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POSI 1 > Patella-pelvis > Flashcards

Patella-pelvis Flashcards

(47 cards)

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1
Q

SS:

• Subluxation of patella and patellar fx

• Allow radiologic assessment of the femoral condyle

A

HUGHSTON METHOD

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2
Q

CR AND RP OF HUGHSTON METHOD

A

CR: 45 deg cephalad RP: Directed through the patellofemoral joint

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3
Q

HUGHSTON METHOD Slowly flex the affected knee so that tibia and fibula form. what deg?

A

50 to 60 deg

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4
Q

PP: Prone

  • Patella parallel with the IR
  • Heel rotated 5 deg to 10 deg laterally

CR: ⊥ to mid popliteal, exiting patella

SS: Patella - Walang OID si patella pag PA

A

PA PROJECTION

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5
Q

PP:

  • Pt in lateral recumbent
  • Flex affected knee 5 to 10 deg
  • Increasing flexion reduces patellofemoral joint space
  • Adjust knee in lateral position

CR: ⊥ to IR RP: Entering knee at mid patellofemoral joint

SS: Lateral projection of patella and patellofemoral joint space

A

LATERALLMediolateral

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6
Q

P:

  • From prone position medially rotate the knee 45 to 55 deg
  • Flex knee approx. 5 to deg

CR: ⊥ to IR RP: Exiting the palpated patella

SS: PA oblique image of medial portion of patella free of femur

A

PA OBLIQUEMedial Rotation

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7
Q

PP:

  • Flex knee 5 to 10 deg
  • Externally (laterally) rotate knee 45 to 55 deg from prone position

CR: ⊥ to IR, exiting the palpated patella

SS: Oblique projection of lateral aspect of the patella free of femur

A

PA OBLIQUELateral Rotation

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8
Q

P:

  • Pt in prone
  • Elevate hip of affected side 2 or 3 inches
  • Knee slightly flexed (appox. 10 deg) to relax
  • Laterally rotate the knee to 35 to 40 deg from prone
  • Rest knee on its anteromedial side

CR: 25 to 30 deg caudad RP: Directed to joint space between patella and femoral condyle

A

KUCHENDORF METHOD

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9
Q

KUCHENDORF METHOD GEST DEM.

A

Slightly oblique PA projection of patella,

• with most of patella free of superimposed structure

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10
Q

PP:

  • Using axial viewer device
  • Elevate pt knee approx. 2 inches to place femora parallel with tabletop
  • Knee flexion 40 deg

IR: ⊥ to CR and resting on pt shins approx. 1 foot distal to the patellae

CR:

  • ⊥ to IR approx. 30 deg caudad from horizontal plane
  • 60 deg from vertical plane

RP: Enters midway between patellae at the level of the patellofemoral joint

SS:

  • Bilateral tangential image demonstrates an axial projection of the patellae and patellofemoral joints
A

MERCHANT METHOD

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11
Q

PP:

  • Pt in prone
  • Flex knee slowly as much as possible or until patella is perpendicular to IR
  • If pt is seated on radiographic table, hold the IR

CR:

  • ⊥ to knee joint space between the patella and femoral condyles when joint is ⊥
  • Degree of CR depends on degree of flexion of the knee.
  • Usually, 15 to 20 deg cephalad

SS:

• Vertical fx of bone

• Articular surfaces of the patellofemoral articulation

A

SETTEGAST METHOD

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12
Q
  1. Projection of Distal Femur
A

Rotate the limb internally to place it in true anatomic position

  • Bottom of IR 2 inches below the knee joint
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13
Q

Projection of Proximal Femur

A
  • Place the top of IR at level of the ASIS
  • Rotate limb internally 10 to 15 deg to place the femoral neck in profile
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14
Q

FEMUR AP CR

A

⊥ to the mid femur and center of the IR

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15
Q

PP:

  1. Projection of the distal femur
  • draw the pt uppermost limb forward
  • Adjust the pelvis in a true lateral position
  • Flex the affected about 45 deg
  • IR projects approx. 2 inches beyond the knee to be included
  1. Projection of proximal femur
  • Place the top of IR at level of ASIS
  • Draw the upper limb posteriorly
  • Adjust the pelvis so that it is rolled posteriorly 10 to 15 deg from the lateral position is sufficient

CR: ⊥ to the mid femur and center of the IR

SS: Lateral projection of the Femur

A

Lateral femur

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16
Q

NON-TRAUMA BILATERAL:

A

Original Cleaves & Modified Cleaves

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17
Q

PP: Pt in supine

  • Media rotate leg and feet 15 to 20 deg to place femoral necks parallel to IR o To avoid foreshortening
  • Heels placed 8 to 10 inches apart
  • Upper border of IR 1-1 ½ inches above iliac crest

CR: ⊥ midway between ASIS and symphysis pubis RP: 2” inferior to ASIS and 2” superior to

symphysis pubis

SS:

• Greater trochanter in profile

• Femoral head and neck

• Provides general survey of the bones of the entire pelvis and proximal femur.

A

PELVIS AP

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18
Q

PP:

  • Pt in lateral recumbent
  • Pelvis in true lateral position

CR: ⊥ to level of soft tissue depression 2” above

greater trochanter

DORSAL DECUBITUS LATERAL PROJECTION

  • Best demonstrate Gull-Wing sign in cases of fracture dislocation of the acetabular rim and posterior dislocation of the femoral head.
A

Lateral

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19
Q

NON-TRAUMA UNILATERAL:

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A

Launstein, Hickey, Friedman

20
Q

TRAUMA (HIP JOINT):

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A

Danelius Miller, Clements Nakayama, & Leonard George

21
Q

SS:

• demonstrate an axial projection of the pelvic ring or inlet in its entirety.

CR: 40 deg caudad to ASIS

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A

BRIDGEMAN METHOD

22
Q

LOCATION OF FEMORAL HEAD & NECK

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A

ASIS & Symphysis Pubis

• Determine the midpoint of a line between the ASIS and the symphysis pubis.

• The neck is approximately 2.5 inches and the head 1.5 inches distal and at right angle to the midpoint of this line.

23
Q

.ASIS Only

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A

The femoral neck is 1-2 inches medial and 3-4 inches distal to ASIS.

24
Q

F-A-T-E-

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A

F-oreshortening A-ntomy T-ube E-longation

25
PP: Pt in supine - Media rotate leg and feet 15 to 20 deg to place femoral necks parallel to IR o To avoid foreshortening - Heels placed 8 to 10 inches apart - Upper border of IR 1-1 ½ inches above iliac crest CR: ⊥ midway between ASIS and symphysis pubis RP: 2” inferior to ASIS and 2” superior to symphysis pubis SS: • Greater trochanter in profile • Femoral head and neck • Provides general survey of the bones of the entire pelvis and proximal femur.
AP PROJECTION
26
PP: - Pt in lateral recumbent - Pelvis in true lateral position CR: ⊥ to level of soft tissue depression 2” above greater trochanter DORSAL DECUBITUS LATERAL PROJECTION - Best demonstrate Gull-Wing sign in cases of fracture dislocation of the acetabular rim and posterior dislocation of the femoral head.
LATERAL PROJECTION
27
- Often called the bilateral frog leg position - Non-Trauma Indication: congenital hip disease Contraindication: pt with suspected hip fx PP: - Pt in supine - Abduct the thighs 45 deg from vertical CR: 40 deg cephalad to femoral shafted SS: • Axiolateral projection of the femoral heads and neck • Lesser trochanter on medial side of femur • Femoral neck without superimposition of greater trochanter • Lesser trochanter on medial side of femur. • Femoral neck without superimposition of the greater trochanter.
FEMORAL NECK AP OBLIQUE PROJECTION ORIGINAL CLEAVES BILATERAL PROJECTION
28
- Often called the bilateral frog leg position - Non-Trauma Indication: congenital hip disease Contraindication: pt with suspected hip fx PP: - Pt in supine - Abduct the thighs 45 deg from vertical CR: ⊥ enter the patient’s MSP at the level 1 inch superior to symphysis pubis SS: • AP oblique projection of the femoral heads and neck.
FEMORAL NECK AP OBLIQUE PROJECTION MODIFIED CLEAVES BILATERAL PROJECTION
29
- Often called the bilateral frog leg position - Non-Trauma Indication: congenital hip disease Contraindication: pt with suspected hip fx PP: - Pt in supine - Abduct the thighs 45 deg from vertical CR: ⊥ enter the patient’s MSP at the level 1 inch superior to symphysis pubis SS: • AP oblique projection of the femoral heads and neck.
FEMORAL NECK AP OBLIQUE PROJECTION MODIFIED CLEAVES BILATERAL PROJECTION
30
NON-TRAUMA UNILATERAL:
Launstein, Hickey, Friedman
31
HICKEY CR
20-25 deg cephalad
32
FRIEDMAN CR
35 deg cephalad
33
LAUNSTEIN CR
⊥
34
TRAUMA (HIP JOINT):
Danelius Miller, Clements Nakayama, & Leonard George
35
- Trauma - Unilateral - The cross-table or surgical lateral projection of the hip joint - Common projection for trauma, surgery, post-surgery or other patients who cannot move or rotate the affected leg for frog-leg lateral. PP: - Invert the leg 15-20 deg - Unaffected side yung itataas CR: ⊥ to the femoral neck
DANELIUSMILLER METHOD
36
- Trauma - Unilateral - The cross-table or surgical lateral projection of the hip joint - Common projection for trauma, surgery, post-surgery or other patients who cannot move or rotate the affected leg for frog-leg lateral. PP: - Invert the leg 15-20 deg - Unaffected side yung itataas CR: ⊥ to the femoral neck
DANELIUSMILLER METHOD
37
- performed when both routine lateral and axiolateral are contra-indicated when a patient has bilateral hip arthroplasty. - Usually performed when patient has limited movement in both lower limbs - Alternative Danelius-Miller method. PP: - Both legs fully extended and in anatomical position CR: 15 to 20 deg posteriorly and ⊥ to the femoral neck IR: tilted 15 deg posterior angle from the vertical and 2 inches below tabletop
CLEMENTSNAKAYAMA MODIFICATION
38
- The reverse Danelius Miller method. - Bilateral PP: - Rotate foot 15 – 20 degrees internally - Place cassette (special curve) in vertical position well up between thigh & center it to crease of the groin of affected side
LEONARD – GEORGE METHOD
39
JSK: 1. Superior aperture • The oblique plane defined by the brim of the pelvis. • Also known as the INLET of the true pelvis. 2. Inferior aperture • Defined by the two ischial tuberosities in the tip of the coccyx. • Also known as the OUTLET of the true pelvis.
40
PELVIC OUTLET VIEW METHOD?
41
PELVIC INLET VIEW METHOD?
BRIDGEMAN METHOD LILIENFIELD STAUNIG
42
STAUNIG CR?
35 cephalad
43
PP: - Pt in semi prone position on the affected side - Elevate affected side, so that anterior surface of the body forms 38 degrees angle from table CR: 12° cephalad RP: inferior level of coccyx at 2 inches lateral to MSP towards side being examined SS: demonstrate fovea capitis particularly superoposterior wall of the acetabulum
TEUFEL METHOD
44
AP OBLIQUE PROJECTION PP: - Patient in semi supine position - Anterior surface of the body forms a 45 deg angle from the table. CR: ⊥to 2 inches inferior to ASIS Two 45-degree posterior oblique positions - useful in diagnosing fractures of the acetabulum and dislocation.
JUDET METHOD
45
- (AFFECTED HIP UP) - IIP (Iliopubic/ Posterior rim) • Suspected fracture in iliopubic column and posterior rim of acetabulum. • Obturator foramen visualized.
(JUDET METHOD)INTERNAL OBLIQUE
46
- (AFFECTED HIP DOWN) - IIA (Ilioishial/ Anterior rim) • Fracture in ilioischial column and anterior rim of acetabulum. • Iliac wing
(JUDET METHOD)EXTERNAL OBLIQUE
47
- (AFFECTED HIP DOWN) - IIA (Ilioishial/ Anterior rim) • Fracture in ilioischial column and anterior rim of acetabulum. • Iliac wing
(JUDET METHOD)EXTERNAL OBLIQUE

POSI 1 (3 decks)

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