Elbow

Question 1

CR: Perpendicular to the elbow joint
Px P: Extend the elbow, supinate the hand and center the IR to the elbow joint
SS: projection of the elbow joint, distal arm and proximal forearm

Answer 1

AP Projection

Question 2

CR: P to the elbow joint
Px P: Flex the elbow 90 degrees and adjust the hand in the lateral projection and ensure that the humeral epicondyles are perpendicular to the plane of the IR
SS: elbow joint, distal arm and proximal forearm

Answer 2

Lateral Projection

Question 3

Importancr of 90 degrees flexion of the elbow according to Griswold:

Answer 3

1. The olecranon process can be seen in profile
2. The elbow fat pads are the least compressed. It must be realized that in partial or complete extension the olecranon process elevates the posterior elbow fat pad and simulates joint pathology

Question 4

CR: P to the elbow joint
Px P: Extend the limb in position for an AP projection. Internally rotate or pronate the hand, and adjust the elbow at an angle of 45 degrees
SS: elbow with coronoid pricedd projectef free of superimposition

Answer 4

AP Oblique (Medial Rotation)

Question 5

CR: P to the elbow joint
Px P: Extend the px’s arm in position for an ap projection. Rotate the hand externally at an angle of 45 degrees
SS: elbow with radial head and neck projected free of superimposition of the ulna

Answer 5

AP Oblique (lateral Rotation)

Question 6

CR: P to the humerus, traversing the elbow joint
Px P: Supinate the hand, Place IR under the elbow and center it to the condyloid area of the humerus
SS: distal humerus when elbow cannot be fully extended

Answer 6

AP PROJECTION ( Distal Humerus Partial Flexion)

Question 7

CR: P to the elbow joint and long axis of the forearm
P: Seat the px high enough to permit the dorsal surfacd of the forearm to rest on the table
SS: proximal forearm when elbow cannot be fully extended

Answer 7

AP PROJECTION (Proximal Forearm Flexion)

Question 8

CR: P to the humerys approx. 2” (5cm) superior to the olecranon process
P: Center IR proximal to the epicondylular area of the humerus. The long axis of the arm and forearm should be parallel with thr long axis of the IR
SS: superimposes the bones of the forearm and arm. Olecranon proces should br clearly demonstrated

Answer 8

AP PROJECTION ( Distal humerus acute flexion) (Jonas Method)

Question 9

CR: - Perpendicular to the flexed forearm, entering approximately 2 inches (5 cm) distal to the olecranon process.
STRUCTURE SHOWN: The superimposed bones of the arm and forearm are outlined. The elbow joint should be more open than for projections of the distal
humerus. Proximal ulna and radius, including outline
of radial head and neck, should be visible through superimposed distal humerus.

Answer 9

PA PROJECTION (of Proximal Forearm Acute Flexion)

Question 10

CR: Perpendicular to the elbow joint
POSITION:
Lateral elbow. With hand supinated as much as possible.
Lateral elbow. With hand in lateral position.
Lateral elbow. With hand pronated.
Lateral elbow. With hand internally rotated.

STRUCTURE SHOWN: The radial head is projected in varying degrees of rotation.

Answer 10

LATERAL PROJECTION (of Radial Head Lateromedial Rotation Four Position Series)

Question 11

These are special projections taken for pathologic processes or trauma to the area of the radial head or the coronoid process of ulna. These are effective projections when patient cannot extend elbow fully for medial or lateral oblique projections of the elbow.

Answer 11

AXIAL LATEROMEDIAL PROJECTIONS
(COYLE METHOD)

Question 12

• Elbow flexed 90° if possible; hand pronated.
  CR: directed at 45° angle toward shoulder,
  centered to radial head (mid-elbow joint).
  SS: Radial head, neck, and tuberosity should be in profile and free of superimposition except for a small part of the coronoid process.

Answer 12

AXIAL LATEROMEDIAL PROJECTIONS
(COYLE METHOD) POSITION 1- RADIAL HEAD

Question 13

CR: angled 45° from shoulder, into midelbow joint.
- Elbow flexed only 80° from extended position (because >80° may obscure coronoid process) and hand pronated.
STRUCTURE SHOWN: Distal (anterior) portion of the coronoid appears elongated but in profile.

Answer 13

AXIAL LATEROMEDIAL PROJECTIONS
(COYLE METHOD) POSITION 2 – CORONOID PROCESS

Question 14

CR: Perpendicular to the ulnar sulcus, entering at a point just medial to the olecranon process.
POSITION
- Rest the patient’s forearm on the table
- Flex the elbow and place the arm in a nearly vertical position (humerus at an angle of approximately 75 degrees from the forearm).
- Supinate the hand to prevent rotation of
the humerus and ulna.
STRUCTURE SHOWN: This projection demonstrates the epicondyles, trochlea, ulnar sulcus (groove between the medial epicondyle and the trochlea), and olecranon fossa. The projection is used in radiohumeral bursitis (tennis elbow) to detect otherwise obscured calcifications located in the ulnar sulcus.

Answer 14

PA AXIAL PROJECTION

Question 15

CR: Perpendicular to the olecranon process at 20-degrees angle towards the wrist.
POSITION
- Position of part
- Adjust the arm at an angle of 45 to 50 degrees from the vertical position.
-Supinate the hand.

SS: olecranon process and the articular margin of the olecranon and humerus.

Answer 15

PA AXIAL OLECRANON PROCESS