RAD111 Ch7 Projections

If the site of interest is in the area of the proximal femur, what projection should be performed?

Unilateral hip routine or pelvis

What is the routine for a femur projection

AP mid to distal

AP mid to proximal

lateral mid to distal

Lateral mid to proximal

Range of kVp for AP femur mid to distal

75-85 kVp

Part position for AP femur mid to distal

Supine

Leg rotated 5 degrees for a true AP, as for AP knee

For an AP femur mid to proximal you should rotate the leg

15-20 degrees internally, as for AP hip

On an AP femur mid to distal, will the knee joint appear open

No because of divergent xray beam

For an AP femur mid to distal, how much should you lwoer the IR under the knee

2 inches

CR angle for AP femur mid to distal

0, perpendicular

For possible truama, if the site of interest is in the area of the proximal femur, a unilateral truama _____ is recommended

Unilateral truama hip

For the lateral femur, you should flex the knee

45 degrees

The unaffected leg of the lateral femur should be behind or infront of the affected leg

Behind

In a truama lateromedial femur projection, the IR should be against the medial or lateral aspect of the thigh to include knee

Medial aspect

In a lateral femur mid to proximal, flex the knee

45 degrees

In a latera femur mid to proximal, the patient should roll back how many degrees to prevent superimpostiong to the proximal femur and hip joint

15 degrees

In a lateral femur to mid proximal projection, the upper IR should be at the level of the

ASIS

Another name for AP pelvis

Bilateral hips

KVp for AP pelvis

80-90

Internally rotate the lower limb how many degrees for AP pelvis

15-20

The CR for AP pelvis is midway between

ASIS and symphysis pubis or 2in below ASIS

Another name for the AP Apxial outlet projection

Taylor method

The Taylor method is a bilateral

Pubis and iscium

CR for the Taylor method for males and females

Cephalad 20-35 degrees for males

Cephalad 30-45 degrees for females

For the Taylor method, direct the CR to a midline point _ to _ inches distal to the superior border of the symphysis pubis or greater trochanters

1 to 2 inches

the AP axial inlet projection is for the

Pelvis

The AP axial inlet projection asses pelvis

Truama for posterior displacement or inward or outward rotation of the anterior pelvis

For the AP axial inlet pelvis projection, the CR angle is

Caudad 40 degrees (near perpendicular to plane of inlet)

For the AP axial inlet pelvis projection, the centering should be at the level of

ASIS

The AP axial inlet pelvis demonstrates the

Pelvic ring or inlet (superior aperture)

Another name for the posterior oblique pelvis—acetabulum

Judet method

What is the judet method used for

Acetanbular fractures

Pelvic ring fractures

T/F in the judet method, right and left oblique projections are taken for comparison, with both centered for upside or both for downside acetabulum. With possible pelvic ring fractures due to a contrecoup injury, the entire pelvis must be included. In this case centering should be adjusted to include both hips

True

For the judet method, the patient should be how many degrees oblique

45

In the judet method,if the acetabulum is the area of interest and the affected side is down, where should you center

2 inches distal and 2 inches medial to downside of ASIS

In the judet method if the acetabulum is the area of interest and the affected side side is up, where should the CR be directed and centered

2 inches directly distal to upside ASIS

In the judet method, if the pelvic ring is the area of interest, would should you center the CR to

2 inches inferior from level of ASIS

2 inches medial to upside ASIS

In the judet method, when the acetabulum is centered downside, the _____ rim of the acetabulum and ______ (ilioischial) column is demonstrated

Anterior rim of the acetabulum

And

Posterior column

The iliac wind is also well visualized

In the judet method, when the acetabulum is centered to the upside, the _____ rim and _______ (iliopubic) colouumn are demonstrated

Posterior rim of the acetabulum

And

Anterior column

Obtruator foramen are well shown

In the judet method, when the pelvic ring is centered, the _____ and _____ coloumn are well demonstrated, along with other aspects of the pelvic ring

Ilioschial and iliopubic columns

Another name for the PA axial oblique projection of the acetabulum

Teufeul method

The teufeul method demonstrates

Acetabulum fractures, especially the posterior wall of the acetabulum

True or false, the right or left posterior oblique is taken to show the side of interest, centered to the downside acetabulum to demonstrate the hip joint and acetabulum in the center of the iamge, with the femoral head in profile. The concave area of the fovea capitis should be shown, along with the superb posterior wall of the acetabulum

True

What is the kVp for the teufeul method

75-85 kVp

In the teufeul method, is the affected side up or down

Down

In the teufuel method, the patient should be in a posterior or anterior oblique

Anterior oblique

In the teufuel method, the patient should be how many degrees from tabletop or wall Bucky

35-40

In the teufeul method, the anatomy of interest is downside or upside

Downside

In the teufeul method, the CR is

Perpendicular

Centered 1 inch superior to the level of the greater trochanter (2 inches lateral to the midsagittal plane)

In the teufeul method, the CR is angled how many degrees

12 degrees cephalad

In the teufeul method, the ____ wall of the acetabulum is demonstrated

Superoposterior wall

The oblique projection of the acetabulum is also known as the

False profile method

The false profile method is used for

dysplasia and instability, femoraoacatabular impingement (FAI)

In the false profile method, the patient is in a anterior or posterior oblique

Posterior oblique

In the false profile method, the patient is rotated how many degrees

65 degrees to wall Bucky

The false profile method will demonstrate the

Superolateral aspect of thr acetabulum with the femoral head centered within it

The modified false profile projection is positioned in the same manner as the false profile projection by with the dependent lower limb and foot rotated

Internally 35 degrees away from IR

The AP unilateral hip is used for

Post ops or follow up exams to show the acetabulum, femoral head, neck, and greater trochanter, and evaluation of condition and placement of orthopedic appliances

KVp for AP unilateral hip

80-85

For the AP unilateral hip, you should locate the

Femoral neck and align to the CR

For AP unilateral hip, you should rotate the affected leg internally how many degrees

15-20f

The femoral neck can be located about

1 to 2 inches medial and 3 to 4 inches distal to ASIS

Another name for the Axiolateral (inferosuperior) projection—truama: hip and prox femur

Danelius-miller method

When is the danelius miller method used

For fractured hip and for patients who can't rotate or move the affected leg for the modified cleaves or frog leg

Where should to place the IR for the danelius miller method

In the crease above iliac crest and adjust so that it is parallel to the femoral neck and perpendicular to CR

Another name for the AP bilateral projection - hips

Modified cleaves method

The modified cleaves method shows

No truama hip, developmental dysplasia of hip (DDH)

KVp for modified cleaves method

80-90

In the modified cleaves method, the patients knees are flexed

90 degrees

In the modified cleaves method, the patients feet are

Together

In the modified cleaves method, the patients femora are abducted

40-45 degrees from verticle

In the modified cleaves method, the CR is

3 inches below level of ASIS or 1 inch above symphysis pubis

What amount of degree flexion from vertical plane provides for the least foreshortening of femoral head and neck region, but foreshortens the entire proximal femoral, which may not be desirable in the modified cleaves method

20-30 degrees

Another name for the mediolateral— hip and proximal femur

Modified cleaves method

The modified cleaves method (mediolateral) hip and femur are for

Lateral view to assess hip joint and proximal femur for non traumatic hip situations

In the modified cleaves method, mediolateral hip and proximal femora, the femur should be abducted how many degrees from verticle

45

A modified version of the modified cleaves method mediolateral hip and femur is where the patient rotates onto thr affected side until the femur is in contact with the tabletop and parallel to the IR. It shoes the head and acetabulum well if affected leg can be a survey sufficiently

Lauenstein-Hickey

Another name for the modified Axiolateral projection — possible truama: hip and prox femur

Clements-nakayama method

The Clemens's nakayama method is

Lateral oblique view for assessment of hip fractures, or arthorplastic when patient sha limited movement in both lower limbs and inferiorosuperior can't be obtained

Arthroplasty

Surgery for hip prosthesis

In the Clement's nakayama method, the legs are

Neutral

In the Clement's nakayama method, what degree does the CR use

15 degree posterior

The IR in the Clement's nakayama mwthod should be rotated

15 degrees from vertical

The CR in the Clement's nakayama method is angled

Mediolateral as needed so the femoral neck is perpendicular to IR

Angled 15-20 degrees from horizontal