Patella Anatomy and Positioning

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Last updated 10:59 PM on 8/25/26
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29 Terms

1
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Femur

thigh bone

<p>thigh bone</p>
2
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Patella

Approximately 2in in diameter

<p>Approximately 2in in diameter</p>
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base of patella

Superior Border

<p>Superior Border</p>
4
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Anterior surface of patella

Rough & Convex

<p>Rough & Convex</p>
5
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Posterior surface of patella

Smooth & oval shaped, Articulates with femur

<p>Smooth & oval shaped, Articulates with femur</p>
6
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Apex of patella

Inferior border

<p>Inferior border</p>
7
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Patellofemoral joint

between patella and patellar surface of femur

<p>between patella and patellar surface of femur</p>
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Patellar Ligament

Located anteriorly, Connects to the quadricep femoris tendon, Extends over patella & attaches to tibial tuberosity

<p>Located anteriorly, Connects to the quadricep femoris tendon, Extends over patella & attaches to tibial tuberosity</p>
9
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Protects the anterior aspect of the knee joint, Increase the leverage of the quadriceps femoris muscle

What's the role of the Patella?

<p>What's the role of the Patella?</p>
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Patella is loose & movable, Sits more superior

When the leg is extended, how is the patella positioned?

<p>When the leg is extended, how is the patella positioned?</p>
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Patella locks into position, Sits more distally

When the leg is flexed, how is the patella positioned?

<p>When the leg is flexed, how is the patella positioned?</p>
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Anterior surface of patella

1?

<p>1?</p>
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Patella

2?

<p>2?</p>
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Posterior surface of patella

5?

<p>5?</p>
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Patellofemoral joint

6?

<p>6?</p>
16
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Medial condyle of femur

7?

<p>7?</p>
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intercondylar sulcus (trochlear groove)

8?

<p>8?</p>
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Lateral condyle of femur

9?

<p>9?</p>
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radiopaque objects, clothing removed placed in gown , long hair, oxygen tubing, and pacemaker leads to avoid reduced detail/scatter

during patient preparation, what must be removed?

<p>during patient preparation, what must be removed?</p>
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1. Limit the number of exposures

2. Collimation

3. shielding (led apron)

4. Position correctly

What 4 things help protect you and the patient against radiation?

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BEFORE the examination

When must the anatomical marker be placed?

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kVp: 70-80 (increase 4-6 for PA)

mAs: Depends

Grid: Depends (bigger than 4in or 10cm?)

SID: Varies

What technical factors are needed for a good Patella (kVp, grid, mA, SID)?

23
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PA

Lateral

Tangential (Merchant, Inferiorsuperior, Settegast, hobbs)

Routine patella projections?

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What is the evaluation criteria and procedure for an PA Patella X-ray?

SID: 40in

kVp: 70-80

Grid: depends (bigger than 4in or 10cm?)

CR: perpendicular, directed to midpatella, about midpopliteal crease

Patient position: prone, legs extended, may internally rotate for perpendicular patella

Evaluation criteria: knee joint and patella are shown, no rotation, patella is centered to femur with slight internal rotation of anterior knee

<p>SID: 40in</p><p>kVp: 70-80</p><p>Grid: depends (bigger than 4in or 10cm?)</p><p>CR: perpendicular, directed to midpatella, about midpopliteal crease</p><p>Patient position: prone, legs extended, may internally rotate for perpendicular patella</p><p>Evaluation criteria: knee joint and patella are shown, no rotation, patella is centered to femur with slight internal rotation of anterior knee</p>
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What is the evaluation criteria and procedure for an Lateral (mediolateral) Patella X-ray?

SID: 40in

kVp: 70-80

Grid: depends (bigger than 4in or 10cm?)

CR: perpendicular, directed at mid-patellofemoral joint

Patient position: Flex knee only 5-10°, lateral recumbent position affected side down

Evaluation criteria: patellofemoral joint and femorotibial join demonstrated, true lateral

<p>SID: 40in</p><p>kVp: 70-80</p><p>Grid: depends (bigger than 4in or 10cm?)</p><p>CR: perpendicular, directed at mid-patellofemoral joint</p><p>Patient position: Flex knee only 5-10°, lateral recumbent position affected side down </p><p>Evaluation criteria: patellofemoral joint and femorotibial join demonstrated, true lateral</p>
26
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What is the evaluation criteria and procedure for a Merchant Bilateral method patella X-ray?

SID: 48-72in

kVp: 70-80

Grid: No grid (air gap method)

CR: Angled 30˚ caudad, directed to point midway between patellae

Patient position: Patient supine with knees flexed 40˚ over the end of the table, resting on leg support

Evaluation criteria: intercondylar sulcus (trochlear groove) and patella of each distal femur should be visualized, patellofemoral joint space open

<p>SID: 48-72in</p><p>kVp: 70-80</p><p>Grid: No grid (air gap method)</p><p>CR: Angled 30˚ caudad, directed to point midway between patellae</p><p>Patient position: Patient supine with knees flexed 40˚ over the end of the table, resting on leg support</p><p>Evaluation criteria: intercondylar sulcus (trochlear groove) and patella of each distal femur should be visualized, patellofemoral joint space open</p>
27
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What is the evaluation criteria and procedure for a Inferosuperior patella

X-ray?

SID: 40-48in

kVp: 70-80

Grid: No grid

CR: Directed inferosuperiorly at 10-15˚ from lower legs (start at horizontal) to be tangential to patellofemoral joint

Patient position: Place patient in supine position, legs together, with sufficient-sized support placed under knees for 40-45˚ knee flexion (legs relaxed)

Evaluation criteria: intercondylar sulcus (trochlear groove) and patella of each distal femur should be visualized, patellofemoral joint space open

<p>SID: 40-48in</p><p>kVp: 70-80</p><p>Grid: No grid</p><p>CR: Directed inferosuperiorly at 10-15˚ from lower legs (start at horizontal) to be tangential to patellofemoral joint</p><p>Patient position: Place patient in supine position, legs together, with sufficient-sized support placed under knees for 40-45˚ knee flexion (legs relaxed)</p><p>Evaluation criteria: intercondylar sulcus (trochlear groove) and patella of each distal femur should be visualized, patellofemoral joint space open</p>
28
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What is the evaluation criteria and procedure for a Settegast Method patella

X-ray?

SID: 40in

kVp: 70-80

Grid: No grid

CR: Directed inferosuperiorly at 15-20˚ from lower legs (start at horizontal) to be tangential to patellofemoral joint

Patient position: prone or seated position, Flex knee to a minimum of 90˚ (Have patient hold onto gauze or tape for prone)

Evaluation criteria: intercondylar sulcus (trochlear groove) and patella of each distal femur should be visualized, patellofemoral joint space open

<p>SID: 40in</p><p>kVp: 70-80</p><p>Grid: No grid</p><p>CR: Directed inferosuperiorly at 15-20˚ from lower legs (start at horizontal) to be tangential to patellofemoral joint</p><p>Patient position: prone or seated position, Flex knee to a minimum of 90˚ (Have patient hold onto gauze or tape for prone)</p><p>Evaluation criteria: intercondylar sulcus (trochlear groove) and patella of each distal femur should be visualized, patellofemoral joint space open</p>
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What is the evaluation criteria and procedure for a Hobbs Modification patella X-ray?

SID: 48-50in

kVp: 70-80

Grid: No grid

CR: mid-patellofemoral joint

Patient position: patient seated in a chair, IR under knees resting on a step stool or support (reduce OID), Knees should be flexed with feet placed slightly underneath the chair, perpendicular to IR

Evaluation criteria: intercondylar sulcus (trochlear groove) and patella of each distal femur should be visualized, patellofemoral joint space open

<p>SID: 48-50in</p><p>kVp: 70-80</p><p>Grid: No grid</p><p>CR: mid-patellofemoral joint</p><p>Patient position: patient seated in a chair, IR under knees resting on a step stool or support (reduce OID), Knees should be flexed with feet placed slightly underneath the chair, perpendicular to IR</p><p>Evaluation criteria: intercondylar sulcus (trochlear groove) and patella of each distal femur should be visualized, patellofemoral joint space open</p>