projections

Lateral ankle

Patient sits or lies with knee flexed and leg externally rotated, dorsiflex foot with plantar surface perpendicular to the IR. Superimpose malleoli. Centre over medial malleolus, collimate to include skin edge posteriorly, midfoot anteriorly and distal 1/3 of tib/fib. Medium detector, FFD 100cm, kVp 55-65, mAs 3-5, fine focus and marker distal R/L

Mortise ankle

Patient sits or lies with knee flexed and foot dorsiflexed. From AP internally rotate leg 15 degrees so malleoli are equidistant from IR. ensuring alignment of the tibia and fibula. Center between malleoli. collimate to include ankle, midfoot, and 1/3 of tib/fib. Medium detector, FFD 100cm, kvp 55-65 cm, fine focus, mAs 3-5, distal marker.

AP ankle

Patient sits/lies on table with leg extended out front. long axis of leg is aligned parallel to the long axis of the IR. Dorsiflexed foot so plantar surface is perpendicular to IR. Centre CR between malleoli at level of malleoli. COllimate to include skin edges laterally and inferiorly, including distal 1/3 of tib/fib. Medium detector, 55-65, 100cm, 3-5, fine focus, marker distal

Lateral elbow

Position the patient seated or lying with the elbow flexed at 90 degrees. The forearm should rest on the table, with the hand in a lateral position. Distal radius and ulnar superimposed, humeral epicondyles superimposed (raise wrist). Centre the CR to the elbow joint, collimating to include the proximal forearm and distal humerus. Use a medium detector, FFD of 100cm, kVp of 55-65, and mAs of 3-5.

AP external oblique elbow

long axis of elbow aligned parallel to edge of IR. Start in AP position then rotation the forearm externally 45 degrees so epicondyles are oblique to IR.P A. Center the CR to the elbow joint with the distal humerus and proximal forearm included in the collimation. Use a medium detector, FFD of 100cm, kVp of 55-65, and mAs of 3-5.

AP elbow

long axis of elbow parallel to edge of IR, elbow in full extension and palm supinated. Humeral epicondyles equidistant to IR, hand elb and shoulder in same horizontal plane. COllimate to include 8-10cm of proximal forearm and distal humerus. Centre at cubital fossawith the CR perpendicular to the IR. Use a medium detector, FFD of 100cm, kVp of 55-65, and mAs of 2-5.

Lateral forearm

Forearm aligned parallel to long edge of IR or diagonally across IR. Hand/wrist in true lateral positoon ( elbow flexed 90 degrees, distal radius and ulna superimposed, humeral epicondyles superimposed - raise wrist) . Collimate to include both joints and 5-8cm of distal humerus. Large detector, 100cm, 55-60, 2-5, fine focus.

AP forearm

forearm aligned parallel to long edge of IR or diagonally across. Hand supinated on IR with arm in full extension, collimate to include both joints in field and lateral skin edges. Large detector, 100cm, 55-60, 2-5, fine focus, marker distal/lateral.

AP wrist

hand/wrist pronated with posterior aspect in contact with Ir, mid coronal plane parallel to IR

AP oblique wrist

raise radial aspect 45 degrees from AP or supinate 45 from lateral position

PA wrist

hand palm down (pronated), anterior aspect of wrist in contact w/ IR, CR mid sag plane.

Oblique wrist

supinate hand and wrist 30-45 degrees from PA position so radial aspect is raised

Lateral wrist

wrist perpendicular to IR, radius and ulna stacked/ superimposed, orthopaedic raised 20 degrees to open radiocarpal joint. Medium detector, 100cm, 50-60, 2-3, fine focus, marker lateral/anterior distal/proximal.

Lateral finger

Finger positioned parallel to the imaging receptor and hand perpendicular. 2nd digit - radial aspect in contact with IR, 3rd-5th digit ulnar aspect in contact with IR. Fold/extend other digits out of superimposition, CR perpendicular to IR, collimate to digit including skin edge and MC. Small detector, 100cm, 50-55, fine focus, 1-2, marker distal.

Oblique finger

Finger of interest aligned parallel to edge of IR. From PA, rotate (supinate) hand and wrist 45 degrees so radial aspect raised. collimate to digit including skin edge and MC, CR located at proximal phalanx. Small, 100cm, 50-55, 1-2, fine focus, marker distal.

PA finger

finger parallel to edge of IR, hand palm down pronated on IR with fingers straight to ensure joint spaces open, collimate including skin edge and MC, CR over proximal phalanx

Thumb

PA/AP: hand perpendicular to IR, thumb relaxed parallel to IR

Oblique: hand down in contact w IR

Lateral: hand in fist, or raised on sponge to raise ulnar aspect, collimate to thumb inc skin edge and CMC joint. 100,50-551-2, fine focus

Hand

3rd digit aligned parallel to edge of IR, collimate for skin edge and 1-2cm of rad ulna proximally, centre at 3rd MCP joint

PA: hand palm down, parallel to IR, fingers straight, slightly spread and parallel to IR

oblique: from PA, supinate hand and wrist 45 so radiala spect raised, fingers straight, use sponge

lateral: hand perpendicular to IR, Ok sign or stacked superimposed, fingers straight supported by sponges.

50-55,1-3,medium

Lateral calcaneus

knee flexed with leg externally rotated, long axis of foot parallel to IR, dorsiflex foot, plantar surface perpendicular to ir. collimate to skin edge of heel, talocrural joint, and anterior articulation of calcaneus. CR distal to medial malleolus. 100, 55-65, 3-5, fine focus, marker distal.

Axial calcaneus

Sitting/lying on table with leg extended, long axis aligned parallel to IR, dorsiflex foot so plantar surface is perpendicular to IR, angle CR 40 degrees cephalad. CR base of 3rd MT, collimate for skin edge and edges of foot. 60-65,100,5-8,fine focus, marker distal

AP foot

sitting/lying on tale, bend knee placing sole of foot flat on IR, long axis of foot parallel to edge of IR, uncurl toes. CR angled 5-15 degrees posteriorly towards calcaneum. Centre to base of 3rd MT, collimate for skin edges. medium, 100, 2-5, 55-60.

Oblique foot

long axis of foot parallel to edge of IR, rotate 40 degrees medially from AP use sponges. centre at base of 3rd MT, collimate for skin edges, 100,55-60,2-5, fine focus, marker distal

Lateral foot

knee flexed with leg externally rotated, long axis of foot parallel to ir, dorsiflex foot plantar surface perpendicular to IR, collimate for skin edges and ankle joint. may need to use 15 degree sponge uner toes to ensure no over rotation. 52-60, 3-6, 100cm