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Positioning Errors Flashcards

(65 cards)

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1
Q

PA Finger Rotation

A

Medial/External Rotation
- concavity and soft tissue increase on anterior surface & decreases on posterior surface

Lateral/Internal Rotation
- concavity and soft tissue increases on posterior & decreases on anterior surface

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2
Q

PA Finger : Flexed/CR not perp.

A

Closed IP and MCP joint spaces and phalanges foreshortened

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3
Q

PA Oblique Finger Rotation

A

Insufficient Rotation
- finger rotated <45 degrees
- concavity/soft tissue equal

Excessive Rotation
- finger rotated >45 degrees
- soft tissue more than twice as much
- one aspect is concave and other convex

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4
Q

Lateral Finger Rotation

A

Inadequate Rotation
- concavity on both sides
- soft tissue closer to twice as much on anterior than posterior

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5
Q

Thumb AP Rotation

A

Excessive Internal Rotation
- anterior thumb soft tissue and greater phalangeal concavity is demonstrated on side of thumb closet to the hand

Insufficient Internal Rotation
- medial palm soft tissue SI MC
- begin seeing overlap of adjacent MC on thumb

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6
Q

Thumb flexion/extension

A

foreshortened phalanges and closed IP joint spaces

failure to align MC parallel with IR = closed CM joint

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7
Q

Thumb PA Oblique Rotation

A

Excessive Rotation
- increased concavity on anterior surface & decreased concavity on posterior surface

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8
Q

Lateral Thumb Flexion

A

Insufficient hand flexion
- some degree of concavity on both sides

Over flexion of hand
- second proximal MC to SI on first proximal MC
- thumb beyond lateral towards AP Oblique projection

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9
Q

PA Hand Rotation

A

External Rotation
- slight SI 3-5th MC heads
- unequal soft tissue & concavity

Internal Rotation
- rarely (seldom) a problem

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10
Q

Hand PA Oblique - Obliquity

A

Insufficient obliquity
- hand rotate <45 degrees
- MC SI evenly spaced, little or no SI

Excessive obliquity
- hand rotated >45 degrees
- space btwn 4-5th MC midshafts obscured and SI

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11
Q

Lateral Hand Rotation

A

External Rotation
- 5th MC anterior to 2nd to 4th MC

Internal Rotation
- 2nd MC anterior to 3-5th MC

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12
Q

Wrist PA - ulnar styloid placement

A
  • humeral epicondyles perp. to IR : ulnar styloid in profile medially
  • humeral epicondyles parallel to IR : ulnar styloid distal to ulnar head midline
  • humeral epicondyles in internal oblique : ulnar styloid btwn previous two projection
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13
Q

Wrist PA Rotation

A

External Rotation
- medially located carpal bones and MC bases - increase SI and decreased carpal joint space visualization
- laterally located carpal bones and MC bases - less SI and increase carpal joint space visualization
- radioulnar articulation closed

Internal Rotation
- laterally located carpal bones and MC bases - increased SI and decreased carpal joint space visualization
- pisiform and hamate hook - increase visibility
- radioulnar articulation closed

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14
Q

Wrist Forearm Parallelism

A

Wrist Extension
- posterior radial margin SI >1/4 of lunate

Wrist Flexion
- posterior radial margin SI <1/4 of lunate
- open radioscaphoid and radiolunate joint spaces

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15
Q

Wrist PA deviation

A

Radial deviation
- results in 3rd MC pointing twd medial side of wrist
- situates lunate medially

Ulnar deviation
- results in 3rd MC pointing twd lateral side of wrist
- situates lunate laterally

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16
Q

Oblique Wrist Deviation

A

Radial deviation
- 3rd MC pointing twd medial side of wrist and lunate moves medially

Ulnar deviation
- 3rd MC pointing laterally and lunate moves laterally

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17
Q

Oblique Wrist Obliquity

A

Insufficient
- trapeziotrapezoidal and trapeziocapitate joint spaces closed
- trapezoid SI 1/2 trapezium
- <1/2 of trapezoid SI capitate
- equal separation btwn 2-4 MC

Excessive
- trapeziotrapezoidal and trapeziocapitate joint spaces closed
- trapezium SI small part of trapezoid
- >1/2 trapezoid SI capitate
- 3-5th MC SI

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18
Q

Lateral Wrist Rotation

A

External
- anterior aspect of distal scaphoid is posterior to anterior aspect of pisiform
- pisiform seen anteriorly

Internal
- anterior aspect of distal scaphoid is anterior to anterior aspect of pisiform
- scaphoid seen anteriorly

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19
Q

Lateral Wrist Deviation & forearm position

A

Radial deviation - proximal forearm elevated
- forces distal scaphoid to move anteriorly and proximally
- distal scaphoid will be proximal to the distal aspect of pisiform

Ulnar deviation - proximal forearm depressed
- shifts distal scaphoid posteriorly and distally
- distal scaphoid positioned distal to distal aspect of pisiform

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20
Q

Forearm - distal rotation

A

Internal
- 1&2nd MC bases and carpal SI
- medially located MC bases without SI
- pisiform and hamulus of hamate better seen
- increase in internal rotation = increase in degree of radial and ulnar crossover

External
- 4&5 MC bases and carpal SI
- laterally located MC bases and carpal demonstrate less SI

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21
Q

Forearm - proximal rotation

A

Internal
- humeral epicondyles poorly positioned
- >1/8 radial head SI over ulna

External
- <1/8 radial head SI over ulna

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22
Q

Lateral Forearm rotation

A

Internal
- distal radius anterior to ulna

External
- distal radius posterior to ulna
- elbow rotation occurs

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23
Q

Lateral Forearm - humeral epicondyle positioning

A

Proximal humerus elevated
- poor humeral condyle alignment
- anterior aspect of radial head posterior to coronoid process
- proximal radius and ulna increased SI

Proximal humerus depressed
- anterior aspect of radial head is anterior to coronoid process

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24
Q

Elbow Rotation

A

Internal
- humeral epicondyles not in profile
- >1/8 of radial head SI over ulna

External
- humeral epicondyles not in profile
- <1/8 of radial head is SI over ulna

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25
AP Elbow Radial Tuberosity
Wrist in AP - radius and ulna parallel Wrist internally rotated - increased SI of radius Wrist externally rotated - radial tuberosity anterior and out of profile
26
AP Elbow - Elbow Flexion
Humerus parallel & distal forearm elevated - closed elbow joint space - radial head partially on-end Forearm parallel & proximal humerus elevated - open elbow joint space
27
AP Elbow - CR centering
CR centered proximal to elbow joint - capitulum projects into joint CR centered distal to elbow joint - radial head projected into joint space
28
Elbow Medial - Obliquity
Insufficient - <3/4 radial head SI ulna Excessive - >3/4 of radial head SI ulna
29
Elbow Lateral - Obliquity
Insufficient - radial head/radial tuberosity partially SI ulna Excessive - coronoid process partially SI radial head - radial tuberosity and ulna no SI - radial tuberosity not in profile
30
Oblique Elbow - flexion
Humerus parallel, proximal forearm elevated - Lateral O : closed capitulum-radial head & articulating surfaces of radial head - Medial O : closed trochlear-coronoid process & articulating surfaces of trochlea Forearm parallel, distal humerus elevated - Lateral O : open capitulum-radial head - Medial O : open trochlear-coronoid jiont
31
Lateral Humerus humerus position
Elevated proximal humerus - distal surface of capitulum too far distal to distal surface of medial trochlea - radial head is too far posterior to coronoid Depressed proximal humerus - distal capitulum too far proximal to distal medial trochlea - radial head too far anterior to coronoid
32
Lateral Elbow - distal forearm
Depressed distal forearm - capitulum anterior to medial trochlea - radial head distal to coronoid Elevated Distal forearm - capitulum posterior to medial trochlea - radial head proximal to coronoid process
33
Lateral Elbow Wrist Rotation
Lateral Wrist - radial tuberosity on medial aspect of radius and SI by radius External Wrist Rotation - radial tuberosity twd anterior surface of arm Internal Wrist Rotation - radial tuberosity twd posterior surface of arm, profile posteriorly
34
Humerus - Rotation
External - <1/8 radial head SI ulna Internal - >1/8 radial head SI ulna - greater tubercle not in profile laterally
35
Lateral Humerus - mediolateral vs lateromedial
Mediolateral - medial trochlea distal to capitulum Lateromedial - capitulum distally to medial trochlea
36
AP Shoulder - torso rotation
Twd. Affected Shoulder - medial clavicular end rotated away from lateral edge of vertebral column - increase thoracic and scapular body SI - decreased glenoid cavity visualization Away from affected shoulder - medial clavicular end SI vertebral column - decreased thoracic and scapular body SI - increased glenoid cavity visualization
37
AP Shoulder Tilt
Anterior tilt - superior scapular angle shown superior to mid clavicle Posterior tilt - superior scapular angle inferior to clavicle
38
AP Shoulder - arm rotation
External Rotation - epicondyle parallel to IR - greater tubercle in profile Neutral Rotation - epicondyle 45 degrees - greater tubercle moves anteriorly Internal Rotation - epicondyle perp. to IR - greater tubercle moves medially - lesser tubercle in profile
39
Glenoid AP Oblique Shoulder - rotation
Excessive - glenohumeral joint space closed - >1/3 of lateral coracoid process is SI over humeral head Insufficient - glenohumeral joint space closed - <1/3 of coracoid process SI humeral head
40
Glenoid Shoulder Tilt
Anterior tilt - superior margin of coracoid process inferior to superior margin of glenoid cavity Posterior Tilt - superior margin of coracoid process superior to superior margin of glenoid cavity
41
Scap Y Shoulder - obliquity
Excessive - lateral border SI by thorax or positioned closer to thorax than vertebral border - glenoid cavity rotate in same direction as lateral border Insufficient - vertebral border SI thorax or is closer to thorax than lateral border - glenoid cavity will rotate in same direction as lateral border
42
Scap Y Shoulder - Tilt
Anterior tilt - superior scapular angle superior to clavicle Posterior tilt - superior scapular angle inferior to clavicle
43
AP Toe - Rotation
Lateral Rotation - soft tissue and concavity greater on medial side of toe Medial Rotation - soft tissue and concavity greater on lateral side of toe
44
AP Oblique Toes - obliquity
Insufficient - concavity and soft tissue closer to equal Excessive - more than twice width of soft tissue and more concavity than anterior aspect -excessive lateral : more s.t on medial side -excessive medial : more s.t on lateral
45
Lateral Toe Rotation
Insufficient - MT heads shown posterior to first toe Excessive - MT heads SI or anterior to first toe
46
AP Foot Rotation
Lateral - MT bases increased SI - medial and intermediate cuneiform joint is closed - talus moves over calcaneus - >1/3 of talus SI calcaneus Medial - MT bases decreased SI - medial and intermediate cuneiform joint is closed - talus moves away from calcaneus - <1/3 of talus SI calcaneus
47
AP Oblique Foot - obliquity
Insufficient - cuneiform-cuboid, navicular-cuboid and 3-5th interMT spaces closed - 4th MT abse SI 5th MT base Excessive - cuneiform-cuboid, navicular-cuboid and 3-5th interMT spaces closed - 5th proximal MT in profile and SI 4th MT tubercle
48
Lateral Foot - tilt
Proximal lower leg farther from IR - distal fib more proximal and distal tibia more distal - lateral talar dome proximal to medial talar dome Distal lower leg farther from IR - distal fib more distal and distal tib more proximal - lateral talar dome distally to medially talar dome
49
Lateral foot - leg rotation
External - lateral talar dome demonstrated posterior to medial talar dome - anterior fibula posterior to mid-tibia Internal - lateral talar dome anterior to medial talar dome - anterior fibula anterior to mid-tib
50
AP Ankle - rotation
External - tibia SI >1/2 of fibula - anterior tibial margin SI talus closing medial mortise Internal - tibia SI <1/2 fibula
51
AP Ankle - leg elevation
Proximal lower leg elevated - anterior tibial margin more distal and tibiotalar joint space narrow Distal lower leg elevated - anterior tibial margin proximal and tibiotalar joint space expanded
52
Oblique Ankle - obliquity
Insufficient - tibia SI >1/4 of fibula - lateral and medial mortises closed Excessive - tibia SI <1/4 of fib - lateral mortise open
53
Oblique Ankle - leg elevation
Proximal lower leg elevated - anterior tibial margin projected distally - space btwn anterior and posterior tibial margins <3mm Distal lower leg elevated - anterior tibial margin projected more proximally - space btwn anterior and posterior tibial margins >3mm
54
Lateral Ankle Tilt
elevated proximal lower leg - lateral talar dome proximal to medial dome - <1/2 cuboid posterior to navicular bone - distal fib more proximal, distal tibia more distal elevated distal lower leg - lateral talar dome distal to medial dome - >1/2 cuboid posterior to navicular - distal fib more distal, distal tibia more proximal - open talocalcaneal joint and closed tibiotalar joint
55
Lateral Ankle Rotation
External - medial talar dome anterior to lateral talar dome - anterior distal fib aligned posteriorly to mid tibia Internal - medial talar dome posterior to lateral talar dome - anterior distal fibular aligned anteriorly to mid tibia
56
Tib/Fib rotation
External Rotation - tibia SI >1/4 of fib head and >1/2 of distal fib
57
Lateral Tib/Fib Rotation
External - tibia SI <1/2 of fib head Internal - tibia SI >1/2 of fib head - tibial and fibular midshafts demonstrate some SI - posterior aspect of distal fibula will be slightly anterior to posterior aspect of distal tibia
58
AP Knee Rotation
Internal - lateral femoral condyle will be larger than medial condyle - tibia will SI <1/2 fib head External - medial femoral condyle larger than lateral condyle - tibia will SI >1/2 of fib head
59
AP Knee - Femoral tilt
knee in full extension - slight upward curve btwn medial and lateral femoral condyles - patella normally in slight lateral position knee in flexion - distal femur moves away from IR - increased tilt means more of intercondylar fossa - intercondylar fossa in full visualization at around 60-70 degrees of flexion - >70 degrees: obscure intercondylar fossa & patellar apex within fossa - patella apex proximal to intercondylar fossa
60
Medial Oblique Knee - Rotation
Insufficient - tibia partially SI over fib head Excessive - excessive femoral condyle SI
61
Lateral Oblique Knee Rotation
Insufficient - fib head without full tibial SI Excessive - fib head not aligned with anterior edge of tibia and seen posterior
62
Knee CR angulation
Excessive cephalic - fib head more than 0.5 inch distal to tibial plateau Insufficient cephalic - fib head elongated and less than 0.5 inch distal to tibial plateau
63
Lateral Knee - CR angle
Insufficient - medial condyle in joint space - narrowed/closed joint space - less than 0.5 inch of distance btwn fib head and tibial plateau Excessive - lateral condyle in joint space - narrowed/closed joint space - more than 0.5 inch of distance btwn fib head and tibial plateau
64
Lateral Knee Rotation
Internal - adductor tubercle and medial condyle posterior to lateral condyle - patella situated too far from IR External - medial condyle anterior to lateral condyle - patella situated too close to IR
65

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