Lower Leg, Knee, & Patella Positioning Multiple Choice Questions (RAD 1101)

During radiography of a lateral projection of the knee, in order to relax the muscles and demonstrate the maximum volume of the knee joint, a ________ flexion is required.

a. 20-30 degrees

b. 40-45 degrees

c. 55-60 degrees

d. 70-90 degrees

a. 20-30 degrees

A radiographic image of the patella is obtained in the tangential (Settegast) projection. This is often used for the evaluation of:

a. vertical fractures of the patella

b. joint mice (loose bony fragments)

c. subtalar dislocations

d. tears of cruciate ligaments

a. vertical fractures of the patella

A radiographic image of the knee is obtained in the lateral projection. Which of the following will prevent the medial femoral condyle from obscuring the joint space?

a. 30-45 degree flexion of the knee joint

b. 20-30 degree medial rotation of the leg

c. 5-7 degree cephalic angulation of the CR

d. 10-15 degree lateral rotation of the leg

c. 5-7 degree cephalic angulation of the CR

A radiographic image of the patella in the tangential projection should not be attempted until a lateral image has been obtained to rule out:

a. damage to the collateral ligaments

b. transverse fracture of the patella

c. severe arthritis of patellofemoral joint space

d. damage to the patellofemoral bursa

b. transverse fracture of the patella

A radiographic image obtained in the PA axial (Camp-Coventry) projection may be used to demonstrate:

a. joint mice in intercondyloid fossa

b. vascular malformation in popliteal fossa

c. dislocation of talofibular articulation

d. dislocation of patellofemoral articulation

a. joint mice in intercondyloid fossa

A radiographic image of the knee is obtained in the AP projection on a patient measuring 22 cm from the ASIS to the tabletop. The CR should be directed:

a. 1" distal to the medial border of the patella

b. 1" distal to the lateral border of the patella

c. 1/2" distal to the base of the patella

d. 1/2" distal to the apex of the patella

d. 1/2" distal to the apex of the patella

Positions for demonstration of the intercondyloid fossa include the:

I- Holmblad

II- Beclere

III- Camp-Conventry

a. I

b. II

c. III

d. I, II, III

d. I, II, III

An intercondylar projection is taken with the patient leaning on his hands and knees and moved slightly forward (Holmblad Method). The central ray is directed:

a. slightly towards the head

b. slightly towards the feet

c. perpendicular to the IR

d. does not matter

e. none of the above

c. perpendicular to the IR

To visualize loose bodies in the knee joint space, one must obtain a profile view of the:

a. femur

b. tibia

c. patella

d. intercondyloid fossa

d. intercondyloid fossa

A radiographic image of the knee is obtained in a standing AP projection to evaluate arthritis. The CR is directed:

a. at a cephalad angle of 5-7 degrees to the knee joint

b. at a caudad angle of 5-7 degrees to the knee joint

c. perpendicular to the knee joint

d. parallel to the patellofemoral joint

c. perpendicular to the knee joint

A radiographic image of the knee is obtained in the AP axial (Beclere Method) projection to demonstrate the intercondyloid fossa. The CR should be directed to enter the knee joint:

a. parallel to the long axis of the femur

b. perpendicular to the long axis of the femur

c. perpendicular to the long axis of the patella

d. perpendicular to the long axis of the tibia

d. perpendicular to the long axis of the tibia

A radiographic image of the intercondyloid fossa is obtained in the PA axial (Holmblad) projection. If the long axis of the femur forms an angle of 70 degrees to the plane of the IR, the CR should be directed throught the knee joint:

a. at a caudad angle of 20 degrees

b. at a cephalad angle of 20 degrees

c. at a cephalad angle of 45 degrees

d. perpendicular to the lower leg

d. perpendicular to the lower leg

If properly positioned, which of the following articulation will be demonstrated in the lateral knee?

1. patellofemoral

2. femorotibial (knee)

3. proximal tibiofibular

a. 1 only b. 1 & 2

c. 2 & 3 d. 1, 2, & 3

b. 1 & 2

For the routine lateral projection of the knee, the central ray should be directed:

a. 5-7 degrees cephalad

b. 5-7 degrees caudad

c. 15 degrees cephalad

d. 15 degrees caudad

a. 5-7 degrees cephalad

Which of the following would best demonstrate the interspace between the femoral condyles and the patella?

a. AP projection

b. lateral projection

c. 45 degree medial oblique

d. 45 degree lateral oblique

e. PA projection

b. lateral projection

One important factor to remember when attempting to demonstrate the intercondyloid fossa using the Camp-Coventry position is:

a. direct the central ray perpendicular to the joint space

b. direct the central ray perpendicular to the femur

c. direct the central ray at right angles to the leg at the popliteal depression

c. direct the central ray at right angles to the leg at the popliteal depression

What is the flexion of the affected knee for a lateral patella?

a. 5-10 degrees

b. 20-30 degrees

c. 45 degrees

d. 55-65 degrees

a. 5-10 degrees

What is the central ray angle for AP projection of the knee when the patient's ASIS measures 26 cm from the tabletop?

a. 90 degrees

b. 3-5 degrees caudad

c. 3-5 degrees cephalad

d. 10 degrees cephalad

c. 3-5 degrees cephalad

Which projection best demonstrated possible cartilage degeneration of the knee?

a. AP

b. AP, weightbearing

c. PA axial, intercondylar fossa

d. lateral

b. AP, weightbearing

When radiographing the knee of a hypersthenic patient in the AP projection, it may be helpful to angle the central ray:

a. 5 degrees cephalad

b. 5 degrees caudad

c. 12 degrees cephalad

d. 12 degrees caudad

a. 5 degrees cephalad

With the patient prone and the affected knee fully flexed with the patella at right angles to the IR, one obtains a(n):

a. tangential view of the patella

c. intercondyloid view

c. PA view of patella

d. superoinferior view of patella

a. tangential view of the patella

In a lateral radiograph of the knee, the medial condyle is obscuring the retropatellar space. In repeating the exam, which of the following would be most useful in remedying this?

a. rotate leg slightly posterior and angle tube 5 degrees cephalic

b. rotate leg slightly anterior and angle tube 5 degrees caudad

c. shift central ray slightly to the posterior aspect of the knee joint

d. flex the knee to form a 45 degree angle

a. rotate leg slightly posterior and angle tube 5 degrees cephalic

A patient is placed in prone position with the femur in contact with the radiographic table. The lower leg is elevated to form an angle of 50 degrees with the plane of the IR. In order to demonstrate the intercondyloid fossa, the central ray should be directed:

a. perpendicular to the IR

b. 20 degrees cephalad

c. 40 degrees cephalad

d. 50 degrees cephalad

e. parallel to the femoral shaft

d. 50 degrees cephalad

Patella (sunrise view):

a. AP knee

b. oblique knee

c. tangential projection

d. all of the above

e. none of the above

c. tangential projection

Which of the following names is not associated with a tangential projection of the patella?

a. sunrise

b. Settagast

c. skyline

d. tunnel

d. tunnel

The space between the articular surface of the patella and the femur is best shown in the:

a. PA projection

b. AP projection

c. oblique projection

d. tangential projection

e. axial projection

d. tangential projection

Settegast described the methods of taking tangential projections of the:

a. calcaneus

b. elbows

c. talus

d. patella

d. patella

Of the following structures, which is closest to the IR for a tangential projection of the patella?

a. apex of patella

b. base of patella

c. medial aspect of knee

d. lateral aspect of knee

e. popliteal area

b. base of patella