Upper and Lower Limb Radiographic Anatomy and Procedures

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Comprehensive vocabulary flashcards covering skeletal anatomy, joint classifications, fractures, pathology, exposure adjustments, and standard and special radiographic projections for the upper and lower limbs.

40 Terms

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Boxer's Fracture

A transverse fracture extending through the neck of the metacarpal, most commonly occurring at the fifth metacarpal as a result of a closed-fist punch.

<p>A transverse fracture extending through the neck of the metacarpal, most commonly occurring at the fifth metacarpal as a result of a closed-fist punch.</p>
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Bennett's Fracture

A fracture occurring at the base of the first metacarpal (thumb), extending into the first carpometacarpal joint.

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Barton's Fracture

A fracture and dislocation of the posterior lip (styloid) of the radius at the distal end (wrist).

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Colles' Fracture

A distal radius fracture typically caused by a FOOSH (fall onto outstretched hand) injury, characterized by posterior (dorsal) displacement of the distal fragment, with an associated ulnar styloid fracture present in approximately 50–60%50\text{–}60\% of cases.

<p>A distal radius fracture typically caused by a FOOSH (fall onto outstretched hand) injury, characterized by posterior (dorsal) displacement of the distal fragment, with an associated ulnar styloid fracture present in approximately $$50\text{–}60\%$$ of cases.</p>
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Smith's Fracture

A fracture of the distal radius featuring anterior (ventral) displacement of the distal fragment, commonly termed a 'reverse Colles' fracture.'

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Greenstick Fracture

An incomplete fracture common in pediatric patients where a bending force fractures the bone cortex on one side without breaking completely through to the opposite side.

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Skier's Thumb

A sprain or rupture of the ulnar collateral ligament (UCL) at the first metacarpophalangeal (MCP) joint caused by hyperextension of the thumb.

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Folio Method

A bilateral PA stress projection of the hands/thumbs utilizing a rubber band around the distal phalanges to evaluate for tears of the ulnar collateral ligament.

<p>A bilateral PA stress projection of the hands/thumbs utilizing a rubber band around the distal phalanges to evaluate for tears of the ulnar collateral ligament.</p>
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Modified Robert's Method

An AP axial projection of the thumb with a 15∘15^\circ proximal central ray angle centered to the first carpometacarpal (CMC) joint, utilized specifically to rule out a Bennett's fracture.

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Norgaard Method

An AP oblique bilateral projection of the hands (termed the 'Ball-Catcher\'s' view) with both hands rotated 45∘45^\circ and the CR directed to the level of the fifth MCP joints to detect early radiologic changes of rheumatoid arthritis.

<p>An AP oblique bilateral projection of the hands (termed the 'Ball-Catcher\'s' view) with both hands rotated $$45^\circ$$ and the CR directed to the level of the fifth MCP joints to detect early radiologic changes of rheumatoid arthritis.</p>
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Gaynor-Hart Method

A tangential inferosuperior projection of the wrist with the central ray angled 25∘–30∘25^\circ\text{–}30^\circ to the long axis of the hand and the wrist rotated 10∘10^\circ toward the radius to demonstrate the carpal canal (sulcus) and median nerve compression.

<p>A tangential inferosuperior projection of the wrist with the central ray angled $$25^\circ\text{–}30^\circ$$ to the long axis of the hand and the wrist rotated $$10^\circ$$ toward the radius to demonstrate the carpal canal (sulcus) and median nerve compression.</p>
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Modified Stecher Method

A PA projection of the wrist with the hand elevated on a 20∘20^\circ sponge (with or without ulnar deviation) and a perpendicular central ray directed to the scaphoid to prevent foreshortening.

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Coyle Method

A trauma axial lateromedial projection of the elbow that demonstrates either the radial head (90∘90^\circ elbow flexion, CR angled 45∘45^\circ toward the shoulder) or the coronoid process (80∘80^\circ elbow flexion, CR angled 45∘45^\circ away from the shoulder).

<p>A trauma axial lateromedial projection of the elbow that demonstrates either the radial head ($$90^\circ$$ elbow flexion, CR angled $$45^\circ$$ toward the shoulder) or the coronoid process ($$80^\circ$$ elbow flexion, CR angled $$45^\circ$$ away from the shoulder).</p>
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Three Concentric Arcs (Lateral Elbow)

The three radiographic arcs visible on a true lateral elbow radiograph flexed 90∘90^\circ: (1) the trochlear sulcus, (2) the outer ridges of the capitulum and trochlea, and (3) the trochlear notch of the ulna.

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Cast Conversions

Technique adjustments for radiographic imaging through casts: small to medium dry plaster requires an increase of +5–7 kV+5\text{–}7\text{ kV}, large or wet plaster requires +8–10 kV+8\text{–}10\text{ kV}, and fiberglass requires +3–4 kV+3\text{–}4\text{ kV}.

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Proximal Carpal Row

The four carpal bones ordered from lateral to medial: scaphoid, lunate, triquetrum, and pisiform.

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Distal Carpal Row

The four carpal bones ordered from lateral to medial: trapezium, trapezoid, capitate, and hamate.

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First Carpometacarpal (CMC) Joint

A synovial, sellar (saddle) joint formed between the trapezium and the base of the first metacarpal, allowing wide range of movement including opposition.

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Radiocarpal Joint

A synovial, ellipsoidal (condyloid) joint formed by the articulation of the distal radius and articular disk with the scaphoid and lunate.

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Elbow Fat Pads and Stripes

Three diagnostic soft-tissue structures on the lateral elbow: the anterior fat pad, the posterior fat pad (located within the olecranon fossa and non-visible normally), and the supinator fat stripe.

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Jones Fracture

An avulsion fracture occurring at the base of the fifth metatarsal tuberosity of the foot.

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Lisfranc Joint Injury

A traumatic injury or displacement involving the tarsometatarsal (TMT) joints, best evaluated and demonstrated using weight-bearing foot projections.

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Osgood-Schlatter Disease

A chronic condition characterized by fragmentation or detachment of the tibial tuberosity from the tibial shaft at the insertion of the patellar tendon, best evaluated on AP and lateral knee radiographs.

<p>A chronic condition characterized by fragmentation or detachment of the tibial tuberosity from the tibial shaft at the insertion of the patellar tendon, best evaluated on AP and lateral knee radiographs.</p>
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Chondromalacia Patellae

A condition known as runner's knee marked by the softening, progressive erosion, and degradation of the articular cartilage lining the posterior aspect of the patella.

<p>A condition known as runner's knee marked by the softening, progressive erosion, and degradation of the articular cartilage lining the posterior aspect of the patella.</p>
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Osteoclastoma (Giant Cell Tumor)

A locally aggressive, typically benign lucent lesion involving the epiphyseal end of long bones, characteristically occurring around the knee joint in the distal femur or proximal tibia.

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Sustentaculum Tali

A prominent, shelf-like medial bony projection of the calcaneus that supports the middle articular facet for articulation with the talus.

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Sinus Tarsi

A canal/opening formed between the calcaneal sulcus and the talus, demonstrated radiographically in profile on an AP medial oblique projection of the foot.

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Ankle Mortise

The three-sided socket formed by the inferior articular surface of the tibia, the medial malleolus of the tibia, and the lateral malleolus of the fibula, which articulates with the trochlea of the talus.

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AP Oblique Mortise Projection

An ankle projection in which the leg and foot are rotated medially 15∘–20∘15^\circ\text{–}20^\circ to place the intermalleolar plane parallel to the IR, demonstrating all three sides of the mortise joint in open profile without overlap.

<p>An ankle projection in which the leg and foot are rotated medially $$15^\circ\text{–}20^\circ$$ to place the intermalleolar plane parallel to the IR, demonstrating all three sides of the mortise joint in open profile without overlap.</p>
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Lewis and Holly Methods

Tangential projections of the sesamoid bones of the foot, performed prone (Lewis) or seated (Holly) with the great toe dorsiflexed to project the metatarsal heads and sesamoids in profile free of superimposition.

<p>Tangential projections of the sesamoid bones of the foot, performed prone (Lewis) or seated (Holly) with the great toe dorsiflexed to project the metatarsal heads and sesamoids in profile free of superimposition.</p>
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Axial (Plantodorsal) Calcaneus

A projection of the calcaneus performed with the ankle dorsiflexed 90∘90^\circ and the central ray angled 40∘40^\circ cephalad, entering the plantar surface at the base of the third metatarsal to visualize the talocalcaneal joint and sustentaculum tali.

<p>A projection of the calcaneus performed with the ankle dorsiflexed $$90^\circ$$ and the central ray angled $$40^\circ$$ cephalad, entering the plantar surface at the base of the third metatarsal to visualize the talocalcaneal joint and sustentaculum tali.</p>
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AP Knee CR Angulation Rules

Criteria based on the patient's ASIS-to-tabletop measurement: <19 cm<19\text{ cm} requires a 3∘–5∘3^\circ\text{–}5^\circ caudad angle, 19–24 cm19\text{–}24\text{ cm} requires a perpendicular (0∘0^\circ) beam, and >24 cm>24\text{ cm} requires a 3∘–5∘3^\circ\text{–}5^\circ cephalad angle.

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Holmblad Method

A PA axial projection of the intercondylar fossa performed with the patient kneeling, standing on a stool, or standing beside the table with the affected knee flexed 70∘70^\circ from full extension and the central ray directed perpendicular to the lower leg.

<p>A PA axial projection of the intercondylar fossa performed with the patient kneeling, standing on a stool, or standing beside the table with the affected knee flexed $$70^\circ$$ from full extension and the central ray directed perpendicular to the lower leg.</p>
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Camp-Coventry Method

A PA axial projection of the intercondylar fossa performed prone with the knee flexed 40∘40^\circ or 50∘50^\circ and the CR angled caudad at an identical angle (40∘40^\circ or 50∘50^\circ) perpendicular to the lower leg.

<p>A PA axial projection of the intercondylar fossa performed prone with the knee flexed $$40^\circ$$ or $$50^\circ$$ and the CR angled caudad at an identical angle ($$40^\circ$$ or $$50^\circ$$) perpendicular to the lower leg.</p>
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Béclére Method

An AP axial projection of the intercondylar fossa performed supine with the knee flexed to place the femur at a 60∘60^\circ angle to the tibia, directing the CR perpendicular to the lower leg entering 1/2 inch1/2\text{ inch} below the patellar apex.

<p>An AP axial projection of the intercondylar fossa performed supine with the knee flexed to place the femur at a $$60^\circ$$ angle to the tibia, directing the CR perpendicular to the lower leg entering $$1/2\text{ inch}$$ below the patellar apex.</p>
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Settegast Method

A tangential projection of the patella performed with the knee flexed until the patella is perpendicular to the IR and the CR angled 15∘–20∘15^\circ\text{–}20^\circ cephalad into the patellofemoral joint space; contraindicated if a transverse patellar fracture is suspected.

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Merchant Method

A bilateral tangential projection of the patellae and patellofemoral joints performed supine with knees flexed 40∘40^\circ using an Axial Viewer, a 6-foot6\text{-foot} (2 m2\text{ m}) SID, and a CR angled 30∘30^\circ caudad from the horizontal plane.

<p>A bilateral tangential projection of the patellae and patellofemoral joints performed supine with knees flexed $$40^\circ$$ using an Axial Viewer, a $$6\text{-foot}$$ ($$2\text{ m}$$) SID, and a CR angled $$30^\circ$$ caudad from the horizontal plane.</p>
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Longitudinal and Transverse Arches

The structural arches of the foot: the longitudinal arch has medial and lateral components (predominantly on the medial/mid aspects), while the transverse arch is primarily formed by the wedge-shaped cuneiforms and cuboid.

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Adductor Tubercle

A small prominence located on the posterosuperior aspect of the medial femoral condyle used as an anatomical landmark to evaluate rotation on lateral knee radiographs.

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Tarsal Mnemonic

'Come To Colorado (the) Next 3 Christmases', corresponding to the seven tarsals: Calcaneus, Talus, Cuboid, Navicular, and the three Cuneiforms (Medial, Intermediate, Lateral).