Forearm and Elbow Radiography

Question 1

Identify the structures of the forearm

Answer 1

Question 2

Identify the structures of the elbow joint

Answer 2

Question 3

What is ossification?

Answer 3

The process of bone formation

Question 4

When does primary ossification occur?

Answer 4

Occurs before birth and forms shafts of long bones

Question 5

When does secondary ossification occur?

Answer 5

Occurs after birth when the epiphysis develops at long bone ends

Question 6

When does complete ossification occur?

Answer 6

Occurs when the diaphysis grows into epiphysis and joins completely

(between ages of 15-21 - more rapid in females)

Question 7

Define diaphysis

Answer 7

Primary center of ossification - shaft of long bone

Question 8

Define epiphysis

Answer 8

Secondary center of ossification - separated from diaphysis by epiphyseal plate

Question 9

Define epiphyseal plate

Answer 9

Growth plate - zone of spongy bone between diaphysis and epiphysis

Question 10

What are the routine projections for the radius and ulna?

Answer 10

AP and lateral

Question 11

What is the SID and KVP for a radius and ulna x-ray?

Answer 11

SID= 40”

kVP= 60 nongrid

Question 12

For an AP projection of the radius and ulna, how is the patient seated?

Answer 12

End of radiographic table so that entire upper extremity will lie in same plane

Question 13

For an AP projection of the radius and ulna, how is the patient positioned?

Answer 13

Patient’s forearm is in center of IR, elbows extended so that arm is straight and hand is supinated

Question 14

What must be included in an AP radius and ulna x-ray?

Answer 14

Both wrist and elbow joint

Question 15

For an lateral projection of the radius and ulna, how is the patient positioned?

Answer 15

Elbow is flexed at 90° With forearm in lateral position with ulnar surface down. Thumb should be up so that hand is perfectly lateral

Question 16

What should be superimposed on a lateral radius and ulna x-ray?

Answer 16

• Humeral epicondyles
• Distal radius and ulna

Question 17

What must be included in an lateral radius and ulna x-ray?

Answer 17

Both wrist and elbow joint

Question 18

What are routine projections for an elbow x-ray?

Answer 18

AP and lateral

Question 19

What is the SID and kVp of an elbow projection?

Answer 19

SID= 40”

kVp= 60 nongrid

Question 20

How is a patient positioned for an AP elbow x-ray?

Answer 20

At end of radiographic table, low enough to have entire extremity in same plane. Shoulder should be at same level of elbow

Question 21

For an AP elbow, where does the patient put their elbow on IR?

Answer 21

Elbow is extended and at center or IR

Question 22

Where do you direct the CR for an AP projection of the elbow?

Answer 22

Perpendicular to elbow joint

Question 23

How is a patient positioned for a lateral elbow x-ray?

Answer 23

From the supine position, elbows at 90° and humerus and forearm in contact with table (so that shoulder and elbow are in the same plane)

Question 24

For a lateral elbow, where does the patient put their elbow on IR?

Answer 24

Elbow in center or IR and adjust hand to a true lateral position

Question 25

Where is the CR directed for a lateral projection of elbow?

Answer 25

Perpendicular to elbow joint

Question 26

What will a lateral projection of the elbow demonstration?

Answer 26

The olecranon process in profile and humeral epicondyles will be super imposed

Question 27

How do you position a patient for a medial oblique projection of the elbow?

Answer 27

From AP position, medially rotate hand and adjust elbow to place its anterior surface at an angle of 45° to IR

Question 28

Where do you direct the CR for a medial oblique projection of elbow?

Answer 28

Perpendicular to elbow joint

Question 29

What will a medial oblique projection of elbow demonstrate?

Answer 29

The coronoid process in profile

Question 30

How do you position a patient for a lateral oblique projection of the elbow?

Answer 30

From AP position, rotate hand laterally to place posterior surface of elbow to a 45° angle with IR

(When properly achieved, patient’s first and second digits should be touching table)

Question 31

Where is the CR directed for a lateral oblique projection of elbow?

Answer 31

Perpendicular to elbow joint

Question 32

What will a lateral oblique projection of the elbow demonstrate?

Answer 32

Radial head and neck free of superimposition of ulna

Question 33

When is a partial flexion done?

Answer 33

When patient is unable to extend elbow for AP projection – 2 separate projections in place of AP projection

Question 34

How do you position a patient for a partial flexion projection?

Answer 34

• Position distal humerus for an AP projection - CR directed to distal humerus
• Position proximal forearm for an AP projection - CR directed to proximal forearm