radiology: elbow projections
standard routine for elbow
-AP -lateral -axiolateral (coyle method)- radial head
lateral elbow projection
-SID=40" -flex elbow 90 degrees, keep upper limb in same plane -forearm resting on ulnar surface -wrist in true lateral position=keep wrist up -CR enters perpendicular to elbow joint -collimate 3" proximal and distal to elbow joint and 1" on the sides -shield gonads -looking for concentric circles demonstrates superimposition
AP elbow
-SID=40" -upper limb in same plane with posterior surface in contact with IR -elbow centered to middle of IR , humeral epicondyles equidistant from IR -CR enters perpendicular to elbow joint -collimate 3" proximal and distal to elbow joint and 1" on the sides -shield gonads -we want epicondyles are equal distance to IR
axiolateral for radial head
-SID=40" -flex elbow 90 degrees, keep upper limb in same plane -hand pronated to be in PA position=wrist flat -CR angled 45 degrees toward shoulder -collimate 3" proximal and distal to elbow joint and 1" on the sides -shield gonads -center at radial head and include few inches in each direction
other projections for elbow
-axiolateral (coyle method)- coronoid -AP oblique= medial rotation position and lateral rotation position -AP= partial flexion position
axiolateral for coronoid process
-elbow flexed 80 degrees -hand pronated to be in PA position -CR angled 45 degrees away from shoulder=tube above the patients head -collimate 3" proximal and distal to elbow joint and 1" on the sides -shield gonads
AP elbow-distal humerus, partial flexion position
-humerus in same plane with posterior surface resting on IR -elevated forearm supported=forearm will be distorted -supinate hand (if possible) and center IR to condyles of humerus -CR perpendicular to humerus, passing through elbow joint
AP elbow-proximal forearm, partial flexion position
-leaving elbow flexed, place dorsal surface of forearm on IR -supinate hand (if possible) and center IR to condyles of humerus -CR perpendicular to elbow joint and long axis of forearm -humerus is distorted
AP oblique elbow-lateral rotation position
-limb in same plane with elbow extended -elbow centered to IR -supinated hand and laterally (or externally) rotate elbow to place anterior surface 45 degrees from IR plane=rotate laterally epicondyles -CR centered perpendicular to elbow joint -radial head, neck, and tuberosity free of superimposition of the ulna
AP oblique elbow-medial rotation position
-limb in same plane with elbow extended -elbow centered to IR -pronate hand and medially (or internally) rotate elbow to place anterior surface 45 degrees from IR plane=feel the humerus epicondyles to move elbow -CR centered perpendicular to elbow joint -medial epicondyle and trochlea should appear elongated and in partial profile