positioning review of upper and lower extremities
DESCRIPTION
Positioning Review of Upper and Lower Extremities. Reference Images in this presentation are from: Merrill’s Atlas of Radiographic Positioning and Procedures. Eugene Frank, Bruce Long, Barbara Smith. Fingers PA. Fifth Digit. Second Digit. Third Digit. Fourth Digit. CR - PIP. Lateral. - PowerPoint PPT PresentationTRANSCRIPT
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Positioning Review of Positioning Review of Upper and LowerUpper and Lower
ExtremitiesExtremities
ReferenceReferenceImages in this presentation are from:Images in this presentation are from:
Merrill’s Atlas of Radiographic Positioning and Merrill’s Atlas of Radiographic Positioning and Procedures.Procedures.
Eugene Frank, Bruce Long, Barbara SmithEugene Frank, Bruce Long, Barbara Smith
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FingersFingersPAPA
Third Digit
Fifth Digit
Fourth Digit
Second Digit
CR - PIP
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LateralLateral
Third DigitSecond Digit
Fourth Digit
Fifth Digit
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ThumbThumbAPAP
CR – MCP
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LateralLateral
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HandHandAPAP
CR – 3rd MCP
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PA ObliquePA Oblique
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LateralLateral
Extension Lateral
Fan Lateral
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WristWrist PA PA
CR – Mid Carpal
1. Scaphoid = Navicular 2. Lunate= Semilunar3. Triquetrum = Triquetral, Triangular4. Pisiform
5. Trapezium = Greater
Multangular6. Trapezoid = Lesser Multangular7. Capitate = Os Magnum8. Hamate = Unciform
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LateralLateral
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PA ObliquePA Oblique
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AP ObliqueAP Oblique
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Ulna Deviation – Ulna Ulna Deviation – Ulna FlexionFlexion
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Stecher Method – Cassette Stecher Method – Cassette raised raised
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Stecher Method – Tube Stecher Method – Tube angledangled
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Carpal Tunnel (Tangential Carpal Tunnel (Tangential Projection) - Gaynor-Hart Projection) - Gaynor-Hart
MethodMethod
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ForearmForearmAPAP
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Lateral Lateral
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ElbowElbowAP AP
Epicondyles are parallel to the IR
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LateralLateral
Epicondyles are perpendicular to the IR
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Medial (Internal) Rotation Medial (Internal) Rotation ObliqueOblique
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Lateral (External) Rotation Lateral (External) Rotation ObliqueOblique
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Distal Humerus – Partial Distal Humerus – Partial FlexionFlexion
APAP
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Proximal Forearm – Partial Proximal Forearm – Partial FlexionFlexion
APAP
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HumerusHumerusAPAP
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LateralLateral
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Transthoracic LateralTransthoracic Lateral
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Lower ExtremityLower Extremity
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ToesToes AP – Perpendicular CR AP – Perpendicular CR
CR - 3rd MTP
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AP AxialAP Axial
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AP Oblique – Medial AP Oblique – Medial RotationRotation
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FootFoot AP AxialAP Axial
CR - Base of 3rd metatarsal
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AP Oblique – Medial AP Oblique – Medial RotationRotation
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Lateral - MediolateralLateral - Mediolateral
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AnkleAnkleAPAP
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Lateral - MediolateralLateral - Mediolateral
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Medial Rotation (Internal) Medial Rotation (Internal) ObliqueOblique
for bony structuresfor bony structures
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15-20 degree Medial Rotation 15-20 degree Medial Rotation for Ankle Mortise Jointfor Ankle Mortise Joint
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Lateral (External) Rotation Lateral (External) Rotation ObliqueOblique
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Stress MethodStress Method
Inversion StressEverson Stress
For verification of ligament tear
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CalcaneusCalcaneus Axial – PlantodorsalAxial – Plantodorsal
CR - base of 3rd metatarsal
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Lateral CalcaneusLateral Calcaneus
CR - 1” distal to medial malleoulus
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Lower LegLower Leg AP AP
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LateralLateral
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KneeKneeAP – Sthenic PatientAP – Sthenic Patient
CR - 1/2” distal to apex of patella
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AP - Hypersthenic PatientAP - Hypersthenic Patient
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AP - Asthenic PatientAP - Asthenic Patient
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LateralLateral
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AP Oblique - Lateral (External) AP Oblique - Lateral (External) RotationRotation
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AP Oblique – Medial (Internal) AP Oblique – Medial (Internal) Rotation Rotation
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Bilateral knees – weight- Bilateral knees – weight- bearingbearing
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Patella Patella PAPA
CR - mid patella
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Lateral PatellaLateral Patella
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Settegast Method for PatellaSettegast Method for Patella“Sunrise or Skyline View”“Sunrise or Skyline View”
Typical tube angle is 15-20 degrees
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Hughston Method for PatellaHughston Method for Patella
Lower leg forms 50-60 degree angle from table
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Intercondylar Fossa - PA Axial Intercondylar Fossa - PA Axial Projection (Holmblad Method)Projection (Holmblad Method)
Femur is at 20 degree angle
“Tunnel” projection
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Camp-Coventry MethodCamp-Coventry Method
If knee is flexed 40 degrees, the tube is angled 40
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FemurFemur
AP Projection (for distal femur)AP Projection (for distal femur)
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AP Projection (for proximal femur)AP Projection (for proximal femur)
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Lateral femur to include kneeLateral femur to include knee
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Lateral Projection (for proximal Lateral Projection (for proximal femur)femur)