Download - Anatomy Technical FOPH BBFF Monteggia Galeazzi Essex-Lop. Fat Pads Peds Elbow Supracond. Lat. condyle Med. epicon. 4 © 2013 Ken L Schreibman, PhD/MD

AnatomyTechnicalFOPH

BBFFMonteggiaGaleazziEssex-Lop.

Fat PadsPeds Elbow

Supracond.Lat. condyleMed. epicon.

4

© 2013 Ken L Schreibman, PhD/MDwww.schreibman.info

Elbow & Forearm Trauma ASRT @ RSNA

1 of 99

Elbow CT: Positioning

We don’t scan patients with their elbow down at their side

Excess radiation across torsoX-ray scatter decreases res.

NEVER scan patients with their elbow laying on their abdomenElbow moves with

patient breathingMakes it impossible

to get good reformatsInstead get terrible

images like this

- WRONG WAY

CT Scout

http://www.schreibman.info/



Fat PadsPeds Elbow


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2 of 99

Elbow CT: Positioning - RIGHT WAYElbow over head!

Avoids torso radiationAvoids scatter from torso

Supine = OK Prone/Decubitus = OK

Optimal PositionElbow straightHead bent out of field

However the patient is most comfortable




Fat PadsPeds Elbow


4



3 of 99

Elbow CT: Positioning - BEST WAY

S,Y 30yoMCT Scout

Straight arm & elbowPerpendicular to

CT scanning planeEasier reformattingYields highest

resolution reformats

SagittalReformat

CoronoidFracture




Fat PadsPeds Elbow


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4 of 99

Elbow CT: PositioningThis is the position to avoid!

with arm parallel to CT scanning plane

- With a cast…

CT ScoutT,B 65yoF

SagittalReformat

Streak artifacts from scanning

length of forearm limits resolution




Fat PadsPeds Elbow


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5 of 99

Elbow CT: PositioningThis is a better position

with arm oblique to CT scanning plane

- With a cast…

CT ScoutR,A 27yoF

SagittalReformat

CoronoidFracture

Minimizes forearmstreak artifacts

Minimizes radiation to patient’s head




Fat PadsPeds Elbow


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6 of 99

Elbow CT:Reformat in 6 planes

3 planes relative to distal humerus3 planes relative to proximal forearmOff Sagittal reference image:

1) Axial to Humerus2) Axial to Forearm3) Coronal to Radius4) Coronal to Ulna

Off Axial Humerus reference:5) Parallel to Inter-Epicondyle Line6) Perpendicular to Epicondyle Line

If elbow is straight, only need 3!

UW 2-page Protocol Sheets

www.radiology.wisc.edu

PositioningReformattingReformatting


http://www.radiology.wisc.edu/

Download - Anatomy Technical FOPH BBFF Monteggia Galeazzi Essex-Lop. Fat Pads Peds Elbow Supracond. Lat. condyle Med. epicon. 4 © 2013 Ken L Schreibman, PhD/MD

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