Angles

Question 1

Where is the centre point for a finger projection (PA, Lateral and Oblique)?

Answer 1

Proximal-Inter-Phalangeal (PIP) Joint (first joint above knuckles)

Question 2

What is the film size for a finger projection?

Answer 2

18 x 24

Question 3

What is the centre point for a thumb projection?

Answer 3

1st Metacarpophalangeal (MCP) joint (knuckles), AKA thumb knuckle

Question 4

What is the film size for a thumb projection?

Answer 4

18 x 24

Question 5

What is the collimation for a thumb projection?

Answer 5

Distal phalanx (finger) to trapezium (bone directly under thumb)

Question 6

What is the centre point for a PA or Oblique hand x-ray?

Answer 6

Head of the 3rd Metacarpal (3rd knuckle)

Question 7

What is the centre point for a Lateral hand x-ray?

Answer 7

Head of the 2rd Metacarpal (2nd knuckle from the thumb)

Question 8

What is the collimation for a hand x-ray?

Answer 8

Distal Radius & Ulna to distal Phalanges (fingers)

Question 9

What is the elbow angle for a hand x-ray?

Answer 9

90 degrees

Question 10

What is a Norgaard Series?

Answer 10

PA bilateral hands, and “ball catchers” bilateral hands. Film size is 24 x 30

Question 11

What is the centre point for a wrist x-ray?

Answer 11

Lateral: radial styloid process
PA or Oblique: between radial and ulnar styloid processes

Question 12

What is the elbow angle for a wrist x-ray?

Answer 12

90 degrees

Question 13

What is the collimation for a wrist x-ray?

Answer 13

Distal 1/3rd of radius and ulna to mid-MC (middle of palm)

Question 14

What deviation of the hand is used for a scaphoid image?

Answer 14

Ulna deviation, external/ lateral deviation

Question 15

What angle is used for a scaphoid x-ray?

Answer 15

30 degrees towards elbow (cephalad technically)

Question 16

What is in a scaphoid series?

Answer 16

PA wrist, Oblique wrist and angled PA - all with ulnar deviations. And then a lateral wrist

Question 17

What is the centre point for a lateral and AP forearm

Answer 17

Mid forearm

Question 18

What direction should the hand face for a AP forearm?

Answer 18

Hand supinated, palm up

Question 19

What angle should the elbow be for a lateral forearm?

Answer 19

90 degrees, thumb facing upward

Question 20

What positions are in a elbow series

Answer 20

AP, external oblique, and lateral

Question 21

What is the technique for a radial head projection?

Answer 21

1. 45 degree cephalad tilt (along humerus)
2. Patient perpendicular to table
3. elbow flexed at a 90 degree angle
4. centre point is radial head

Question 22

What is in a trauma shoulder series?

Answer 22

AP, Glenohumeral joint, lateral

Question 23

What is the technique for a AP shoulder?

Answer 23

Positioning: internal or external rotation, just ensure the opposite is done for the GH

Centre point: 2.5cm inferior to coracoid process

Central Ray: perpendicular to patient

Collimation: include clavicle, scapula and soft tissue

Question 24

What is the technique for a GH shoulder?

Answer 24

Positioning: patient rotated 35-45 degrees facing the beam, affected side on plate, opposite hand rotation to AP

Centre point: GH joint

Central Ray: 15-20 degrees caudad

Collimation: tight to GH

Question 25

What is the technique for a lateral shoulder

Answer 25

Positioning: patient facing the buckey, rotate 45-60 degrees to IP, affected side on IP, hand on tummy Centre point: mid scapula Central ray: perpendicular Collimation: to include scapula and acromion

Question 26

What is in a chronic shoulder series?

Answer 26

AP, GH, Neer's and SI (Axial)

Question 27

What is a Neer's projection?

Answer 27

A shoulder projection of joint outlet Positioning: patient facing bucky, body rotated 45-60 degrees, affected side on IP, arm by side or across abdomen Centre point: humeral head or mid-scapula, depending on request Central ray: 10-15 degrees caudad Collimation: tight to outlet or whole scapula, depending on request

Question 28

What is a SI (axial) projection?

Answer 28

Positioning: patient sitting, arm abducted, elbow flexed 90 degrees, head tilted away from affected side as much as possible Centre point: shoulder joint Central ray: 5-15 degrees to elbow (caudad) Collimation: soft tissue and joint

Question 29

What is the difference between a 1st presentation clavicle and a follow up clavicle?

Answer 29

1st presentation: AP shoulder Follow up: AP clavicle Both have an Axial clavicle

Question 30

What is the angle for an axial clavicle?

Answer 30

15-30 degrees cephalad

Question 31

What is in a scapula series?

Answer 31

AP shoulder, lateral shoulder

Question 32

What is an AC joint series?

Answer 32

AP bilateral non-weight bearing AP bilateral weight bearing

Question 33

What is in a humerus series?

Answer 33

AP, lateral

Question 34

What is the technique for a lateral humerus?

Answer 34

Patient is perpendicular to IP, and their elbow is extended posteriorly, with their hand on their abdomen

Question 35

What are all the types of chest x-rays? (5)

Answer 35

1. PA Chest 2. Lateral 3. AP supine chest (patient laying on back) 4. Lateral decubitus (patient laying on their side) 5. Lordotic (patient leans back)

Question 36

What is the angle for a lordotic chest, when a patient cannot lean back?

Answer 36

15-20 degrees cephalad

Question 37

Inhale or Exhale for a standard chest x-ray?

Answer 37

Inhale

Question 38

What is the difference between a LPO and RAO?

Answer 38

RAO has the patient facing the buckey, LPO the patient faces the beam

Question 39

What is the centre point for an AP lower ribs?

Answer 39

Midline between zyphoid and lower rib cage

Question 40

Inspiration or expiration for an AP ribs?

Answer 40

Inspiration

Question 41

Where should the bottom of the image plate be for an AP ribs?

Answer 41

Top of iliac crests

Question 42

When do you do an LPO?

Answer 42

oblique ribs of one affected side

Question 43

When do you do a RAO

Answer 43

RAO sternum, and RAO SCJ For bilateral SCJ, an LAO is also required.

Question 44

How much should the patient be rotated for a RAO

Answer 44

15 - 20 degrees

Question 45

For a sternum RAO, which shoulder should always be on the image plate?

Answer 45

right shoulder because it decreases the likelihood of other structures superimposing the sternum

Question 46

What is the centre point for a RAO sternum?

Answer 46

2.5cm left of the spine, mid sternum level

Question 47

If you use the Moore method to take a RAO sternum, what degree should the x-ray tube be turned?

Answer 47

15-25 degrees

Question 48

Where should the arms be for a lateral sternum?

Answer 48

Hands should be clasped behind the back, and shoulders pulled back to bring sternum out

Question 49

What is the centre point for a PA SCJ?

Answer 49

T3, through midline

Question 50

What is in a toe series?

Answer 50

Dorsal-Plantar (DP), oblique, lateral

Question 51

What angle is used for a DP toe?

Answer 51

10 degrees cephalad

Question 52

What is the centre point for a DP toe?

Answer 52

Metatarsal-phalangeal joint, first toe knuckle

Question 53

What is the collimation for a DP and oblique toe?

Answer 53

Tight to toe, but include 1/2 the metatarsal

Question 54

What direction should you rotate the knee for a DP toe?

Answer 54

internally rotate knee

Question 55

What directions should you rotate the foot for a lateral toe?

Answer 55

Internal rotation: big toe (hallucis), 2nd and 3rd digits External rotation: 3rd, 4th and 5th (digiti minimi) digits

Question 56

What is the difference between an acute/ trauma foot x-ray series and a chronic one?

Answer 56

All chronic projections are done weight bearing (i.e. standing to bear own body weight)

Question 57

What angle is used for a DP foot?

Answer 57

10 degrees cephalad

Question 58

What is the centre point for an oblique and DP foot?

Answer 58

Base of 3rd metatarsal

Question 59

Is the knee bent for a DP foot?

Answer 59

yes

Question 60

Internal or external rotation of the knee for an oblique foot?

Answer 60

internal

Question 61

Where is the other leg positioned for a lateral foot?

Answer 61

behind the leg in question to prevent rotation of foot in question

Question 62

Is the foot dorsiflexed or plantarflexed for a lateral foot x-ray

Answer 62

dorsiflexed at 90 degrees

Question 63

What is a sesamoid series for the foot?

Answer 63

DP, oblique, lateral foot + axial

Question 64

physically show the position for a Axial (prone) foot and a axial (supine) foot

Answer 64

prone: foot upside down, toes on image plate, arch overdone to prevent the heel from accidentally being imaged supine: foot right way up, heel on image plate, band used to pull toes out the way

Question 65

What is the difference between a acute/ trauma ankle series and a chronic series?

Answer 65

The chronic series are all weight bearing (i.e. patient is standing so their own body weight acts as a weight)

Question 66

What is in a ankle series

Answer 66

AP, oblique/ mortise, lateral

Question 67

What is a mortise ankle?

Answer 67

x-ray to image ankle at a 45 degree angle. It is done by putting the leg straight out, and then medially rotating the knee by 30 degrees

Question 68

How much of the lower leg should you include in an ankle x-ray?

Answer 68

distal 1/3rd of the tibia and fibula

Question 69

What is a calcaneus series?

Answer 69

Heel series, includes a lateral and axial

Question 70

What is the centre point for a lateral calcaneum?

Answer 70

Mid-calcaneus, 2.5cm inferior to medial malleolus

Question 71

How is the foot positioned for an axial calcaneus

Answer 71

Foot supine, heel on plate, dorsiflexion as much as possible

Question 72

What angle is used for an axial calcaneus?

Answer 72

40 degrees down through the heel

Question 73

What is in a Tib/Fib series?

Answer 73

AP and lateral

Question 74

What is in an acute/ trauma knee series?

Answer 74

AP and horizontal ray lateral

Question 75

What angle is the beam for an AP knee?

Answer 75

+- 5 degrees

Question 76

What is the centre point for an AP knee

Answer 76

2.5cm distal to patella

Question 77

What is the centre point for a lateral knee?

Answer 77

Midpoint of knee joint

Question 78

What is in a chronic knee series?

Answer 78

AP Bilateral weight-bearing Skyline bilateral Intercondylar Lateral

Question 79

What is the midpoint for bilateral AP knees?

Answer 79

Performed standing, 1.5cm inferior/ below to patella

Question 80

What angle should the knee be bent for bilateral skyline (axial) knee?

Answer 80

45 degree bend

Question 81

What angle is the beam for a bilateral Skyline?

Answer 81

10-15 degrees uptilt (ceph)

Question 82

what is the centre point for a skyline knee?

Answer 82

midway between patellae

Question 83

Where does the image plate go for a skyline knee?

Answer 83

Patient hold it upright on their abdomen

Question 84

What angle is the knee flexed at for a intercondylar knee

Answer 84

40-45 degrees

Question 85

What angle should the beam be for an intercondylar knee?

Answer 85

40 - 45 degrees cephalad

Question 86

Where does the image plate go for an intercondylar knee?

Answer 86

below the knees, preferably not in the table buckey

Question 87

What is the centre point for an intercondylar knee?

Answer 87

1.5 cm inferior to patella apex

Question 88

How much should the knee be flexed for a lateral knee?

Answer 88

20 - 30 degrees

Question 89

What can you do to make the knee more lateral if the patient is too rotated?

Answer 89

rotate the opposite hip to affected knee anteriorly or posteriorly, depending on what is required

Question 90

What is the central ray angle for a lateral knee?

Answer 90

5 degrees cephalad

Question 91

Is the medial or lateral side facing up for a lateral knee?

Answer 91

medial side

Question 92

What is the centre point for a lateral knee?

Answer 92

2.5cm distal to medial epicondyle