The elbow 3

Question 1

Axial projections ( jones methods)

Answer 1

• Axial projections are done if the patient’s elbow is
  treated or immobilized in full flexion (Jones orthopedic
  technique).
• Where the patient’s elbow is in complete flexion, AP
  projection is replaced by performing an axial projection.
• The axial projection demonstrates gross injury and
  general alignment of bones at the elbow

Question 2

Infero-superior axial projection of the elbow joint patient positioning.

Answer 2

• The patient is seated alongside the x-ray couch with
  shoulder of the affected side near and same level with the
  couch
• The elbow in full flexion and palm of the hand facing and
  touching the shoulder
• The posterior aspect of the humerus in contact with the image
  receptor and parallel to the long axis of the image receptor
• Adjust the patient’s trunk such that the medial and lateral
  epicondyles of the humerus are equidistant to the image
  receptor
• Centre the image receptor proximal to the epicondylar area of
  the humerus

Question 2

Types of axial projections( jones method)

Answer 2

1.Infero-superior axial projection.
2. Supero-inferior axial projection.

Question 2

Infero-superior axial projection centering point.

Answer 2

In the midline 5 cm distal to the olecranon
process

Question 3

Axial projections ( jones method) equipments required

Answer 3

• 18 x 24 or 24 x 30 cm image receptor lengthwise
• Sandbag
• Lead protective waist apron

Question 4

Direction of central ray in infero-superior axial projection.

Answer 4

– Vertical at 90⁰ to image receptor to demonstrate the olecranon
process (Distal humerus).
OR
– Angle 30⁰ towards the shoulder to demonstrate the
radio humeral joint space (proximal forearm).

Question 5

Supero-inferior axial projection
Patient positioning

Answer 5

• The patient is seated alongside the x-ray couch with the affected
  side nearest to the couch
• The elbow is fully flexed and the palm of the hand is facing
  upwards
• The forearm is fully supinated with posterior aspect of the
  forearm resting on the image receptor.
• The arm should be parallel to the long axis of the image
  receptor
• Adjust the patient’s trunk such that the medial and lateral
  epicondyles of the humerus are equidistant to the image
  receptor

Question 5

Supero-inferior axial projection centering points.

Answer 5

In the midline 5 cm superior to the olecranon
process