Positioning Test Of The Elbow For Practical

Front 1

What is the default IR size for an elbow?

Back 1

10 x 12 inches

Front 2

For an AP Projection of the Elbow, is the hand supinated or pronated?

Back 2

When doing AP Projection of the ELBOW, you must make sure that the humeral epicondyles are parallel to the IR; therefore the hand is supinated. (Pronated would give you an AP Oblique Medial/Internal Rotation of the Elbow as the humeral epicondyles will be at a 45 degree angle)

Front 3

What is a crucial positioning step you must not forget when positioning an AP Projection of the Elbow for a true AP Projection?

Back 3

Ask patient to lean laterally as necessary for true AP projection.

Front 4

What is the general centering point for an elbow joint?

Back 4

Mid-elbow joint (a.k.a 3/4 inches distal to midpoint of a line between epicondyles).

Front 5

What projection(s) should we perform when the patient's elbow cannot be fully extended?

Back 5

AP Projection: Elbow in Partial Flexion (humerus parallel to IR with a 45 degree sponge supporting the forearm)

AP Projection: Elbow in Partial flexion (forearm parallel to IR and the humerus making a 45 degree angle with the image receptor)

Front 6

What is the general area of collimation for an elbow projection?

Back 6

Four sides of collimation.

Collimate on sides to the soft tissue borders.

Lower margin to include proximal radius and ulna.

Upper margin to include distal humerus.

Front 7

If the elbow cannot be fully extended and it's angle is more than 90 degrees, what method should we use?

Back 7

Acute Flexion of the Elbow.

For the distal humerus, the CR is perpendicular to the humerus at a point midway between epicondyles.

For the proximal forearm, the CR is perpendicular to the forearm (angling CR as needed depending on the angle of the forearm) directed at a point approximately 2 inches (5cm) proximal or superior to the olecranon process.

Front 8

To put the distal radius and ulna on the same plane as the elbow [ AP fully extended, AP partial flexion with forearm parallel to IR, AP Oblique Medial/Internal Rotation ] , we must put a ...

Back 8

15 degree sponge to put the hand, forearm, humerus all on the same plane together for true positions

Lateral Lateromedial is not included as a part of the question because you must remember that the only reason you would put a support for a Lateral Lateromedial is if the patient has a heavy muscular forearm and doing so would give us a true lateral position as the forearm would be parallel to the IR for a true lateral elbow. No point in putting it if everything is already on the same plane.

Also, a support sponge is not required for the radial head laterals projections either.

Front 9

What "accessories" are helpful for an AP Oblique - Lateral (External) Rotation of the Elbow?

Back 9

45 degree sponge and sandbags.

Front 10

What is the centering point for both acute flexion projections?

Back 10

For the distal humerus, the CR is perpendicular to the humerus at a point midway between epicondyles.

For the proximal forearm, the CR is perpendicular to the forearm (angling CR as needed depending on the angle of the forearm) directed at a point approximately 2 inches (5cm) proximal or superior to the olecranon process.

Front 11

Describe the patient position for the four radial head laterals (Lateromedial Projections) of the elbow and their general centering point.

Back 11

Patient positioned with elbow flexed 90 degrees with hand, forearm, & arm on the same plane (slouched /table height required for specific patient)

The central ray is directed to the radial head (1 inch distal to the lateral epicondyle).

1. Hand supinated (with maximum external rotation). The hand will not be able to be completely supinated; this is normal.

2. Hand lateral (place hand in true lateral position with thumb up)

3. Pronate hand (palm down).

4. Internally rotate hand (thumb down) as far as the patient can tolerate.

Front 12

What is the difference between a Lateral Lateromedial projection of the elbow and a Radial Head Lateral Lateromedial Projection with the hand lateral?

Back 12

For a Lateral Lateromedial projection: CR is 1.5 inches medial to easily palpated posterior surface of olecranon process

For a Radial Head Lateral Lateromedial with the hand lateral: CR is 1 inch distal to the lateral epicondyle which points to the radial head.

Front 13

What is a routine elbow examination?

Back 13

AP Elbow

Oblique (First projection with Lateral/External Rotation and Second projection with Medial/Internal Rotation)

Lateral Lateromedial