibula
large prominent process superior and lateral on the shaft
greater trochanter
large, rounded eminence on the superior end
head
What are the two intercondylar fossa method?
holmblad methond and camp-coventry method
What is the CR orientation and entrance point for the AP-standing (weight-bearing) projection of the knee joint?
horizontal and perpendicular to 1/2 in below patellar apex
sharp projection between the two superior articular surfaces
intercondylar eminence
Shallow, triangular area on the anterior surface between the condyles
intercondylar fossa
For the lateral projection of the great toe, the central ray should enter at the ___ joint of the great toe
interphalangeal
What do you have to include for the lateral femur?
knee joint and hip joint
The PA axial projection, first described by holmblad in 1937, requires the patient to assume a____________ position?
kneeling
What is the key patient/positioning points for the PA axial (Homblad Method) projection of the intercondylar fossa?
kneeling on table; knee flexed 70 degrees from full extension; femur placed placed at 20 degree angle from central ray
For patient comfort, which side of the foot (medial or lateral) should be placed in contact with the IR for the lateral projection?
lateral
enlarged distal end of the fibula
lateral malleolus
write M if the statement refers to the medial oblique, L if the statement refer to the lateral oblique projection, or B if the statement refers to both oblique projection. fibula should be superimposed over the lateral half of the tibia
lateral oblique projection
write M if the statement refers to the medial oblique, L if the statement refer to the lateral oblique projection, or B if the statement refers to both oblique projection. margin of the patella should project slightly beyond the edge of the femoral lateral condyle
lateral oblique projection
What is the key patient/part positioning points for the lateral projection for the femur?
lateral recumbent lying on affected side; proximal femur-pelvis rotated 10 to 15 degrees from true lateral distal femur-pelvis lateral, epicondyles perpendicular; knee flexed 45 degrees
What is the key patient/part positioning points for the lateral projection for the patella and patellofemoral joint?
lateral recumbent on affected side knee flexed 5 to 10 degrees patella perpendicular to IR
large process at the distal end of the tibia
medial malleolus
write M if the statement refers to the medial oblique, L if the statement refer to the lateral oblique projection, or B if the statement refers to both oblique projection. lateral femoral and tibial condyles should be demonstrated
medial oblique projection
write M if the statement refers to the medial oblique, L if the statement refer to the lateral oblique projection, or B if the statement refers to both oblique projection. margin of the patella should project slightly beyond the edge of the femoral medial condyle
medial oblique projection
write M if the statement refers to the medial oblique, L if the statement refer to the lateral oblique projection, or B if the statement refers to both oblique projection. tibia and fibula should be separated at their proximal articulation
medial oblique projection
For the AP oblique projection demonstrating all of the toes which way (medially or laterally) should the foot and lower leg be rotated?
medially
What should be seen superimposed in a lateral foot?
metartarsals
For for ankle AP oblique projection angle at 15 degrees what is best seen in this projection?
mortise joint
constricted portion just inferior from the head
neck
What is the anatomic landmarks and relation to IR for the AP projection for the patella and patellofemoral joint?
patella parallel and in center of IR
For the lateral projection of the leg, should the patella be positioned perpendicular or parallel with reference to the plane of the IR?
perpendicular
With reference to the plane of the IR, the plantar surface of the foot should be ____________for the axial projection?
perpendicular
What is the CR orientation and entrance point for the PA axial (Homblad Method) projection of the intercondylar fossa?
perpendicular to lower leg; enters midpoint of IR
What is the CR orientation and entrance point to IR for the AP projection for the femur?
perpendicular to midfemur
What is the CR orientation and entrance point to IR for the lateral projection for the femur?
perpendicular to midfemur
What is the CR orientation and entrance point for the AP projection for the ankle?
perpendicular; enters ankle joint midway between malleoli
What is the CR orientation and entrance point for the AP oblique-medial rotation for mortise joint projection for the ankle?
perpendicular; enters ankle joint midway between the malleoli
What is the CR orientation and entrance point for the AP oblique-medial rotation projection for the ankle?
perpendicular; enters ankle joint midway between the malleoli
What is the CR orientation and entrance point for the AP oblique projections of the foot?
perpendicular; enters base of third metatarsal
What is the CR orientation and entrance point for the lateral projections of the foot?
perpendicular; enters base of third metatarsal
What is the CR orientation and entrance point for the lateral projection for the patella and patellofemoral joint?
perpendicular; enters patellofemoral joint space
**Which patient body position should be used when performing this projection?
prone
What is the key patient/positioning points for the PA axial (Camp-Coventry Method) projection of the intercondylar fossa?
prone with lower leg elevated and supported
What is the key patient/part positioning points for the plantodoral axial projection of the calcaneus
seated or supine with leg extended; posterior surface of foot resting on IR; foot dorsiflexed so plantar surface is vertical and not rotated
What is the patient/part positioning points for the AP- standing (weight-bearing) projection of the knee joint?
standing upright facing x-ray tube; posterior surface of knees in contact with IR; standing straight; knees extended with weight equally distributed
What is the key patient/part positioning points for the Tangential (settegast method) projection for the patella and patellofemoral joint?
supine or prone; knee flexed as much as possible
What is the patient/part positioning points for the AP oblique in medial rotation position projection of the knee joint?
supine; knee extended; lower limb internally rotated 45 degrees
What is the key patient/part positioning points for the AP projection for the femur?
supine; proximal femur-knee extended; lower extremity internally rotated 10 to 15 degrees distal femur-knee extended; femoral condyles parallel to IR
For AP oblique projections, the central ray should enter the foot at ?
the 3rd MTP joint. (all toes)
the larger of the two bones of the leg
tibia
What is the anatomic landmarks and relation to IR for the AP oblique medial rotation position projection of the knee joint?
tibial condyles at a 45 degree angle to IR; 1/2 in below apex of patella at center of IR
What is the anatomic landmarks and relation to IR for the Tangential (settegast method) projection for the patella and patellofemoral joint?
tibial condyles parallel to IR
What is the anatomic landmarks and relation to IR for the AP- standing (weight-bearing) projection of the knee joint?
tibial condyles parallel to IR; 1/2 in below apex of patella at center of IR
For for ankle AP oblique projection angle at 45 degrees what is best seen in this projection?
tibiofibular articulation
True or false Interphalangeal and metatarsophalangeal joint spaces should appear open
true
True or false both knees should be demonstrated without rotation.
true
True or false the ap projection image of a normal knee should demonstrate a femorotibial joint space with equal distances on both sides
true
True or false the femoral condyles should appear superimposed.
true
True or false the talofibular joint space should be demonstrated in profile without any bony superimposition.
true
True or false the lateral projection should demonstrate some interosseous space between the shafts of the fibula and tibia.
true
true or false the bony trabecular detail of the femoral condyles should be demonstrated.
true
true or false the patella should be seen in profile.
true
true or false the tuberosity and base of the fifth metatarsal should be demonstrated as a lateral projection image of the ankle.
true
Two peaklike processes arising from the intercondylar eminence
tubercles
prominent process on the anterior surface of the tibia; just below the condyles
tuberosity
What do you need to know about the femur projections?
•Common that both joints will not fit on one IR •Take additional image of the other joint using a smaller IR
