Patella

Question 1

Examinations of the Patella

Answer 1

•PA PROJECTION

•LATERAL PROJECTION

•PA OBLIQUE PROJECTION
Medial Rotation

•Lateral Rotation

•KUCHENDORF METHOD
PA AXIAL OBLIQUE PROJECTION
Lateral Rotation

•HUGHSTON METHOD
TANGENTIAL PROJECTION

•MERCHANT METHOD
TANGENTIAL PROJECTION

•SETTEGAST METHOD
TANGENTIAL PROJECTION

•SUNRISE METHOD
TANGENTIAL PROJECTION
MOUNTAIN/SKYLINE VIEW

Question 2

PP:
PA PROJECTION

Answer 2

PP: Prone; heel 5-10o laterally (places
patella // to IR)

Question 3

RP
PA PROJECTION

Answer 3

RP: Midpopletial depression

Question 4

CR:

PA PROJECTION

Answer 4

CR: Perpendicular

Question 5

SS: Sharper image of patella (closer OID)

Answer 5

PA PROJECTION

Question 6

PP:
LATERAL PROJECTION

Answer 6

PP: Lateral recumbent; unaffected knee & hip flexed; unaffected foot in front; affected knee flexed 5-10o or flexed not >10 (for new or unhealed patellar fx); femoral epicondyles & patella ┴ to IR;

Question 7

RP

LATERAL PROJECTION

Answer 7

RP: Midpatellofemoral joint

Question 8

CR

LATERAL PROJECTION

Answer 8

CR: ┴

Question 9

SS: Patella & patellofemoral joint space

Answer 9

LATERAL PROJECTION

Question 10

PP

PA OBLIQUE PROJECTION
Medial Rotation

Answer 10

PP: Prone; knee flexed 5-10o; knee 45-55o medially

Question 11

RP
PA OBLIQUE PROJECTION
Medial Rotation

Answer 11

RP: Patella

Question 12

CR
PA OBLIQUE PROJECTION
Medial Rotation

Answer 12

CR: ┴

Question 13

SS: Medial portion of patella free of femur

Answer 13

PA OBLIQUE PROJECTION
Medial Rotation

Question 14

PP

Lateral Rotation

Answer 14

PP: Prone; knee flexed 5-10o; knee 45-55o laterally

Question 15

RP

Lateral Rotation

Answer 15

RP: Patella

Question 16

CR
Lateral Rotation

Answer 16

CR: ┴

Question 17

SS: Lateral portion of patella free of femur

Answer 17

Lateral Rotation

Question 18

PP

KUCHENDORF METHOD
PA AXIAL OBLIQUE PROJECTION
Lateral Rotation

Answer 18

PP: Prone; hip elevated 2-3 in.; knee flexed 10o (relax the muscles); knee rotated 35-40o laterally

Question 19

RP
KUCHENDORF METHOD
PA AXIAL OBLIQUE PROJECTION
Lateral Rotation

Answer 19

RP: Joint space b/n patella & femoral condyles

Question 20

CR
KUCHENDORF METHOD
PA AXIAL OBLIQUE PROJECTION
Lateral Rotation

Answer 20

CR: 25-30ocaudad

Question 21

SS: Oblique patella free superimposition of femur

Answer 21

KUCHENDORF METHOD
PA AXIAL OBLIQUE PROJECTION
Lateral Rotation

Question 22

PP

HUGHSTON METHOD
TANGENTIAL PROJECTION

Answer 22

PP: Prone; anterior surface of knee against IR; knee flexed 50-60o; foot rested against collimator/support

Question 23

RP

HUGHSTON METHOD
TANGENTIAL PROJECTION

Answer 23

RP: Patellofemoral joint

Question 24

CR
HUGHSTON METHOD
TANGENTIAL PROJECTION

Answer 24

CR: 45o cephalad

Question 25

SS: Patella; patellofemoral joint ER:  To demonstrate subluxation of patella & patellar fx  It allows assessment of femoral condyles

Answer 25

HUGHSTON METHOD TANGENTIAL PROJECTION

Question 26

PP MERCHANT METHOD TANGENTIAL PROJECTION

Answer 26

PP: Supine; both knee flexed 40o or b/n 30-90o (to demonstrate various patellar disorders); IR resting on patient’s shins; uses IR holding device & axial viewer device

Question 27

RP MERCHANT METHOD TANGENTIAL PROJECTION

Answer 27

RP: Midway b/n patellae at level of patellofemoral joint

Question 28

CR MERCHANT METHOD TANGENTIAL PROJECTION

Answer 28

CR: 30o caudad from horizontal

Question 29

SS: Femoral condyle; intercondylar sulcus & magnified nondistorted patellae

Answer 29

MERCHANT METHOD TANGENTIAL PROJECTION

Question 30

PP SETTEGAST METHOD TANGENTIAL PROJECTION

Answer 30

PP: Supine or prone (preferable); knee acutely flexed until patella ┴ to IR; loop bandage around ankle or foot to hold the leg in position

Question 31

Disadvantage: Extreme flexion

Answer 31

SETTEGAST METHOD TANGENTIAL PROJECTION

Question 32

RP SETTEGAST METHOD TANGENTIAL PROJECTION

Answer 32

RP: Joint space b/n patella & femoral condyles

Question 33

CR SETTEGAST METHOD TANGENTIAL PROJECTION

Answer 33

CR: Perpendicular (if joint is ┴); 15-20o cephalad (if joint isn’t ┴)  Angulation depends on knee flexion

Question 34

SS: Patella; patellofemoral joint ER:  Useful for demonstrating vertical & transverse fx of patella  Useful for investigating articulating surfaces of patellofemoral articulation

Answer 34

SETTEGAST METHOD TANGENTIAL PROJECTION

Question 35

PP SUNRISE METHOD TANGENTIAL PROJECTION MOUNTAIN/SKYLINE VIEW

Answer 35

PP: Supine/Sitting; knee flexed 40-45o

Question 36

RP SUNRISE METHOD TANGENTIAL PROJECTION MOUNTAIN/SKYLINE VIEW

Answer 36

RP: Patellofemoral joint

Question 37

CR SUNRISE METHOD TANGENTIAL PROJECTION MOUNTAIN/SKYLINE VIEW

Answer 37

CR: 30o from horizontal

Question 38

ER: Joint space b/n patella & femoral condyles

Answer 38

SUNRISE METHOD TANGENTIAL PROJECTION MOUNTAIN/SKYLINE VIEW