Imaging of upper limb- elbow up

Question 1

What are the standard and additional projections for an elbow?

Answer 1

Standard:
-DP
-Lateral
Additional:
-Radial head views.

Question 2

what is the Elbow AP patient position?

Answer 2

☢Patient seated with their affected side next to the x-ray table without placing legs underneath
☢Affected arm abducted and extended and placed on image receptor
☢Arm supinated with wrist, elbow and shoulder in the same horizontal place
☢Humeral epicondyles equidistant from image receptor

Question 3

What are the centring points for an elbow AP?

Answer 3

*Central ray vertical to the image receptor
*Midway between humeral epicondyles and 2.5cm distally

Question 4

How do we collimate for a elbow AP?

Answer 4

*Laterally – include skin margins
*Proximally – distal 1/3 of humerus
*Distally – proximal 1/3 of radius and ulna

Question 5

How do we position a patient for an elbow lateral?

Answer 5

☢From the AP position, flex the elbow to 90 degrees and medially rotate the arm so that the ulnar aspect is in contact with the image receptor
☢Ensure the wrist, elbow and shoulder are in the same transverse plane
☢Palmar aspect of the hand should be 90 degrees to the image receptor
☢Humeral epicondyles superimposed

Question 6

What is the centring point for an elbow lateral?

Answer 6

*Central ray vertical ò to the image receptor
*Over the lateral humeral epicondyle

Question 7

How do we collimate for an elbow lateral?

Answer 7

*Laterally – include skin margins
*Proximally – distal 1/3 of the humerus
*Distally – proximal 1/3 of radius and ulna

Question 8

What are the standard and additional projections for the Humerus?

Answer 8

Standard projections
☢ DP
☢ Lateral
Additional projections
☢ Joint specific projections if unclear from initial imaging

Question 9

what is the patient position for a humerus AP?

Answer 9

☢Patient is stood with their back to the image receptor.
☢The arm is in the true anatomical position, palm facing forwards
☢The posterior aspect of the upper arm should be in contact with the image receptor to reduce movement and magnification

Question 10

What is the centring point of a Humerus AP?

Answer 10

*Central ray horizontal to the image receptor
*Middle of the humerus on the anterior aspect of the upper arm, midway between the shoulder and elbow joints

Question 11

How do you collimate for a humerus AP?

Answer 11

*Laterally – include skin margins
*Superiorly – The skin margin above the glenohumeral joint
*Inferiorly – Include the distal humerus including the elbow joint

Question 12

What is the patient position for a humerus lateral PA?

Answer 12

☢Patient is stood facing the image receptor
☢The elbow is flexed so that the palm of the hand rests on the anterior abdominal wall
☢The anterior aspect of the upper arm should be in contact with the image receptor to reduce movement and enlargement
☢The patient should be rotated so that the lateral aspect of the shoulder of the affected side, the upper arm and elbow are all in contact with the image receptor

Question 13

What is the centring point for a humerus lateral PA?

Answer 13

☢Central ray horizontal to the image receptor
☢(PA) Middle of the humerus shaft, on the medial aspect of the upper arm, midway between the shoulder and elbow joints
☢(AP) Middle of the humerus shaft, on the lateral aspect of the upper arm, midway between the shoulder and elbow joints

Question 14

How do you collimate for a humerus lateral PA?

Answer 14

☢Laterally – include skin margins
☢Superiorly – The skin margin above the glenohumeral joint
☢Inferiorly – Include the distal humerus including the elbow joint

Question 15

What are the standard and additional shoulder projections?

Answer 15

Standard projections
☢ AP
☢ Axial
Additional projections
☢ Modified Axial
☢ Y-view Scapula
☢ Clavicle
☢ Acromioclavicular joint views

Question 16

Shoulder AP patient position?

Answer 16

☢ Patient is stood with their back to the image receptor
☢ The arm is in the true anatomical position with the palm facing forwards
☢ The patient is rotated 5-10 degrees towards the affected side (straight for trauma)
☢ The posterior aspect of the shoulder is in contact with the image receptor to reduce movement and magnification

Question 17

What is the centring point for a shoulder AP?

Answer 17

☢ Central ray horizontal to the image receptor
☢ Corocoid process

Question 18

How do you collimate for a shoulder AP?

Answer 18

☢ Laterally – include skin margins
☢ Superiorly – Skin margins
☢ Inferiorly – Include 1/3 of the proximal humerus

Question 19

What is the patient position for a shoulder axial?

Answer 19

☢ Patient is seated with the affected arm nearest to the image receptor
☢ The affected arm is abducted and ”stretched” across the image receptor
☢ The image receptor is underneath the axilla (the gleno-humeral joint over the image receptor)
☢ Legs should not be underneath the image receptor
☢ The head should be tucked towards the unaffected shoulder

Question 20

what is the centring point for a shoulder axial?

Answer 20

☢ Central ray vertical to the image receptor
☢ Head of the humerus