RAD 151 - Positioning test 2

AP Ankle

Position: back of heel against IR, foot vertical

CR: Ankle joint midway between malleoli

Structures Shown: distal tib fib, proximal portion of talus

AP Mortise

Position: back of heel against IR, rotate medially 15-20 degrees

CR: Ankle joint midway between malleoli

Structures Shown: Ankle joint open all the way around

Medial Oblique Ankle

Position: back of heel against IR, rotate medially 45 degrees

CR: ankle joint midway between malleoli

Structures shown: distal ends of the tib fib

Mediolateral Lateral Ankle

Position: lateral side of ankle against IR

CR: medial malleolus

Structures Shown: lower 1/3 of tib fib, ankle joint, and tarsals

Plantodorsal Axial Calcaneus

Position: leg and heel touching IR

CR: 40 degrees cephalic, base of 3rd MT

Structures Shown: Axial projection of the calcaneus

Lateral Calcaneus

Position: recumbent on affected side, true lateral, dorsiflexed

CR: 40 degrees cephalic, 1in distal to medial malleolus

AP Foot

Position: plantar surface of foot on IR

CR: base of 3rd MT

Structures Shown: tarsals anterior to talus, metatarsals, and phalanges

Medial Oblique Foot

Position: plantar surface of foot on IR, rotate leg and foot medially 30 degrees from IR

CR: Base of 3rd MT

Structures Shown: interspaces between lateral portions of the foot (tarsals, metatarsals, phalanges)

Lateral Foot

Position: mediolateral, lateral portion of foot on IR

CR: base of 3rd MT

Structures Shown: Entire foot in profile, ankle joint, distal ends of lower leg

AP Axial (Beclere)

Position: Patient supine, flex knee-support knee, tib/fib should be parallel to CR (30degrees)

CR: To knee joint (1/2in below apex of patella), 30 degrees cephalic

Structures Shown: Intercondylar fossa, intercondylar eminence, and knee joint

AP Knee

Position: Leg extended, posterior knee against IR/Bucky (Supine or Erect)

CR: 1/2in inferior to apex of patella

Structures Shown: AP projection of knee structures

Medial Oblique Knee

Position: “AP”, then rotate medially 45 degrees

CR: 1/2in inferior to apex of patella

Structures Shown: Medially rotated femoral condyles, patella, tibial condyles, proximal tibiofibular joint, head of fibula.

Lateral Oblique Knee

Position: “AP", then rotate laterally 45 degrees

CR: 1/2in inferior to apex patella

Structures Shown: Laterally rotated femoral condyles, patella, tibial condyles, head of fibula.

Lateral knee

Position: Patient lying or standing in lateral position 20-30 degrees, epicondyles perpendicular to IR

CR: 1in distal to medial epicondyle, CR 5-7 degrees cephalic

Structures Shown: Lateral image of the distal femur, patella, knee joint, proximal ends of tibia and fibula also soft tissue

X-table lateral (NON ARRT)

Position: pt supine with support under affected knee, patella perpendicular to IR with condyles super imposed (IR between legs)

CR: 1in distal to condyle (Vertical line), Mid leg (horizontal line)

AP Lower Leg

Position: Extend leg, posterior portion of leg against IR

CR: midpoint of leg, SID 40-48in

Structures Shown: Tibia, fibula, and adjacent joints

Lateral Lower Leg

Position: place lateral portion of leg against IR, patella is perpendicular, knee may be flexed

CR: midpoint of leg, SID 40-48in

Structures Shown: Tibia, fibula, and adjacent joints

Tangential (Settegast) Patella

Position: “seated” supine with knee flexed, IR touching distal anterior femur.

CR: Perpendicular to patellofermoral joint or angled depending on flexed knee (CR pointed upwards)

Structures Shown: Vertical fractures of the patella and articulating surfaces of the patellofemoral articulation

AP or AP Axial Toes

Position: Place tow on top of IR

CR: 1st toe, IP Joint. 2nd-5th toes, PIP Joint. For all toes, 3rd MTP Joint (AXIAL 15 degrees posterior)

Structures Shown: phalanges of the toe(s). Distal portions of the metatarsals (AXIAL = IP JOINTS)

Oblique Toe

Position: Toe on IR, medially rotate lower leg and foot to form 30-45 degree angle from IR

CR: 1st toe, IP Joint. 2nd-5th toes, PIP Joint. All toes, 3rd MTP Joint

Structures Shown: Toes and distal portion of metatarsals rotated medially

Lateral Toe

Position: 1st and 2nd toes, medial foot touching IR. 3rd-5th toes, lateral side of foot touching IR. (get other toes out of way)

CR: 1st toe, IP joint. 2-5th toes, PIP joint

Structures Shown: Lateral projection of the phalanges of the tow and IP articulations projected free of superimposition

AP Shoulder - External rotation

Position: shoulder joint midline of grid, back flat against Bucky, abduct and supinate hand, epicondyles parallel to IR

CR: 1inch inferior to coracoid process

AP Shoulder - internal rotation

Position: shoulder joint midline of grid, back flat against Bucky, rotate arm internally and rest back of hand on hip. Epicondyles should be perpendicular to IR

CR: 1inch inferior to coracoid process

Scapular Y (AP)

Position: Affected side away from Bucky (AP), rotate pt 45-60 degrees, palpate scapula and place flat surface perpendicular to IR, affected side arm across lower abdomen

CR: Perpendicular to scapulohumoral joint (on humeral head)

Inferior superior Axial shoulder - Axillary

Position: Supine, elevate affected shoulder, abduct arm of affected side at right angles (to hold IR), have pt turn head away from affected side, IR placed against the neck/ in neck crevice/behind arm

CR: Horizontally through axilla (CR typically rotated 45degrees), SID 40

Transthoracic Lateral Shoulder

Positioning: Pt in lateral position, affected side against Bucky, have pt raise non injured arm, rest forearm on head, raise shoulder as much as possible

CR: MCP at level of surgical neck

Grashey Method (glenoid cavity)

Position: Pt affected side against Bucky, rotated 35-45 degrees, abduct arm slightly and place lam of hand on abdomen, adjust so scapula is parallel with plane of IR

CR: Cr should be 2in medial, 2in inferior so superolateral boarder of shoulder (shoulder joint)

AP clavicle

Position: upright, center clavicle to IR

CR: mid shaft of clavicle

AP axial clavicle

Position: upright, center clavicle to IR, back flat against Bucky

CR: 15-30 degrees cephalic, mid shaft of clavicle

AP Scapula (Stop sign)

Position: Back flat against Bucky, upright, abduct arm to a right angle

CR: Perpendicular to midscapular area 2in inferior to coracoid process (With relaxed arm&shoulder)

Lateral Scapula

Position: AP, affected side away from Bucky, arm across upper chest, pt angled so scapula is perpendicular to IR (medial and lateral border of scapula superimposed)

CR: CR perpendicular to mid lateral border of scapula (I think around armpit ish area/axillary boarder, don’t quote me pls)