Forearm, elbow, foot

Question 1

What OSCE view is used for Distal radius fracture (Colles)

Answer 1

AP, Lateral

Question 2

What OSCE view is used for a radial head fracture

Answer 2

AP, Lateral

Question 3

What anatomy is involved in a distal radius fracture (Colles)

Answer 3

Wrist joints and elbow joints

Question 4

What anatomy is involved in a radial head fracture

Answer 4

Distal 1/3 humerus. Proximal 1/3 of radius and ulna.

Question 5

What OSCE view is used for a LisFranc midfoot fracture-dislocations, Jones fracture

Answer 5

DP, Lateral, Oblique

Question 6

What anatomy is involved in a LisFranc midfoot fracture-dislocations, Jones fracture

Answer 6

Full foot plus distal tibia and fibula

Question 7

What Wellys exposure/position is used for a radial head fracture

Answer 7

AP/Lat - 55 kV 4.0 mAs

Question 8

What Wellys exposure/position is used for a distal radius fracture

Answer 8

AP/Lat - 52 kV 2.5 mAs

Question 9

What position is used for a radial head fracture

Answer 9

AP -Sitting. Arm fully extended and supinated in AP position. Medial and lateral condyles aligned parallel To the detector. Shoulder elbow and wrist in same horizontal plane.

Question 10

What position is used for a distal radius fracture

Answer 10

AP -Forearm fully extended and supine check medial and lateral distances are equal, Lat -All on supine plane, wrist 5° external rotation to bring down styloid process

Question 11

What is the center point for a distal radius fracture

Answer 11

Midway between wrist and elbow

Question 12

What is the center point for a radial head fracture

Answer 12

AP -Midline 2cm distal to epicondyles. Lat -4cm medial to olecranon process

Question 13

What is the center point for a Lisfranc midfoot fracture dislocations, Jones fracture

Answer 13

DP/Obl -Midline at base of 3rd metatarsal Lat -Medial cuneiform at base of 3rd metatarsal

Question 14

What Welly’s exposure/focus is used for a Lisfranc midfoot fracture-dislocation, Jones fracture

Answer 14

DP/Lat/Obl - 55 kV 4.0 mAs

Question 15

What position is used for a Lisfranc midfoot fracture-dislocation, Jones fracture

Answer 15

15° cranially to match the angle of the metatarsals

Question 16

What Welly’s exposure/focus is used for an ankle

Answer 16

AP/Lat/Mortice - 55 kV 5.0 mAs

Question 17

What OSCE view is used for the ankle

Answer 17

AP, Lateral, Mortice

Question 18

What anatomy is involved in a Maisonneuve fracture

Answer 18

Entire tibia and fibula including knee and ankle joints.

Question 19

What OSCE view is used for a Maisonneuve fracture

Answer 19

AP, Lateral

Question 20

What position is used for the ankle

Answer 20

AP -Leg extended. Foot dorsi-flexed until plantar aspect of foot is perpendicular to detector. Rotate entire leg (not just foot) so that the 3rd metatarsal is aligned mid-way between the malleoli and at the centre of the light field.

Lat -Patient rolls onto affected side. Knee flexed slightly and supported. Leg is externally rotated until lateral aspectof foot is approx 5° from table-top. Foot
should be supported with a sponge-pad.
Foot is carefully dorsi-flexed if clinically
appropriate and within tolerable limit.
Mortice -Leg extended. Foot dorsi-flexed until plantar aspect of foot is perpendicular to detector.
Medially rotate entire leg (not just foot) 10 – 15 until the medial and lateral malleoli are equidistant from the table top. is aligned mid-way between the medial and lateral malleoli. If the rotation is correct, the 5th metatarsal should be at the mid-point between the malleoli and align with the centre of the light-field.

Question 21

What anatomy is involved in the ankle

Answer 21

Full foot and Distal 1/3 tibia and fibula, except phalanx

Question 22

What is the center point for the foot

Answer 22

DP/Obl -Midline at base of 3rd metatarsal Lat -Medial cuneiform at base of 3rd metatarsal

Question 23

What is the center point for the ankle

Answer 23

AP -Midline at the level of the medial and lateral malleoli. 3 cm proximal to the malleoli. Lat -Medial malleolus. Mortice -Midline at the level of the
medial and lateral malleoli.

Question 24

What OSCE view is used for the knee

Answer 24

AP, Lateral

Question 25

What anatomy is involved in the knee

Answer 25

Superiorly have included distal 1/3 femur and inferiorly proximal 1/3 tibia and fibula

Question 26

What position is used for the knee

Answer 26

AP -lying flat on bed with epicondyles each same distance from the reseptor, may need to rase feet with sponge to keep leg extended with joint space open. Lat -Patient lies on the affected side. Unaffected leg is flexed, moved beyond the affected leg and rested on the x-ray table. Affected knee is flexed 20-30° and rolled into a medio-lateral position until patella-femoral joint is perpendicular to detector.

Question 27

What is the center point for the knee

Answer 27

AP - 1.25cm (finger width) distal to apex of patella Lat - 1.25cm distal to the apex of the patella and posteriorly 2.5cm

Question 28

What is the Welly position/focus for the knee

Answer 28

AP/Lat - 55 kV 3.2 mAs