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Radiographic Procedures 1 > Knee and Patella > Flashcards

Knee and Patella Flashcards

1
Q

Knee - AP projection

A

supine with leg fully extended
- toes up
femoral condyles parallel to IR
- may require 5 internal rotation
CP: 1/2 inch below patellar apex
CR: Variable

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2
Q

AP Knee CR angles based on hip height measurments

A

18 cm and below - 5 caudad
19-24 cm - perpendicular
25 cm and above - 5 cephalad

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3
Q

what is the other way you can determine angle of the AP knee?

A

match tube angle to the tibia and reduce CR angle by 5 degrees

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4
Q

Knee - AP evaluation criteria

A

open femorotibial joint space
no rotation
- femoral condyles symmetrical
- slight superimposition of fibular with tibia
- petal superimposed on femur

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5
Q

Knee - PA projection

A

Patient is prone with top of toes on table
femoral condyles parallel to IR
CR: perpendicular
CP: Exit 1/2 inch below apex
Marker face down

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6
Q

Knee - PA evaluation criteria

A

open femorotibial joint space
no rotation
- femoral condyles symmetrical
- slight superimposition of fibular with tibia
- petal superimposed on femur

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7
Q

Knee - AP Medial Oblique projection

A

rotate entire leg 45
- elevate hip at affected side
- may need to use sponge
CR: Variable
CP: 1/2 inch below apex

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8
Q

Knee - AP Medial Oblique evaluation criteria

A

open proximal tib/fib joint
both tibial plateaus
lateral femoral/tibial condyles
medial border of patella
open knee

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9
Q

Knee - AP Lateral Oblique projection

A

rotate entire leg 45
- elevate unaffected hip
- may need sponge
CR: variable
CP: 1/2 inch below apex of patella

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10
Q

If doing a knee series of AP, AP medial oblique and AP lateral oblique, what order should you complete the images?

A

AP, AP lateral oblique then AP medial oblique, as the medial oblique will change the CR angle much more than the lateral (may not change at all)

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11
Q

Knee - AP lateral oblique evaluation criteria

A

medial femoral and tibial condyles
tibial plateaus
open knee joint
lateral border of patella
fibula superimposed with lateral half of tibia

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12
Q

Knee - PA internal and external oblique

A

patient prone, full leg rotated
CR: perpendicular
Marker: face down

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13
Q

Knee - Lateral projection

A

mediolateral
affected knee bent 20-30
- maximum of 10 if patellar injury
- pretend patellar injury is not a risk for practical exam
femoral condyles superimposed
CR: 5-7 cephalad
CP: 1 inch below medial condyle

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14
Q

Knee - lateral evaluation criteria

A

femoral condyles superimposed
open femerotibial joint space
open patellafemoral joint space
fibular head slightly superimposed with tibia

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15
Q

How to tell if a knee is under rotated?

A

locate adductor tubercle of medial condyle
more superimposition of tibia and fibula

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16
Q

how to tell if a knee is over rotated?

A

locate smooth posterior surface of lateral condyle
less superimposition of tibia and fibula

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17
Q

Knee - Trauma cross table lateral projection

A

lateromedial
demonstrates fat/fluid levels
- lipohemarthrosis
turn detector so grid lines are going vertical
marker - face down
bring the leg in 5-7 degrees
CR: horizontal
CP: 1 inch distal to lateral epicondyle

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18
Q

What does varus mean?

A

towards midline

19
Q

What does valgus mean?

A

away from the midline

20
Q

What does erect imaging of the knee demonstrate?

A

progression of arthritis
joint space narrowing
varus and valgus deformities

21
Q

Knees - AP standing projection

A

Bilateral, weight bearing
- no shoes
True AP - condyle parallel to the IR
CP: 1/2 an inch below the apex of the patella
CR: 5 caudad for average patient - perpendicular for larger patients
Marker: L and R and up arrow

22
Q

Knee - PA standing projection

A

weight bearing
Legs flexed 45
- toes level to the IR
- knees against the Bucky
be careful shielding is not blocking your image
CP: Exit 1/2 inch below apex
CR: 10 caudad
Marker: facedown with arrow up

23
Q

Knee - PA standing evaluation criteria

A

both knees without rotation
tibial plateaus in profile
intercondylar fossae visible

24
Q

What is joint mince?

A

loose bodies in the intercondylar joint space

25
Q

Knee - PA Axial Tunnel - Holmblad Method - projection

A

Patient kneeling on table
- unaffected knee on sponge
- affected femur bent 20 to CR, or 70 to table
CR: perpendicular
CP: crease of knee
Marker or Shielding

26
Q

Knee - PA Axial Tunnel - Holmblad Method - evaluation criteria

A

open intercondylar fossa
posterioinferior surface of condyles
plateaus should be in profile
visible intercondylar eminence
no rotation

27
Q

Knee - AP Axial Tunnel - Béclère method - projection

A

patient supine
- knee flexed 60 to long axis of tibia
IR non grid under knee on sponges
CR: align with tibia and reduce by 5 degrees
SID: 102 cm
CP: Knee joint

28
Q

Knee - AP Axial Tunnel - Béclère method - evaluation criteria

A

open intercondylar fossa
posterioinferior surface of condyles
plateaus should be in profile
visible intercondylar eminence
no rotation

29
Q

Knee - PA Axial Tunnel - Camp-Coventry Method - projection

A

patient prone
- flex knee 40-50
use sponge
CR: 35-45 caudad (plateau)
CP: exit at the apex of the patella
Marker: face down
SID: 102 cm

30
Q

Knee - PA Axial Tunnel - Camp-Coventry Method - evaluation criteria

A

open intercondylar fossa
posterioinferior surface of condyles
plateaus should be in profile
visible intercondylar eminence
no rotation

31
Q

What is the patella?

A

it is a sesamoid bone
develops in the quadriceps femurs tendon
it is the largest sesamoid bone

32
Q

What is the fabella?

A

develops in the tendon of the lateral head of the gastrocnemius

33
Q

Patella - PA/AP projection

A

patient prone or supine
- PA provides improved spatial resolution because of the OID
patella must be parallel to the IR
- 5-10 internal rotation
CR: perpendicular
Collimate to just beyond patellar borders

34
Q

Patella - AP/PA evaluation criteria

A

patella completely superimposed by femur
no rotation
marker in correct orientation
- face down for PA and face up for AP

35
Q

Patella - lateral projection

A

lateral knee position
knee flexed 5-10
CR: perpendicular
CP: midpatellofemoral joint

36
Q

Patella - lateral evaluation criteria

A

evidence of proper collimation and the presence of a side marker
knee flexed 5-10
patella in lateral profile
open patellofemoral joint space

37
Q

Patella - tangential - inferosuperior projections

A

skyline/sunrise
Hughston
Settegast

38
Q

Patella - Hughston Method projection

A

Prone
Knee flexed 30-45 from perpendicular
CR: 15-20 from long axis of lower leg
- tangential to patellofemoral joint space
SID: 102 cm

39
Q

Patella - Skyline Supine - Projection

A

Patient supine near end of table
Flex knees 30-45
IR on mid thigh patella to tube head
CR: 15-20 from long axis of lower leg

40
Q

Patella - Skyline Sitting - projection

A

similar to supine version
use thyroid, thorax and gonadal shielding

41
Q

Patella - Settegast method - prone - projection

A

prone
knee flexed 90
CR: 15-20 from long axis of lower leg
do not attempt until a transverse fracture has been ruled out

42
Q

Patella - Settegast method - sitting - projection

A

patient sitting near end of table
knee flexed 90
use thyroid, thorax and gonadal shielding
CR: 15-20 from long axis of lower leg
do not attempt until a transverse fracture has been ruled out

43
Q

Patella - tangential projections - evaluation criteria

A

patella in profile
- inferior and superior borders superimposed
open patellofemoral joint
anterior surfaces of femoral condyles
very good for visualizing vertical fractures

Radiographic Procedures 1 (10 decks)

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