Ch 4 elbow rough review (S1) Flashcards

Exam Review

1
Q

How many interphalangeal spaces are there in each digit?

A

2-5 digits have 2 spaces:
Distal interphalangeal (DIP)
Proximal interphalangeal (PIP)
Thumb has one: Interphalangeal (IP)

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2
Q

When it comes to digits what side goes on the IR?

A

1st digit- lateral
2nd digit-lateral
3rd digit- either lateral or medial
4th digit- medial
5th digit- medial
Why? these sides have the least amount of OID.

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3
Q

What are the CR for these digits projections?
PA digit:
Roberts view (AP):
Lateral digit:
Oblique:

A

PA digit: PIP joint
Oblique: PIP joint
Lateral: PIP joint
Roberts: 15 degrees toward wrist at first CMC joint

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4
Q

What are the CR for these wrist projections?
PA wrist:
Oblique wrist:
Lateral Wrist:
Scaphoid Wrist:

A

PA Wrist: Midcarpal
Oblique Wrist: Midcarpal
Lateral Wrist: Midcarpal
Scaphoid Wrist: Angle tube 15 degrees and CR at scaphoid

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5
Q

What are the CR for these hand projections?
PA hand:
Oblique Hand:
Fan Lateral Hand:
Lateral hand:
AP oblique bilateral (ball catcher)

A

PA Hand: third MCP joint
Oblique hand: Third MCP joint
Fan Lateral: Second MCP joint
Lateral Hand: 2nd to fifth MCP joints
AP bilateral: level of the fifth MCP joints

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6
Q

What are the CR for these forearm projections?
AP forearm:
Lateral Forearm:

A

AP forearm: mid-forearm
Lateral Forearm:
Mid-forearm

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7
Q

What are the CR for these elbow projections?
AP elbow:
Internal elbow:
External elbow:
Lateral elbow:

A

AP elbow: mid elbow joint
INT elbow: mid elbow joint
Ext elbow: mid elbow joint
Lateral elbow: mid elbow joint

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8
Q

(t/f) we want the joints to be parallel to the image receptor at all times?

A

true

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9
Q

What articulation do the trochlear and trochlear notch form?
A. Distal radial ulna
B. Proximal radial ulna
C. Humeral ulna
D. Humeral Radial

A

C. Humeral Ulna
Why? Because the trochlear is on: humerus
and the trochlear notch is on:
Ulna

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10
Q

What is the difference between the olecranon and the coronoid?

A

The coracoid is not a viable answer because that pertains to the shoulder.
Answer is:
Coronoid is anterior in AP view
Olecranon is posterior in AP view

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11
Q

When the elbow is in the lateral position the process of the ulna which inserts into the fossa that’s on the distal anterior aspect of the humerus is:

A

coronoid process

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12
Q

When the elbow is in the lateral position the process of the ulna which inserts into the fossa that’s on the distal posterior aspect of the humerus is:

A

Olecranon process

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13
Q

What type of joint is the elbow?

A

Ginglymus (hinge) joint

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14
Q

What type of joints are the metacarpophalangeal joints?

A

second to fifth MCP are ellipsoidal (condyloid) joints
allow movement in 4 ways:
flexion, extension, abduction, and adduction
First MCP (thumb) is ellipsoidal joint with limited adduction and abduction movement

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15
Q

What type of joints are the interphalangeal joints?

A

All IP joints are ginglymus (hinge-type) joints

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16
Q

What type of joints are the first carpometacarpal joints?

A

the first CMC joint of the thumb is a saddle (Sellar) joint

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17
Q

What type of joints are the 2nd-5th carpometacarpal joints?

A

2nd-5th are plane (gliding) type joints

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18
Q

What type of joints are the radiocarpal (wrist) joints?

A

ellipsoidal (condyloid) joints

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19
Q

What type of joint is the distal radioulnar joint?

A

Pivot (trochoidal)

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20
Q

What type of joint is the proximal radioulnar joint?

A

Pivot (trochoidal) joint

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21
Q

What type of joints are the humeroulnar and humeroradial joints?

A

ginglymus (hinge) joints

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22
Q

The epicondyles should be parallel/perpendicular for:
AP elbow:
INT elbow:
EXT elbow:
Lateral Elbow:

A

AP elbow: parallel to IR (humeral epicondyles)
Internal: oblique
External: parallel
Lateral: perpendicular

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23
Q

What would substitute for an AP elbow if patient can’t fully extend?

A

2 projections
1- forearm up against IR
2- Humerus up against the IR

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24
Q

What would use to substitute for INT/EXT elbow obliques?

A

Coyle view

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25
Q

What does ICER stand for/ show?

A

IC-Internal elbow shows coronoid process
ER- External elbow shows radial head

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26
Q

What does external elbow oblique best show?

A

radial head and neck of the radius
& the capitulum of the humerus
“Cap on the head”

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27
Q

What does internal elbow oblique best show?

A

Coronoid process of the ulna
& trochlea in profile

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28
Q

What view shows fat pads?

A

Lateral elbow

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29
Q

What view shows the olecranon process free of superimposition?

A

lateral elbow

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30
Q

What view would best show the capitulum?

A

external elbow
Why? bc the “cap” sits on the radial head.

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31
Q

Trochlear notch is on the:

A

Ulna
And articulates with the trochlea on the humerus

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32
Q

Ulna notch is on the:

A

Radius

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33
Q

radial notch is on the:

A

Ulna

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34
Q

evaluation criteria PA fingers:
Anatomy demonstrated:
Position:
Exposure:

A

A: Distal, middle, and proximal phalanges & distal metacarpal & associated joints
P: long axis of finger should be aligned and parallel to side border of IR
E: no motion no rotation
CR at PIP joint

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35
Q

evaluation criteria oblique fingers:
Anatomy demonstrated:
Position:
Exposure:

A

A: OBLIQUE VIEW OF Distal, middle, and proximal phalanges & distal metacarpal & associated joints
P: IP and MCP spaces should be open, aligned to the side border of IR
E: No motion/no rotation

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36
Q

evaluation criteria mediolateral/ lateromedial (lateral) fingers:
Anatomy demonstrated:
Position:
Exposure:

A

A: lateral views of distal, middle, proximal phalanges & distal metacarpal
P: finger should be in a true lateral position
E: no motion/ rotation
CR PIP

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37
Q

evaluation criteria thumb:
Anatomy demonstrated:
Position:
Exposure:

A

A: distal and proximal phalanges, first metacarpal, trapezium visible
P: finger in a true lateral position
E: no motion/ no rotation
demonstrate soft tissue margins/ clear sharp bony trabecular

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38
Q

evaluation criteria PA thumb:
Anatomy demonstrated:
Position:
Exposure:

A
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39
Q

evaluation criteria lateral thumb:
Anatomy demonstrated:
Position:
Exposure:

A
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40
Q

evaluation criteria AP axial (Roberts):
Anatomy demonstrated:
Position:
Exposure:

A
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41
Q

evaluation criteria PA hand:
Anatomy demonstrated:
Position:
Exposure:

A
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42
Q

evaluation criteria oblique hand:
Anatomy demonstrated:
Position:
Exposure:

A
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43
Q

evaluation criteria Fan Lateral hand:
Anatomy demonstrated:
Position:
Exposure:

A
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44
Q

evaluation criteria AP oblique Bilateral hand:
Anatomy demonstrated:
Position:
Exposure:

A
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45
Q

evaluation criteria AP wrist:
Anatomy demonstrated:
Position:
Exposure:

A
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46
Q

evaluation criteria PA oblique wrist:
Anatomy demonstrated:
Position:
Exposure:

A

(lateral wrist rotation)

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47
Q

evaluation criteria lateral wrist:
Anatomy demonstrated:
Position:
Exposure:

A

(lateromedial rotation)

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48
Q

evaluation criteria Scaphoid view:
Anatomy demonstrated:
Position:
Exposure:

A

(ulnar deviation)

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49
Q

evaluation criteria PA scaphoid hand elevated:
Anatomy demonstrated:
Position:
Exposure:

A
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50
Q

evaluation criteria AP wrist radial deviation:
Anatomy demonstrated:
Position:
Exposure:

A
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51
Q

evaluation criteria Carpal canal (tunnel) tangential inferosuperior projection wrist:
Anatomy demonstrated:
Position:
Exposure:

A
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52
Q

evaluation criteria carpal bridge-tangential projection:
Anatomy demonstrated:
Position:
Exposure:

A
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53
Q

evaluation criteria AP forearm:
Anatomy demonstrated:
Position:
Exposure:

A
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54
Q

evaluation criteria Lateral Forearm:
Anatomy demonstrated:
Position:
Exposure:

A

(Lateromedial projection)

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55
Q

evaluation criteria AP elbow:
Anatomy demonstrated:
Position:
Exposure:

A
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56
Q

evaluation criteria AP partial elbow flexion:
Anatomy demonstrated:
Position:
Exposure:

A

when elbow cannot be fully extended
A: humerus parallel projection shows distal humerus
forearm parallel shows proximal radius and ulna
P: two AP projections forearm/humerus parallel
E: no motion no rotation

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57
Q

evaluation criteria external elbow:
Anatomy demonstrated:
Position:
Exposure:

A

A: Best shows radial head and neck of radius and capitulum of the humerus, tuberosity free of superimposition
P: 45 degrees lateral oblique
E: no motion no rotation

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58
Q

evaluation criteria internal elbow:
Anatomy demonstrated:
Position:
Exposure:

A

A: best shows coronoid process of ulna and trochlea in profile
P: rotated 45 degrees medially
E: no motion no rotation

59
Q

evaluation criteria lateral elbow:
Anatomy demonstrated:
Position:
Exposure:

A

A: soft tissues, fat pads, olecranon process, distal forearm, and proximal forearm
P: elbow joint flexed 90 degrees
E: no motion no rotation

60
Q

evaluation criteria trauma axial elbow (coyle):
Anatomy demonstrated:
Position:
Exposure:

A

(coyle)

61
Q

evaluation criteria radial head elbow (lateromedial):
Anatomy demonstrated:
Position:
Exposure:

A

(lateromedial elbow)

62
Q

What does mediolateral mean?
What does lateromedial mean?

A

projection of medial side to lateral
Projection of lateral to medial side

63
Q

AP Axial projection also known as:

A

modified Roberts method

64
Q

AP oblique Bilateral projection is also known as:

A

Ball catchers position

65
Q

Lateral hand flexion position means:
Lateral hand extension position means:

A

flexion: C (or crab position) of hand
Extension: hands in lateral closed fingers and straightforward

66
Q

First Coyle view:

A

Hand pronated
Elbow flexed 90 degrees
CR directed 45 angle toward shoulder at mid elbow joint

67
Q

Second Coyle view:

A

Hand pronated
elbow flexed 80 degrees
CR angled 45 degrees from shoulder CR mid elbow joint

68
Q

When do we do the Coyle view?
What are the angles for these views?

A

special projections for pathological processes or trauma to radial head or coronoid process of ulna

69
Q

what oblique would best display radial head?

A

External elbow oblique

70
Q

What oblique best displays the capitulum?

A

External elbow oblique

71
Q

What position will separate the radial head and neck from the tuberosity of the ulna?

A

external and if that’s not an option then lateral

72
Q

What does the ulna articulate with laterally?

A

radius

73
Q

Where is the radial tuberosity located?

A

toward the head/neck of radius

74
Q

What are the 4 carpal bones in the proximal row?

A

Scaphoid
Lunate
Triquetrum
Pisiform

75
Q

What are the 4 carpal bones in the distal row?

A

Trapezium
Trapezoid
Capitate
Hamate

76
Q

What does proximal vs distal mean?

A
77
Q

what does medial vs lateral mean?

A
78
Q

What would the radius articulate with distally?
(distal articulation)

A

Scaphoid and lunate carpal bones

79
Q

The capitulum is part of what bone?

A

(proximal/distal)

80
Q

When do we see the radial crossover in the forearm?

A

PA forearm
(pronated)
which we don’t want so that’s why we do AP to avoid ulna and radius crossover

81
Q

Flexing the arm in a 90 degree position would be:

A

lateral

82
Q

position vs projection
ex 5th digit:

A

position: the 5th digit is medially on the IR
Projection: 5th digit is lateromedial

83
Q

If there is an anterior posterior fracture of a displaced radius, what view would it be best displayed on?

A

Lateral
(AP would not show this type of fracture because they are superimposed)

84
Q

if there is a lateral fracture of the bone what view would best display this?

A

AP view
(lateral wouldn’t show this)

85
Q

What bone does the third metacarpal articulate with?

A
86
Q

What does the first carpal (scaphoid) bone articulate with?
First lateral proximal carpal

A

medially:
laterally:
proximally:
distally:
First lateral proximal row carpal

87
Q

What does the second carpal (Lunate) bone articulate with?
Second lateral proximal carpal

A

medially:
laterally:
proximally:
distally:
Second lateral proximal row carpal

88
Q

What does the third carpal (triquetrum) bone articulate with?
Second medial proximal carpal

A

medially:
laterally:
proximally:
distally:
Second medial proximal row carpal

89
Q

What does the fourth carpal (pisiform) bone articulate with?
First medial proximal carpal

A

medially:
laterally:
proximally:
distally:
First medial proximal row carpal

90
Q

What does the fifth carpal (Trapezium) bone articulate with?
First lateral distal row carpal

A

medially:
laterally:
proximally:
distally:
First lateral distal row carpal

91
Q

What does the sixth carpal (Trapezoid) bone articulate with?
Second lateral distal row carpal

A

medially:
laterally:
proximally:
distally:
Second lateral distal row carpal

92
Q

What does the seventh carpal (capitate) bone articulate with?
Second medial distal row carpal

A

medially:
laterally:
proximally:
distally:
Second medial distal row carpal

93
Q

What does the eighth carpal (hamate) bone articulate with?
first medial distal row carpal

A

medially:
laterally:
proximally:
distally:
first medial distal row carpal

94
Q

What is the pneumonic for carpal bones?

A

SLTPTTCH
Some lovers try positions that they can’t handle

95
Q

what view demonstrates the scaphoid best?

A

Scaphoid wrist view

96
Q

What is best demonstrated in a fan lateral?

A

the phalanges
why? bc the rest is superimposed

97
Q

what are the views for the thumb?
what is the special view?

A

special: thumb

98
Q

what are the views for wrist?

A

AP Wrist
Oblique Wrist
Lateral Wrist
Scaphoid Wrist

99
Q

What are the views for hand?

A

PA hand
Oblique hand
Fan Lateral hand

100
Q

What are the views for forearm?

A

AP forearm
Lateral forearm

101
Q

What are the views for elbow?

A

AP elbow
Internal Oblique elbow
External Oblique elbow
Lateral elbow

102
Q

What view do we use when we are looking for arthritis?

A
103
Q

What view best looks for carpal tunnel syndrome?

A

Gaynor hart method best shows the calcification of the carpal sulcus

104
Q

What is the second carpal bone in the lateral side of the distal row?

A

trapezoid

105
Q

What is the second carpal bone in the lateral side of the proximal row?

A

Lunate

106
Q

What is the first carpal bone in the lateral side of the proximal row?

A

Scaphoid

107
Q

What is the second carpal bone in the medial side of the distal row?

A

capitate

108
Q

What is the first carpal bone in the medial side of the proximal row?

A

pisiform

109
Q

What view best displays the hook of the hamate?

A

Gaynor heart position 25-30 degrees long axis of hand, CR 1 inch distal to the base of the third metacarpal

110
Q

Osteoporosis:

A

reduction in the quantity of bone or atrophy

111
Q

Osteopetrosis:

A

hereditary disease mark by abnormally dense bone

112
Q

Osteomyelitis:

A

local/generalized infection of bone
bacteria by trauma/surgery

113
Q

Paget Disease:

A

common chronic skeletal disease
characterized by bone destruction caused by a reparative process of overproduction of soft very dense bones that fracture easily

114
Q

Rheumatoid arthritis:

A

Chronic system disease of inflammatory changes through the connective tissues

115
Q

Skier’s Thumb:

A

a sprain/tear of the ulnar collateral ligament of the thumb (near the MCP joint of hyperextended thumb)

116
Q

Tumors:

A

usually benign, can be cancerous
CT/mri best for imaging

117
Q

Multiple Myeloma:

A

most common type of bone cancer
affects ages 40-70
usually fatal within a few years

118
Q

Osteogenic sarcoma:

A

second most common bone cancer
affects ages 10-20

119
Q

Ewing Sarcoma:

A

common bone cancer of children and young adults that derives from bone marrow

120
Q

Chondrosarcoma:

A

slow growing bone cancer of the cartilage

121
Q

Colles fracture:

A

Distal fragment displaced posteriorly
Transverse fracture of distal radius
50-60% of the time there is a ulna styloid fracture

122
Q

Smiths fracture:

A

distal fragment displaced anteriorly
transverse fracture of distal radius
opposite of Colles fracture

123
Q

Boxer’s fracture:

A

transverse fracture extends through the metacarpal neck
most commonly in the fifth metacarpal
name derives from bar fights

124
Q

Bennetts fracture:

A

fracture of the base of the first metacarpal

125
Q

Barton’s fracture:

A

fracture & dislocation of posterior lip of the distal radius involving wrist joint

126
Q

Carpal Tunnel Syndrome

A

possible calcification in carpal sulcus, enlargement of wrist ligaments & median nerve compression
Best view: Gaynor heart/ PA-lateral wrist

127
Q

Joint Effusion

A

Fluid filled joint cavity
Best view: AP/lateral

128
Q

Osteoarthritis

A

narrowing of joint space with periosteal growths

129
Q

Things to focus on this exam:

A

55 questions

130
Q

Make a quizlet test with pictures of anatomy, best views, fractures, diseases,

A
131
Q

Make flashcards that put emphasis on anatomy demonstrated (boxes at the bottom of page) make sure to try and visualize the x-ray

A
132
Q

What is the best projection to rule out a Bennetts fracture of the digits?

A

AP axial projection aka Roberts view
(Base of first metacarpal is demonstrated for ruling out)

133
Q

Criteria for finger:
IR size
Kvp range
Markers
CR
SID

A

8 x 10 inches
60 kvp
Hand of interest (R or L) and # of digit
PIP joint in hand
40”

134
Q

Criteria for hand:
IR size
Technique
Markers
CR
SID

A

10 x 12 inches
60 kvp
Hand of interest (R or L)
Third MCP
Second MCP for fan lateral
Fifth metacarpals for ball catchers

135
Q

Criteria for wrist:
IR size
SID
CR
Technique
Markers

A

8 x 10 inches
40 inches
Mid-carpal
CR is scaphoid for a scaphoid projection
60 kvp
Side of interest (R or L)

136
Q

Criteria for forearm:
IR size
SID
CR
Technique
Markers

A

11 x 14 inches for small patients
14 x 17 for longer forearms
40” SID
CR mid forearm
joiel: 60 textbook: 70 kvp
Side of interest (R or L)

137
Q

Criteria for elbow:
IR size
SID
CR
Technique
Markers

A

10 x 12 inches
40”
CR is mid elbow joint
70 kvp
side of interest (R or L)

138
Q

What position do we use for patients that can’t lay there fingers flat?

A

Ball catcher position
aka Bilateral hand

139
Q

What replaces AP forearm?

A

Humerus parallel
Forearm parallel
Bc Patient can’t extend

140
Q

What replaces internal and external elbow?

A

Coyle view (2 projections)
45 degree CR
1st 90 degree flex replaces
1st 80 degree flex replaces

141
Q

What are the 3 fat pads?

A

Anterior & ( anterior to distal humerus)
Posterior fats pads (posterior distal humerus, near olecranon)
Supinator fat stripe (anteriorly to proximal radius)

142
Q

Coyle views
1st

A

Hand pronated
90 degree flex
45 degree CR towards shoulder
Best shows radial head/capitulum
Replaces external

143
Q

Coyle view
2nd

A

Replaces internal
80 degree flex
45 degree CR
Hand pronated
Shows coronoid and trochlea