Image critique- fall 2025 semester

finger- collimation

distal tip of finger to metacarpal head

finger- PA

1. no soft tissue overlap

2. equal concavity & soft tissue

3. open IP & MCP joints

finger- oblique

1. 45 degrees rotation

2. concavity on elevated side

3. no superimposition of proximal phalanx or MCP joint

4. open IP & MCP joint

finger-lateral

1. fingernail in profile

2. concave anterior surface of phalanges

3. no superimposition

4. open IP joint spaces

Thumb- collimation

distal tip of thumb to trapezium

thumb- oblique

1. concave elevated side

2. open IP & MCP joint spaces

thumb- lateral

1. no rotation

2. thumbnail in profile

3. open IP & MCP joint spaces

thumb- AP

1. no rotation

• concavity of phalangeal & metacarpal bodies

• equal amount of soft tissue

2. thumbnail in center of distal thumb

3. overlap of soft tissue over midshaft of 1st metacarpal

4. open IP & MCP joint spaces w/o overlap of bone

hand- collimation

fingertips to distal radius & ulna

hand-PA

1. no rotation (equal concavity)

2. fingernail in center of each distal phalanx

3. equal distance between metacarpal heads

4. open MCP & IP joints

Hand- Oblique

1. digits separated slightly w/ no overlap of soft tissue

2. 45-degree rotation

3. decreasing amt of separation between metacarpal bodies 2-5, w/ 2nd-3rd having the greatest separation

4. partial overlap of 3rd-5th metacarpal bases & heads

5. open MCP & IP joints

Hand- lateral

1. phalanges are individually seen

2. superimposed metacarpals

3. superimposed radius & ulna 

4. thumb free

Wrist- collimation

distal radius & ulna, carpals, & proximal half of metacarpals

wrist- PA

1. no excessive flexion

2. no rotation

3. open radioulnar space

wrist- oblique

1. 45 degree rotation

2. slight interosseous space between 3rd-5th metacarpal bodies

3. slight overlap of distal radius & ulna

4. trapezium & distal half of scaphoid w/o superimposition

5. open trapeziotrapezoid & scaphotrapezial joint space

wrist- lateral

1. superimposed distal radius & ulna 

2. superimposed metacarpals

Elbow- collimation

4 fingers above & below elbow joint

elbow- AP

1. radial head, neck, & tuberosity slightly superimposed over the proximal ulna 

2. elbow joint open & centered

3. open humeroradial joint

4. no rotation of humeral epicondyles 

• coronoid & olecranon fossae approximately equidistant to epicondyles 

elbow-medial oblique

1. 45 degree rotation

2. elbow joint open & centered

3. coronoid in profile 

4. ulna superimposed by radial head & neck

5. trochlea

elbow-lateral oblique

1. 45 degrees rotation 

2. elbow joint open & center

3. radial head, neck, & tuberosity free of ulna 

4. elongated lateral humeral epicondyle 

5. capitulum 

elbow-lateral

1. elbow joint centered 

2. superimposed humeral epicondyles 

3. radial tuberosity anteriorly 

4. radial head partially superimposing the coronoid process 

5. olecranon process in profile 

6. elbow flexed 90 degrees

forearm- collimation

entire forearm, including wrist & distal humerus

forearm- AP

1. slight superimposition of radial head, neck, tuberosity over proximal ulna

2. partially open elbow joint

3. open radioulnar space

forearm- lateral

1. superimposition of radius & ulna at distal end

2. superimposition by radial head over coronoid

3. radial tuberosity facing anteriorly

4. superimposed humeral epicondyles

5. elbow flexed 90 degrees

toe/ forefoot- collimation

entire toe(s), including distal end of metatarsal (head)

toe- AP axial

1. toe separated 

2. no rotation

3. open IP & MTP joints

toe- medial oblique

1. toe separated

2. proper rotation w/ more concavity on elevated side

3. open IP & 2nd-5th MTP joint spaces- great toe (not always open)

toe-lateral

1. toenail in profile

2. concave plantar surface

3. no rotation

4. open IP joint

forefoot- AP

1. toes separated

2. no rotation

3. open IP & MTP joint spaces

forefoot- medial oblique

1. toes separated 

2. proper rotation 

foot- collimation

entire foot & distal leg

foot- AP dorsoplantar

1. no rotation

2. equal amounts of space between 2nd-4th metatarsals 

3. overlap of 2nd-5th metatarsal BASES

4. open IP, MTP, & TMT joint spaces

5. open medial & intermediate cuneiform joint

foot- medial oblique

1. 3rd-5th metatarsals free of superimposition

2. bases of 1st & 2nd metatarsals superimposed on medial & intermediate cuneiforms 

3. navicular, lateral cuneiform, & cuboid w/ less superimposition than in AP

4. tuberosity of 5th shown

5. lateral tarsometatarsal & intertarsal joint open

6. sinus tarsi

foot- lateral

1. heads of metatarsals superimposed w/ tuberosity of 5th metatarsal seen in profile

2. fibula overlapping the posterior portion of the tibia

3. tibiotalar joint open

heel- AP axial

1. calcaneus & talocalcaneal joint

2. no rotation

• sustentaculum tali in profile on medial side

• 1st or 5th metatarsals not visible on either side

heel- lateral

1. tuberosity in profile 

2. sinus tarsi open 

   1. calcaneocuboid & talonavicular joints open

ankle- collimation

distal tib/fib & talus

ankle- AP

1. ankle joint centered

2. medial & lateral malleoli

3. talus

4. no rotation:

• normal overlap of tibiofibular articulation w/ anterior tubercle slightly superimposed over the fibula

• talus slightly overlapping the distal fibula

• no overlapping of the medial talomalleolar articulation

• tibiotalar joint space open

ankle- AP mortise

1. proper 15-20 degree rotation

2. talofibular & tibiotalar articulation open

3. no overlap of anterior tubercle of tibia & superolateral portion of talus w/ fibula

ankle- lateral

1. tibiotalar joint visualized

2. medial & lateral talar domes superimposed

3. fibula over posterior half of tibia

4. 5th metatarsal base & tuberosity seen (jones fx)

Tib/fib- AP

1. ankle & knee joints on

2. proximal & distal articulation of tibia & fibula moderately overlapped

3. fibular midshaft free of tibial superimposition

Tib/fib- lateral

1. ankle & knee joints on

2. distal fibular superimposed by posterior half of tibia

3. slight overlap of tibia on proximal fibular head

4. moderate separation of tibial & fibular bodies or shafts (except at articular ends)

Abdomen- KUB

kidneys, ureters, bladder are on

Abdomen- obstruction series

erect & AP supine… need full bowel pattern on.. 14×11 if off top…17×14 if off top & sides

advanced chest- AP erect

1. clavicles appear more horizontal than PA

2. approx 1 inch of pulmonary apices should be seen superior to clavicles