Lower Limb Flashcards
Anatomy: Calcaneus
Projections/Positions
-Axial Projection (Plantodorsal)
-Axial Projection (Dorsoplantar)
-Lilienfeld Method Weight-Bearing Coalition Dorsoplantar Axial Projection
-Lateral Projection (Mediolateral)
-Weight-Bearing Method (Lateromedial) Oblique Projection
Anatomy: Calcaneus
Central Ray for axial projection (plantodorsal)
Entrance: 3rd MT base
Angulation: 40° cephalad
Anatomy: Calcaneus
What projection that will show the calcaneus and subtalar joint?
Axial Projection (Plantodorsal)
Anatomy: Calcaneus
In axial projection (plantodorsal), the leg is ___, ____ foot with strip of gauze, and foot ____ to IR.
fully extended, dorsiflex, perpendicular
Anatomy: Calcaneus
What is the central ray for Axial Projection (dorsoplantar)
Entrance: Dorsal surface of ankle joint Angulation: 40° caudad
Anatomy: Calcaneus
What projection will best show the calcaneus, subtalar joint &
sustentaculum tali
Axial Projection (dorsoplantar)
Anatomy: Calcaneus
Axial projection (dorsoplantar)
- ____
Part Position: - Ankle ____
- ____ ankle
- foot ___ to IR
- IR ___
prone, elevated, dorsiflex, perpendicular, vertical
Anatomy: Calcaneus
What is the central ray for Lilienfeld Method Weight-Bearin g Coalition Dorsoplantar Axial Projection
Entrance: Level of 5* MT base
Angulation: 45° anteriorly
Anatomy: Calcaneus
What projection will show the Calcaneotalar coalition
Lilienfeld Method Weight-Bearin g Coalition Dorsoplantar Axial Projection
Anatomy: Calcaneus
Lilienfeld Method Weight-Bearing Coalition Dorsoplantar Axial Projection
- Upright
Part Position: - Posterior surface of heel at ____ of IR
- opposite foot one
step ___
edge, forward
Anatomy: Calcaneus
Central ray for Lateral Projection (Mediolateral)
Entrance: 1 in distal to medial malleolus Angulation: Perpendicular
Anatomy: Calcaneus
What projection will show the Calcaneus & ankle joint
Lateral Projection (mediolateral)
Anatomy: Calcaneus
Lateral Projection (mediolateral)
-___
Part Position:
- Patient turn toward ____ side
- plantar surface ___ to IR
Supine, affected, parallel
Anatomy: Calcaneus
Central ray for Weight Bearing Method Lateromedial Oblique Projection
Entrance: Lateral malleolus
Angulation: 45° caudad (medialy)
Useful in diagnosing stress fractures of calcaneus or tuberosity
Weight Bearing Method Lateromedial Oblique Projection
Anatomy: Calcaneus
What projection will show the Calcaneal tuberosity
Weight Bearing Method Lateromedial Oblique Projection
Anatomy: Calcaneus
Weight Bearing Method Lateromedial Oblique Projection
- ___
Part Position: - Leg ____ to IR
- calcaneus ___ to IR
Upright, perpendicular, center
Anatomy: Subtalar Joint
Projections/ Positions
-Isherwood Method Lateromedial Oblique Projection (Medial Rotation Foot)
-Isherwood Method AP Axial Oblique Projection (Medial Rotation Ankle)
-Isherwood Method AP Axial Oblique Projection (Lateral Rotation Ankle)
-Broden Method AP Axial Oblique Projection (Medial Rotation)
-Broden Method AP Axial Oblique Projection (Lateral Rotation)
Anatomy: Subtalar Joint
Central Ray for Isherwood Method Lateromedial Oblique Projection (Medial Rotation Foot)
Entrance: 1 in. distal & 1 in. anterior to lateral malleolus
Angulation: perpendicular
Anatomy: Subtalar Joint
What projection will show the Anterior subtalar articulation
Isherwood Method Lateromedial Oblique Projection (Medial Rotation Foot)
Anatomy: Subtalar Joint
Isherwood Method Lateromedial Oblique Projection (Medial Rotation Foot)
- ____
Part Position: - foot & leg rotated ___
- knee flexed
semi supine, 45° medially
Anatomy: Subtalar Joint
Central Ray for Isherwood Method AP Axial Oblique Projection (Medial Rotation Ankle)
Entrance: 1 in. distal & 1 in. anterior to lateral malleolus
Angulation: 10° cephalad
Anatomy: Subtalar Joint
What projection will show the Middle subtalar articulation &
“end on” projection of sinus tarsi
Isherwood Method AP Axial Oblique Projection (Medial Rotation Ankle)
Anatomy: Subtalar Joint
Isherwood Method AP Axial Oblique Projection (Medial Rotation Ankle)
- Seated or semi-lateral
recumbent (more
comfortable)
Part Position: - Leg, foot & ankle rotated ____
- dorsiflex foot
30° medially
Anatomy: Subtalar Joint
Central ray for Isherwood Method AP Axial Oblique Projection (Lateral Rotation Ankle)
Entrance: 1 in. distal medial malleolus Angulation: 10° cephalad
Anatomy: Subtalar Joint
What projection will show the Posterior subtalar articulation
Isherwood Method AP Axial Oblique Projection (Lateral Rotation Ankle)
Anatomy: Subtalar Joint
Isherwood Method AP Axial Oblique Projection (Lateral Rotation Ankle)
- Supine/seated
Part Position: - Leg, foot & ankle rotated ____
- dorsiflex foot
30° laterally
Anatomy: Subtalar Joint
Central ray for Broden Method AP Axial Oblique Projection (Medial Rotation)
Entrance: 2-3 cm to lateral malleolus Angulation: 10°, 20°, 30°г 40° cephalad
Anatomy: Subtalar Joint
What projection will show the
- Posterior articulation
- Anterior portion (40°)
- Posterior portion (10°)
- Talus & sustentaculum
tali articulation (20-30°)
Broden Method AP Axial Oblique Projection (Medial Rotation)
Anatomy: Subtalar Joint
Broden Method AP Axial Oblique Projection (Medial Rotation)
- Supine
Part Position: - leg & foot rotated ____
- dorsiflex foot
- foot rested against
___ foam wedge
45° medially, 45°
Anatomy: Subtalar Joint
Central Ray for Broden Method AP Axial Oblique Projection (Lateral Rotation)
Entrance: 2 cm distal & 2 cm anterior to medial malleolus
Angulation: 15° cephalad
Anatomy: Subtalar joint
What projection will show the Posterior articulation
Broden Method AP Axial Oblique Projection (Lateral Rotation)
Anatomy: Subtalar Joint
Broden Method AP Axial Oblique Projection (Lateral Rotation)
- Supine
Part Position: - Leg & foot rotated ___
- dorsiflex foot
- foot rested against
____ foam wedge
45° laterally, 45°
This projection is to determine the presence of joint involvement in cases of comminuted fx
Broden Method AP Axial Oblique Projection (Lateral Rotation)
Anatomy: Ankle
Projections/ Positions
-AP Projection
-Lateral Projection Mediolateral
-Lateral Projection Lateromedial
-AP Oblique Projection (Medial Rotation)
-AP Oblique Projection (Lateral Rotation)
-Stress Method AP Projection
-Weight Bearing Method
AP Projection
Anatomy: Ankle
Central Ray for AP Projection
Entrance: Point midway between malleoli Angulation: Perpendicular to ankle joint
Anatomy: Ankle
What projection will show the ankle joint & tibiotalar joint space
Ap Projection
Anatomy: ankle
Ap Projection
- Supine
Part Position: - Leg & foot vertical & rotated ___ (places malleoli equidistant)
5° medially
Anatomy: ankle
Central Ray for Lateral Projection Mediolateral
Entrance: Medial malleolus
Angulation: Perpendicular to ankle joint
Anatomy: ankle
What projection will show the
- True lateral projection of
lower third of tibia & fibula, ankle joint & tarsals - 5th metatarsal base (identify
Jones fx)
Lateral Projection Mediolateral
Anatomy: ankle joint
Lateral Projection Mediolateral
- Semisupine
Part Position: - ___ surface of foot against IR
- dorsiflex foot
Lateral
Anatomy: ankle
Central Ray for Lateral Projection Lateromedial
Entrance: 0.5 in. superior to lateral malleolus
Angulation: Perpendicular to ankle joint
Anatomy: ankle
What projection will show the
- Lateral projection of lower third of tibia & fibula, ankle joint & tarsals
Lateral Projection Lateromedial
Anatomy: ankle
Lateral Projection Lateromedial
- Semisupine
Part Position: - ___ surface of foot against IR
- dorsiflex foot
Medial
Anatomy: ankle
Central Ray for AP Oblique Projection (Medial Rotation)
Entrance: Point midway between malleoli Angulation: Perpendicular to ankle joint
Anatomy: ankle
What projection will show
- Distal ends of tibia, fibula &
talus; tibiofibular articulation; mortise joints
AP Oblique Projection (Medial Rotation)
Anatomy: ankle
AP Oblique Projection (Medial Rotation)
- Supine
Part Position: - Leg & foot rotated ___;
___[foot - to demonstrate bony structure - Leg & foot rotated ___ medially;
intermalleolar line ____ to IR - to demonstrate mortise joint
45° medially, dorsiflex, 15-20°, parallel
Anatomy: ankle
Centtal Ray for AP Oblique Projection (Lateral Rotation)
Entrance: Point midway between malleoli Angulation: Perpendicular to ankle joint
Anatomy: ankle
What projection will show Superior aspect of calcaneus
AP Oblique Projection (Lateral Rotation)
Anatomy: ankle
Purpose: Useful in determining fractures
AP Oblique Projection (Lateral Rotation)
Anatomy: ankle
AP Oblique Projection (Lateral Rotation)
- Supine
Part Position: - Leg & foot rotated ____
- dorsiflex foot
45° laterally
Anatomy: ankle
Central Ray for Stress Method AP Projection
Entrance: Ankle joint Angulation: Perpendicular
Anatomy: ankle
What projection that will evaluate the presence of ligamentous tear & joint separation
Stress Method AP Projection
Anatomy: ankle
Stress Method AP Projection
- ___
Part Position: - Foot forcibly turned toward the opposite side
-____ stress to joint
Seated, inversion & eversion
Anatomy: Ankle
Central Ray for Weight Bearing Method
AP Projection
Entrance: Midway at level of ankle joint Angulation: Horizontal
Anatomy: ankle
Weight Bearing Method
AP Projection
- ___
Part Position: - ___ against the IR; IR ___
- toes pointing toward the ___
Upright, Heels, vertical, x-ray tube
Purpose: Identify ankle joint space narrowing; side-to-side comparison of joint
Weight Bearing Method
AP Projection
Anatomy: Leg
Projections/ Positions
AP Projection
Lateral Projection Mediolateral
AP Oblique Projection
Anatomy: Leg
Central Ray for AP Projection
Entrance: Midshaft
Angulation: Perpendicular
Anatomy: Leg
What projection will show the
- Tibia & fibula
- ankle & knee joints
AP Projection, Lateral Projection Mediolateral, AP Oblique Projection
Anatomy: Leg
AP Projection
- ___
Part Position: - Femoral condyles ___ to IR; foot in vertical position
Supine, parallel
Anatomy: Leg
Central Ray for Lateral Projection Mediolateral
Entrance: Midshaft
Angulation: Perpendicular
Anatomy: Leg
Lateral Projection Mediolateral
- ___
Part Position: - Patella ____ to IR
- femoral condyles __ to IR
Supine; RPO/LPO, perpendicular, perpendicular
Anatomy: Leg
Central Ray for AP Oblique Projection
Entrance: Midshaft
Angulation: Perpendicular
Anatomy: Leg
AP Oblique Projection
- ___
Part Position: - Leg & foot rotated ___
Supine, 45° medially or
laterally
Anatomy: Knee
Projections/ Positions
•AP Projection
•PA Projection
•Lateral Projection Mediolateral
•AP Oblique Projection (Medial Rotation)
•AP Oblique Projection (Lateral Rotation)
•Weight-Bearin g Method AP Bilateral Projection Leach-Gregg- Siber
•Rosenberg Method
PA Weight-Bearin g Standing Flexion
Anatomy: Knee
Central ray for AP Projection
Entrance: 0.5 in. inferior to patellar apex Angulation:dependin g on the measurement between ASIS & table top
- 3-5°caudad (<19 cm; thin pelvis)
- perpendicular (19-24 cm)
- 3-5°cephalad (>24 cm; large pelvis)
Anatomy: Knee
What projection will show the knee joint space
AP Projection
PA Projection
Lateral Projection Mediolateral
Weight-Bearin g Method AP Bilateral Projection Leach-Gregg- Siber
Anatomy: Knee
AP Projection
- ___
Part Position: - Femoral epicondyles ___ to IR
- leg ____ (places interepicondylar
line parallel to IR)
Supine, parallel, 5° inward
Anatomy: Knee
Central Ray for PA Projection
Entrance: 0.5 in. inferior to patellar apex
Angulation: 5-7°caudad
Anatomy: Knee
PA Projection
- ___
Part Position: - femoral epicondyles ___ to IR
- leg ___ (places interepicondylar
line parallel to IR)
Prone, parallel, 5 degree inward
Anatomy: Knee
Central Ray for Lateral Projection Mediolateral
Entrance: 1 in. distal to medial epicondyle Angulation: 5-7° cephalad
Anatomy: Knee
Lateral Projection Mediolateral
- ____
Part Position: - Knee flexed ____ (relax muscle &
shows maximum volume of joint cavity) or flexed <10° (for new or unhealed patellar fx) - femoral epicondyles ____ to IR
Lateral recumbent, 20-30°, perpendicular
Anatomy: Knee
Central Ray for AP Oblique Projection (Medial Rotation)
Entrance: 0.5 in. inferior to patellar apex
Angulation: depending on the measurement between ASIS & table top
- 3-5°caudad (<19 cm)
- Perpendicular (19-24 cm)
- 3-5°cephalad (>24 cm)
Anatomy: Knee
What projection will show the Proximal tibiofibular joint; fibular head
AP Oblique Projection (Medial Rotation)
Anatomy: Knee
AP Oblique Projection (Medial Rotation)
- ___
Part Position: - leg rotated ____
- hip of a ffected side ___
Supine, 45° medially, elevated
Anatomy: Knee
Central Ray for AP Oblique Projection (Lateral Rotation)
Entrance: 0.5 in inferior to patellar apex
Angulation: 5o cephalad
Anatomy: Knee
What projection will show the - Tibial plateaus - medial femoral & tibial condyles
AP Oblique Projection (Lateral Rotation)
Anatomy: Knee
AP Oblique Projection (Lateral Rotation)
- ___
Part Position: - Leg rotated ___
- hip of ____ side elevated
Supine, 45° medially, unaff ected
Anatomy: Knee
Central Ray for Weight-Bearin g Method AP Bilateral Projection Leach-Gregg- Siber
Entrance: 0.5 in. inferior to patellar apex
Angulation: Horizontal
Purpose:
- To reveal narrowing of
knee joint space
- To evaluate varus & valgus
deformities & degenerative joint disease
Weight-Bearin g Method AP Bilateral Projection Leach-Gregg- Siber
Anatomy: Knee
Weight-Bearin g Method AP Bilateral Projection Leach-Gregg- Siber
- ___
Part Position: - Knee fully ___ - weight equally
distributed on both
feet - IR ___
Upright, extended, vertical
Anatomy: Knee
Central Ray for Rosenberg Method
PA Weight-Bearin g Standing Flexion
Entrance: 0.5 in. inferior to patellar apex
Angulation: Horizontal or 10° caudad
Purpose: Useful for evaluating joint space narrowing & demonstrating articular cartilage disease
Rosenberg Method
PA Weight-Bearin g Standing Flexion
Anatomy: Knee
Rosenberg Method
PA Weight-Bearin g Standing Flexion
- ____
Part Position: - Facing vertical IR - anterior surface of
flexed knee against IR - femur ____ to IR
Upright, 45°
Anatomy: Intercondylar Fossa
Projections/ Positions
•Holmblad Method
PA Axial Projection Tunnel View
•Camp-Coventr y Method
PA Axial Projection
•Beclere Method AP Axial Projection
Anatomy: Intercondylar Fossa
Central Ray for Holmblad Method
PA Axial Projection Tunnel View
Entrance: Popliteal depression
Angulation: Perpendicular
Anatomy: Intercondylar Fossa
Holmblad Method
PA Axial Projection Tunnel View
Part Position:
- Anterior surface of knee against IR;
knee ____ from IR (20° di erence from CR)
60-70°
Anatomy: Intercondylar Fossa
Central Ray for Camp-Coventry Method
PA Axial Projection
Entrance: Popliteal depression
Angulation: 40° (knee flexed 40o) or 50° (knee flexed 50°) caudally
Anatomy: Popliteal depression
Camp-Coventry Method
PA Axial Projection
- ___
Part Position: - Knee flexed ___ from IR
- femur against IR
- with support under
foot
Prone, 40-50°
Anatomy: Intercondylar Fossa
Central Ray for Beclere Method AP Axial Projection
Entrance: 0.5 in. inferior to patellar apex
Angulation: Perpendicular to long axis of lower leg
Anatomy: Intercondylar Fossa
What projection will show the - Intercondylar fossa,
intercondylar eminence, knee joint & tibial plateau
Beclere Method AP Axial Projection
Anatomy: Intercondylar fossa
Beclere Method AP Axial Projection
- ___
Part Position: - Knee flexed
- femur ___ to long
axis of tibia - curved cassette
Supine, 60°
Purpose:
- To detect loose bodies
“joint mice
- To evaluate split &
displaced cartilage in
osteochondritis
- To evaluate flattening or
underdevelopment of lateral femoral condyles in congenital slipped patella
Camp-Coventr y Method
PA Axial Projection
Anatomy: Patella
Positions/ Projections
•PA Projection
•PA Oblique Projection (Medial Rotation)
•PA Oblique Projection (Lateral Rotation)
•Hughston Method (Tangential Projection)
•Merchant Method (Tangential Projection)
•Settegast Method (Tangential Projection)
•Sunrise Method (Tangential Projection) Mountain/Skyl ine View
Anatomy: Patella
Central Ray for PA Projection
- Perpendicular to the mid popliteal
area exiting the patella
Anatomy: Patella
What projection that will show medial portion of patella free of femur
PA Oblique Projection (Medial Rotation)
_____ projection of the patella
provides sharper recorded detail than in the AP projection because of a closer object-to-image receptor distance (aID)
PA
Anatomy: Patella
PA Projection
-___
Part Position:
- Center the IR to the patella.
- Adjust the position of the leg to place
the patella parallel with the plane of the IR. This usually requires that the heel be rotated _____
Prone, 5 to 10 degrees laterally
Anatomy: Patella
Central Ray for PA Oblique Projection (Medial Rotation)
Entrance: Patella
Angulation: Perpendicular
Anatomy: Patella
PA Oblique Projection (Medial Rotation)
-___
Part Position:
- Knee flexed ____; knee ____
Prone, 5-10°, 45-55°
medially
Anatomy: Patella
Central ray for PA Oblique Projection (Lateral Rotation)
Entrance: Patella
Angulation: Perpendicular
Anatomy: Patella
What projection that will show the Lateral portion of patella free of femur
PA Oblique Projection (Lateral Rotation)
Anatomy: Patella
PA Oblique Projection (Lateral Rotation)
- ___
Part Position: - Knee flexed ___; knee ____
Prone, 5-10°, 45-55°
laterally
Anatomy: Patella
Central Ray for Hughston Method (Tangential Projection)
Entrance: Patellofemoral joint
Angulation: 45° cephalad
Anatomy: Patella
What projection that will show the Patella; patellofemoral joint
Hughston Method (Tangential Projection)
Settegast Method (Tangential Projection)
Purpose:
- To demonstrate subluxation of patella & patellar fx
- It allows assessment of femoral condyles
Hughston Method (Tangential Projection)
Anatomy: Patella
Hughston Method (Tangential Projection)
_____
Part Position:
- Anterior surface of knee against IR;
knee flexed _____; foot rested against collimator/support
Prone, 50-60°
Anatomy: Patella
Central Ray for Merchant Method (Tangential Projection)
Entrance: Midway between patellae at level of patellofemoral joint
Angulation: 30° caudad from horizontal
Anatomy: Patella
What projection that will show the Femoral condyle; intercondylar sulcus & magnified non distorted patellae
Merchant Method (Tangential Projection)
Anatomy: Patella
Merchant Method (Tangential Projection)
-__
Part Position:
- Both knee flexed ____ or between ___(to demonstrate various patellar disorders)
- IR resting on patient’s shins; uses IR holding device & axial viewer device
Supine, 40, 30-90°
Anatomy: Patella
Central ray of Settegast Method (Tangential Projection)
Entrance: Joint space between patella & femoral condyles
Angulation:
- Perpendicular (if joint is
perpendicular);
- 15-20 cephalad (if joint isn’t
perpendicular)
- Angulation
depends on knee flexion
Disadvantage: extreme flexion
Purpose:
- Useful for demonstrating
vertical & transverse fx of patella
- Useful for investigating articulating surfaces of patellofemoral articulation
Settegast Method (Tangential Projection)
Anatomy: Patella
Settegast Method (Tangential Projection)
- ____ (preferable);
Part Position: - Knee acutely flexed until patella
perpendicular to IR - loop bandage
around ankle or foot to hold the leg in position
Supine or prone
Anatomy: Patella
Central Ray for Sunrise Method (Tangential Projection) Mountain/Skyl ine View
Entrance: Patellofemoral joint
Angulation: 30° from horizontal
Purpose:
- Joint space between patella & femoral condyles
Sunrise Method (Tangential Projection) Mountain/Skyl ine View
Anatomy: Patella
Sunrise Method (Tangential Projection) Mountain/Skyline View
-____
Part Position:
- Knee flexed ___
Supine/Sitting, 40-45°
Anatomy: Toes
Projections/Positions
•AP/AP Axial Projection
•PA Projection
•AP Oblique Projection (Medial Rotation)
•AP Oblique Projection (Lateral Rotation)
•PA Oblique Projection (Medial Rotation)
•Lateral Projection (Lateromedial/ Mediolateral)
Anatomy: Toes
Central Ray of AP/AP Axial Projection
Perpendicular or 15° posteriorly
entering the 3rd MTP joint
Anatomy: Toes
What projection that shows the Phalanges & distal portion of metatarsals
AP/AP Axial Projection
Anatomy: Toes
AP/AP Axial Projection
-____
Part Position:
- Knee flexed; ____ foam wedge under foot
Supine/Seated, 15 degrees
Anatomy: Toes
Central Ray for PA Projection
- Perpendicular to 3rd MTP joint
Anatomy: Toes
Structures shown:
IP joint spaces are well
visualized
PA Projection
Anatomy: Toes
PA Projection
Patient Position:
- ____ (IP joints parallel to Central
Ray Angulation); dorsal aspect against IR
Prone
Anatomy: Toes
Central Ray for AP Oblique Projection (Medial Rotation)
Perpendicular to 3rd MTP joint
Anatomy: Toes
Structures shown:
- 2nd-5th MTP joint spaces;
- 1st-2nd toes
- 1st (not always opened)
AP Oblique Projection (Medial Rotation)
Anatomy: Anatomy Toes
AP Oblique Projection (Medial Rotation)
- ____
Part Position: - Knee flexed; lower leg & foot rotated
medially ____
Supine/seated, 30-45°
Anatomy: Toes
Central Ray for AP Oblique Projection (Lateral Rotation)
Perpendicular to 3rd MTP joint
Anatomy: Toes
Structures shown:
4th-5th toes
AP Oblique Projection (Lateral Rotation)
Anatomy: Toes
AP Oblique Projection (Lateral Rotation)
- ____
Part Position: - Knee flexed; lower leg & foot rotated
____
Supine/seated, laterally 30-45°
Anatomy: Toes
Central Ray for PA Oblique Projection (Medial Rotation)
- Perpendicular to the MTJ
Anatomy: Toes
Structures Shown:
- Toes and the distal portion of
the metatarsals
rotated laterally - 2nd through 5th
MTJ - 1st (not always
opened)
PA Oblique Projection (Medial Rotation)
Anatomy: Toes
PA Oblique Projection (Medial Rotation)
- ____
Part Position: - Ball of the foot forms an angle of
approximately ___ to the horizontal, or have the patient rest the foot against a foam wedge or sandbag. - Center the IR half to the third ___, and adjust it so that its midline is parallel with the long axis of the foot.
Lateral recumbent, 30°, MTJ
Anatomy: Toes
Central Ray for Lateral Projection (Latermedial/ Mediolateral)
- Perpendicular to (IP) joint of great
toe - Perpendicular to
proximal interphalangeal (PIP) joint of a ected toe (2nd - 5th)
Anatomy: Toes
Structures Shown:
Lateral projection of the
phalanges of the toe and IP articulations free of other toes
Lateral Projection (Latermedial/ Mediolateral)
Anatomy: Toes
Lateral Projection (Latermedial/ Mediolateral)
________
Lateral recumbent
Anatomy: Sesamoid
Projections/ Positions
Lewis Method (Tangential Projection)
Holly Method (Tangential Projection)
Causton Method (Tangential Projection)
Anatomy: Sesamoid
Central Ray for Lewis Method (Tangential Projection)
Perpendicular and tangential to 1st
MTP joint
Anatomy: Sesamoid
Structures shown:
Tangential projection of the
metatarsal head in profile and the sesamoids
Lewis Method (Tangential Projection)
Holly Method (Tangential Projection)
Anatomy: Sesamoid
Lewis Method (Tangential Projection)
- ______ (uncomfortable and often painful)
Part Position: - Dorsiflex and rest great toe on table
- Ball of foot perpendicular to the horizontal place
- Plantar surface of foot forms about
____ angle from
vertical - Elevate ____
ankle on sandbags
(if needed) - IR centered to ___
Prone, 15°-20°, a ffected, 2nd
metatarsal
Anatomy: Sesamoid
Central Ray for Holly Method (Tangential Projection)
Perpendicular and tangential to 1st
MTP joint
Anatomy: Sesamoid
Holly Method (Tangential Projection)
- ____ (more comfortable for the
patient) - Elevate affected ankle on sandbags
(if needed)
Part Position: - Dorsiflex and rest great toe on table
- Adjust foot so that medial border is
vertical - Plantar surface form an angle of ____ with plane of film
Seated, 75 degrees
Anatomy: Sesamoid
Central Ray for Causton Method (Tangential Projection)
Prominence of the MTJ at 40° toward
the heel
Anatomy: Sesamoid
Structures Shown:
- Sesamoid bones projected
axiolaterally with a slight overlap
Causton Method (Tangential Projection)
Anatomy: Sesamoid
Causton Method (Tangential Projection)
- ____ on una ffected side
Part Position: - Limb partially extended
- Foot in ____ position
- First MTJ
perpendicular to the horizontal plane of the IR
Lateral recumbent, lateral