RAD 112 - Radiographic Procedures I: Exam #5 (Module 5)

Is the IR tabletop or bucky for toe & calcaneus projections?

tabletop

How much angulation is used for AP toes projections & in which direction?

15° cephalic (toward the heel)

What is the centering point for AP toes (forefoot)?

3rd MTP joint

What is the collimation standard for AP toes (forefoot)?

1" on sides, include 1" of distal metatarsals

Which joint spaces should be open in AP toes projections?

IP & MTP joints

How can you ensure no rotation in an AP toes (forefoot) projection?

equal concavity on both sides of phalanges & even soft tissue borders

What happens if the AP toes projections are done w/ no angulation?

IP joint spaces will appear closed

What is the centering point for oblique toes & single-digit AP toes?

MTP joint of interest

What is the collimation standard for oblique & single-digit AP toes?

1" on sides, include ½ of distal metatarsal

What is the degree of rotation for oblique toes?

30-40°

For which digits should the foot be rotated medially in an oblique view?

1st-3rd digits

For which digits should the foot be rotated laterally in an oblique view?

4th-5th digits

How do you check for correct rotation on an oblique toe?

increased concavity on 1 side of the phalanges & overlapping of MT heads or soft tissue

Which digits are lateromedial in the lateral view?

1st-3rd digits

Which digits are mediolateral in the lateral view?

3rd-5th digits

Where is the CR centered for the 1st digit in a lateral view?

IP joint

Where is the CR centered for digits 2-5 in a lateral view?

PIP joint

What is the collimation standard for a lateral toe?

collimate tightly to the digit of interest, include distal phalanx

How can you ensure lateral toes are truly lateral?

posterior surfaces of phalanges show concavity & are superimposed

Which joint spaces should be open in a lateral toe?

IP joints

What is the centering point for both sesamoid methods?

tangential to the 1st MTP joint

What is the collimation standard for tangential sesamoids?

tight to sesamoids & 1st MT head

In the Lewis method, the patient is _____ w/ the _____ _____ resting on the IR

prone; great toe

In the Holly method, how is the patient positioned?

seated w/ toes pulled back toward the leg using a positioning aid

Is the lateral calcaneus projection lateromedial or mediolateral?

mediolateral

What is the centering point for the lateral calcaneus?

1" distal to the medial malleolus

What 3 structures should be visible in the lateral calcaneus view?

calcaneus, ankle joint, tarsals

What 3 ways do you ensure no rotation on a lateral calcaneus?

sinus tarsi visible; calcaneocuboid & talonavicular joints open; tuberosity in profile

How does patient positioning differ between the plantodorsal & dorsoplantar axial calcaneus views?

plantodorsal—supine; dorsoplantar—prone w/ ankle elevated on a sponge

What is the CR angle & centering point for the plantodorsal axial calcaneus projection?

40° cephalic, plantar surface @ base of 3rd MT

What is the CR angle & centering point for the dorsoplantar axial calcaneus projection?

40° caudal, posterior ankle

What 2 structures should be visible in axial views of the calcaneus?

talocalcaneal joint & sustentaculum tali

What 2 ways do you ensure no rotation in axial calcaneus projections?

sustentaculum tali in profile; 1st & 5th MTs not visible

In the dorsoplantar axial calcaneus view, both the _____ & _____ are vertical

foot, IR

In which projection of the toe is the knee specifically flexed?

oblique

What are the 2 tangential sesamoid methods?

lewis & holly

What do the 3 axial knee methods demonstrate?

open intercondylar fossa

Are routine patella tangential methods performed tabletop or within the bucky?

tabletop

Are PA & lateral patella views performed tabletop or within the bucky?

within the bucky

What must be ruled out before performing tangential patella methods?

patellar fracture

How is the patient positioned for a PA patella projection?

prone w/ heel rotated laterally 5-10°

What should be minimized in the PA patella & why?

OID, to reduce magnification & improve resolution

What structure is the patella seen through in a PA patella projection?

the femur

How do you ensure no rotation in a PA patella projection?

femoral condyles appear symmetric

What is the projection direction for a lateral patella?

mediolateral

What degree of knee flexion is used for a lateral patella?

5-10° flexion

What happens if the knee is overflexed in the lateral patella projection?

the patellofemoral joint space becomes closed

How do you ensure a true lateral in a lateral patella view?

superimposed femoral condyles

What is the centering point for a lateral patella view?

mid-patellofemoral joint

What joint space should be open in both lateral patella and Settegast views?

patellofemoral joint space

In the Settegast patella method, how is the patient positioned?

supine or prone

In the Settegast patella method, how is the knee positioned & why?

flexed as much as possible to make the patella perpendicular to the IR

In the Settegast patella method, when & how is the CR angled?

if the joint is not perpendicular to the IR; typically 15-20° cephalic

What does the Settegast patella method best demonstrate?

patellofemoral joint articulations & vertical patellar fractures

What 2 structures are seen along w/ the patella in the Settegast & Merchant methods?

femoral condyles & intercondylar sulcus

How is the patient positioned for the Merchant patella method?

supine w/ knees & lower legs hanging off table

Where is the IR located in the Merchant patella method?

in a holding device, about 1 ft distal to the patellae at the shins

How much are the knees flexed in the standard Merchant patella method?

about 40°

To demonstrate irregular disorders, the knees may be flexed how much in the Merchant patella method?

30-90°

What type of projection is the Merchant patella method?

bilateral

What type of projection is the Settegast patella method?

unilateral

What is the centering point for the Merchant patella method?

midway between patellae, passing through the patellofemoral joint

What is the CR angulation for the Merchant patella method?

30° caudal

What are the collimation standards for the Merchant patella method?

2" above patellar shadow & 1" on each side

Why is the Merchant patella method less preferred than the Settegast method?

increased OID causes magnification

How is the patient positioned for a CTL knee?

supine w/ affected leg slightly elevated

What is the CR direction & IR placement for a CTL knee?

horizontal CR; IR placed between the knees

Is the CTL knee projection lateromedial or mediolateral?

lateromedial

What is the centering point for the AP weight-bearing knees?

½" below the patellar apices

What anatomy & deformities are visible in the AP weight-bearing knees view?

knee joint space, varus & valgus deformities

What does varus mean, & which aspect of the leg does it stress?

bowlegged; stresses medial aspect

What does valgus mean, & which aspect of the leg does it stress?

knock-kneed; stresses lateral aspect

How many patient positions can the Holmblad knee method be performed in?

3

What must be flexed in the Holmblad method?

knee

Which surface of the knee is placed against the IR in the Holmblad method?

anterior surface

What is the centering point for the Holmblad & Camp-Coventry knee methods?

at the patellar apex/superior popliteal fossa

What is the degree of knee flexion in the Holmblad method?

70° from full extension

What 3 structures are visible in the Holmblad knee method besides the intercondylar fossa?

intercondylar eminence, tibial plateaus, tubercles

How is the patient positioned for the Camp-Coventry knee method & w/ what flexion?

prone w/ knee flexed 40-50°

What is the CR angle & direction for the Camp-Coventry method?

40° caudal, perpendicular to the lower leg

What 3 structures are visible in the Camp-Coventry knee method?

open intercondylar fossa, tibial plateaus, intercondylar eminence

How is the patient positioned for the Beclere knee method?

supine w/ affected knee flexed

What is the degree of knee flexion in the Beclere method?

60° to the tibia

What is the centering point for the Beclere knee method?

½" below the patellar apex

What 3 structures are seen in the Beclere knee method?

intercondylar fossa, eminence, equidistant femoral condyles

If the axial knee methods are not correctly performed, the intercondylar fossa may be superimposed by what structure?

the patellar apex

How do you ensure no rotation in axial knee methods?

slight tibiofibular overlap

Are routine tibia/fibula projections tabletop or within the bucky?

tabletop

Are routine knee projections tabletop or within the bucky?

either, depending on patient size

Which lower leg bone is on the medial aspect?

tibia

Which lower leg bone is on the lateral aspect?

fibula

The tibia helps form which 2 joints?

knee & ankle joints

The fibula helps form which joint?

the ankle joint

What 3 structures form the ankle mortise?

tibia, fibula, talus

What degree of rotation opens the ankle mortise joint?

15-20 degrees medial rotation

What 4 ligaments support the knee joint?

PCL, ACL, TCL, FCL

What does PCL stand for?

posterior cruciate ligament

What does ACL stand for?

anterior cruciate ligament

What does TCL stand for?

tibial collateral ligament

What does FCL stand for?

fibular collateral ligament