Lower Extremity Exam
Q: Which metatarsal bone of the foot has a prominent tuberosity most frequently fractured?
A: Fifth
Q: The lateral malleolus is part of which bone?
A: Fibula
Q: A mediolateral knee radiograph that is externally rotated can be recognized by which finding?
A: The fibular head will appear less superimposed by the tibia than on a true lateral.
Q: Which foot position best demonstrates the lateral (third) cuneiform?
A: AP oblique with medial rotation
Q: What CR angulation is required for the AP medial oblique (non–weight-bearing) projection of the foot?
A: CR is perpendicular to the image receptor
Q: How much rotation from an AP position of the ankle produces an AP mortise projection?
A: 15–20 degrees medial
Q: What type of CR angle is required for the PA axial weight-bearing bilateral knee projection (Rosenberg method)?
A: 10-degree caudad
Q: How much flexion of the knee is recommended for the lateral projection of the patella?
A: 5–10 degrees
Q: A correctly positioned AP medial oblique foot projection should demonstrate what anatomy?
A: Third through fifth metatarsals free of superimposition
Q: Which ankle projection best demonstrates an open joint space of the entire lateral aspect of the tibia, fibula, and lateral ankle joint?
A: AP mortise projection
Q: To ensure both joints are included on an AP tibia and fibula projection, what should the technologist do?
A: Turn the image receptor diagonally to the lower leg
Q: Which knee projection best demonstrates the neck of the fibula without superimposition of the tibia?
A: AP oblique with medial rotation
Q: On an AP weight-bearing knee image, fibular heads mostly superimposed on the tibia indicate what positioning error?
A: The patient’s toes were inverted too much
Q: On a lateral foot image, where should rotation be evaluated?
A: Heads of the metatarsals, dome of the talus, and tibia/fibula relationship
Q: On a lateral ankle image, the fibula is superimposed mid-to-anterior to the talus. What is the positioning error?
A: The patient’s toes were not turned down enough toward the image receptor
Q: What CR angle is required for the AP axial inlet projection of the pelvis?
A: 40-degree caudad
Q: An AP pelvis shows the lesser trochanters not visualized (nontrauma). What should be done?
A: Do nothing; accept the radiograph
Q: An AP pelvis shows the right iliac wing foreshortened compared with the left. What positioning error is present?
A: Left rotation
Q: Which structure is NOT part of the proximal femur?
A: Obturator foramen
Q: Why must the lower limbs be internally rotated 15–20 degrees for a nontrauma AP pelvis?
A: To open the femoral necks and place them parallel to the image receptor
Q: An AP oblique foot with medial rotation shows excessive superimposition of the 3rd–5th metatarsals. What correction is needed?
A: Decrease obliquity of the foot
Q: How much knee flexion is required for the weight-bearing PA axial knee projection (Rosenberg method)?
A: 45 degrees
Q: A plantodorsal axial calcaneus image shows foreshortening. What modification will improve the image?
A: Increase CR angulation
Q: For the AP weight-bearing feet projection, the CR should be:
A: Angled 15 degrees posteriorly
Q: For the AP weight-bearing knee projection, the CR should be:
A: Perpendicular to the image receptor
Q: An AP ankle mortise projection shows the lateral malleolus slightly superimposed over the talus. What is the likely cause?
A: Insufficient medial rotation of the foot and ankle
Q: Which projection best evaluates the tibial plateau and intercondylar region in osteoarthritis?
A: PA axial weight-bearing bilateral knee (Rosenberg method)
Q: Which projection best evaluates the longitudinal arch of the foot?
A: AP and lateral weight-bearing projections of the foot
Q: An AP knee shows nearly total superimposition of the fibular head and tibia. How should this be corrected?
A: Rotate the knee medially slightly
Q: A Camp-Coventry (PA axial intercondylar fossa) image shows a foreshortened fossa. What correction is needed?
A: CR must be perpendicular to the lower leg
Q: An AP ankle shows the lateral joint space not open, but the medial joint space is open. What should be done?
A: Nothing; this is an acceptable image
Q: A mediolateral knee shows excessive superimposition of the fibular head and neck. What does this indicate?
A: Internal rotation (under-rotation) of the knee toward the IR
Q: What is the correct CR angulation for the AP axial SI joint projection?
A: 30–35 degrees cephalad
Q: Excessive grid lines are seen on an axiolateral hip image. What will correct this?
A: Keep the image receptor and grid parallel to the femoral neck and perpendicular to the CR
Q: A trauma patient presents with left hip pain. Which projection should be taken first?
A: AP pelvis
Q: A nontrauma patient with chronic right hip pain needs imaging. Which routine is best?
A: AP and axiolateral (inferosuperior) projections of the right hip
Q: An AP axial (Taylor method) image shows asymmetric obturator foramina. What is the positioning error?
A: Rotation of the pelvis
Q: A patient cannot tolerate a frog-leg lateral hip. What should the technologist do?
A: Perform the axiolateral (inferosuperior) projection
Q: Which projection will open the right SI joint?
A: LPO
Q: A prosthetic hip image cuts off the end of the prosthesis on the AP view, but the lateral is adequate. What should be done?
A: Repeat the AP projection only
Q: For the lateral knee projection, how is the CR angled?
A: 5–7 degrees cephalad
Q: How many degrees is the patient obliqued for a Judet projection of the acetabulum?
A: 45 degrees
Q: A trauma patient with left femur pain—what projections are required?
A: AP proximal femur and distal femur; cross-table lateral for proximal femur; cross-table lateral for distal femur
Q: Where is the IR placed for lower leg projections?
A: Tabletop
Q: Where is the CR placed for an AP projection of the pelvis?
A: Midway between the ASIS and the symphysis pubis
Q: What CR angle is used for the AP axial (Taylor method) “outlet” projection for a male patient?
A: 20–35 degrees cephalad