ELBOW

Question 1

PP: Elbow extended; hand supinated; patient lean laterally; humeral epicondyles & anterior surface of elbow // to IR
RP: Elbow joint
CR: ┴
SS: Elbow joints; distal arm & proximal forearm
Radial head, neck & tuberosity slightly superimposed over the proximal ulna

Answer 1

AP PROJECTION

Question 2

PP: Elbow flexed 90o; elbow flexed 30-35o (suspected elbow injury); hand in lateral position; humeral epicondyles ┴ to IR
RP: Elbow joint
CR: ┴
SS: Elbow joints; distal arm & proximal forearm
Superimposed humeral epicondyles

-Radial tuberosity facing anteriorly
-Radial head partially superimposing coronoid process
-Olecranon process in profile

Answer 2

LATERAL PROJECTION
Lateromedial

Question 3

: 2 reasons
Olecranon process seen in profile
Elbow fat pads are least compressed

Answer 3

Griswold (Elbow flexing 90o)

Question 4

PP: Hand pronated or medially rotated 45o; anterior surface of elbow 45o to IR
RP: Elbow joint
CR: ┴
SS: Coronoid process in profile; trochlea & medial epicondyle

Answer 4

AP OBLIQUE PROJECTION
Medial Rotation

Question 5

PP: Hand laterally rotated 45o; 1st & 2nd digits touching the table; posterior surface of elbow 45o to IR
RP: Elbow joint
CR: ┴
SS: Radial head & neck in profile; capitulum

Answer 5

AP OBLIQUE PROJECTION
Lateral Rotation

Question 6

PP: Hand supinated; elbow partially flexed
RP: Elbow joint
CR: ┴ to humerus
SS: Distal humerus when elbow cannot be fully extended

Answer 6

AP PROJECTIONS
In Partial Flexion
Distal Humerus

Question 7

PP: Hand supinated; dorsal surface of forearm against IR; elbow partially flexed
RP: Elbow joint
CR: ┴ to forearm
SS: Proximal forearm
ER (2 AP Projections): For patient cannot completely extend the elbow

Answer 7

Proximal Forearm

:AP PROJECTIONS
In Partial Flexion

Question 8

PP: Elbow fully (acutely) flexed
RP: 2 in. superior to olecranon process
CR: ┴ to humerus
SS: Olecranon process

Answer 8

JONES METHOD
AP PROJECTION
Acute Flexion
Distal Humerus

Question 9

PP: Elbow fully (acutely) flexed
RP: 2 in. distal to olecranon process
CR: ┴ to flexed forearm
SS: Elbow joint more open

Answer 9

Proximal Forearm

:JONES METHOD
AP PROJECTION
Acute Flexion

Question 10

PP: Elbow flexed 90o; elbow joint in lateral position; four exposures: 1.) hand supinated 2.) hand in lateral 3.) hand pronated 4.) hand internally rotated
RP: Elbow joint
CR: ┴
SS: Radial head in varying degrees of rotation
-Radial tuberosity facing anteriorly (1st & 2nd exposures)
-Radial tuberosity facing posterior (3rd & 4th exposures)

Answer 10

RADIAL HEAD SERIES
LATERAL PROJECTION
Four-Position Series

Question 11

PP:
Seated: hand pronated
Supine (trauma): distal humerus elevated; IR vertical; humeral epicondyles ┴ to IR; palmar aspect of hand facing anteriorly
Elbow flexed 90o (radial head) or 80o (coronoid process);
RP: Midelbow joint
CR:
Seated: 45o toward the shoulder (radial head); 45o away from the shoulder (coronoid process)
Supine: horizontal; 45o cephalad (radial head); 45o caudad (coronoid process)
SS: Open elbow joint b/n radial head & capitulum or coronoid process & trochlea
ER:
-To demonstrate pathologic processes or trauma in the area of radial head & coronoid process
-Cannot fully extend elbow for medial & lateral oblique

Answer 11

COYLE METHOD
AXIOLATERAL PROJECTION

Question 12

PP: Seated; arm rested vertically against IR; forearm // to IR; humerus 75o from forearm or 15o from CR; hand supinated
RP: Ulnar sulcus
CR: ┴
SS: Epicondyles; trochlea; ulnar sulcus (groove b/n medial epicondyle & trochlea); olecranon fossa
ER:
Used in radiohumeral bursitis (tennis elbow)
To detect otherwise obscured calcification located in the ulnar sulcus
Rafert-Long: AP oblique distal humerus for demonstration of ulnar sulcus

Answer 12

PA AXIAL PROJECTION

Question 13

PP: Seated; arm 45-50o from vertical; hand supinated
RP: Olecranon process
CR: ┴ or 20o toward the wrist
SS: Dorsum of olecranon process (┴); curved extremity & articular margin of olecranon process (20o)

Answer 13

PA AXIAL PROJECTION