UPPER EXTREMITY Flashcards
[RP] Digits 2nd-5th
⊥ PIP JT
Digits 2nd-5th - LAT
Reduce OID
Radial S. 2nd & 3rd
Ulnar S. 4th and 5th
Digits 2nd-5th
PAO - Medial Rotation for 2nd digit
STREET JM
2nd digit - IR
[RP] Thumb 1st
⊥ 1st MCP JT
Thumb 1st MCP
Magnified image
PA PROJECTION
[RP] Thumb 1st Digit
⊥ 1st CMC Jt
ROBERT (AP)
Arm and Hand [posi]
Arm- INT Rot
Hand-HyperE
[SS] ROBERT (AP)
Arthritic Changes
Bennet’s/Rolando Fx
Thumb 1st Digit
RAFERT LONG [CR-RP]
15 deg prox -1st CMP
Thumb 1st Digit
LEWIS [CR-RP]
10-15 deg prox- 1st MCP
BURMAN (AP)
Hand & Thumb [posi]
Hand-HyperE.-INT Rot
Thumb-abd
BURMAN (AP)
[SID,CR]
18” SID -Magnif
45deg twd elbow-1st CMC
BURMAN (AP)
[SS]
magnified
Trapezium -Concave
1st MC Base - Convex
FOLIO (PA)
SKIER’S/GAMEKEEPER’S
[SS]
Dx Ulnar Collateral Ligament Rupture
[RP] Hand
⊥ 3rd MCP JT / Head of 3rd MC
Hand PAO [techniques]
45deg
1. Foam Wedge: IP JT
2.Fingertips: MC JT
[SS] LANE-KENNEDY-KUSCHNER (Reverse Oblique)
SS:severe MC deformities
[PP,CR,SS] KALLEN (Tangential Oblique)
Flex 75-85deg
CR 40-45deg twd Ulnar side& fwd MCP JT
SS: MC Head fx
LAT (Extension)
LM PROJ [..]
ML PROJ [..]
LM Proj: U. Down
ML Proj: R. Down
Thumb 90deg -palm
⊥-2nd MCP JT
Localize Fb & MC fx
displacement
LAT (Extension)
LEWIS METHOD [PP, RP, SS]
Hand 5deg post
⊥- midshaft of 5th MC
SS: 5th MC fx
SS: Anterior or Posterior
Displacement in MC fx
LAT (Flexion)
Rhematoid Arthritis
NORGAARD M. (APO) / Ball Catcher’s
NORGAARD M. (APO) / Ball Catcher’s
[exposure technique]
fine grain -IS; 60-65 kVp
FX 5th MC- Boxer’s fx
STAPCZYNSKI
Erosions of MC heads and bases of phalanges
Alt. Rheumatoid Arthritis
BREWERTON (REVERSE KALLEN)
BREWERTON (REVERSE KALLEN)
[PP,CR]
MCP JT 45deg flexed
CR 20 deg -US to 3rd MC head
[RP] Wrist
⊥ midcarpal / midway b/n the ulnar & radial styloid processes
ELONGATED scaphoid/capitate
DAFFBER-EMMERLING-BUTTERBAUGH REC
PA Axial -30 deg twd elbow
ELONGATED capitate only
DAFFBER-EMMERLING-BUTTERBAUGH REC
PA Axial -30 deg twd fingertips
30 deg twd elbow -
ELONGATED scaphoid/capitate
30deg twd ftips - ELONGATED capitate only
DAFFBER-EMMERLING-
BUTTERBAUGH REC
Carpal interspaces / No rot
of ulna
AP Wrist
Prox MC & dist R&U
Trapezium & Scaphoid (ant)
LAT :LM Projection
90deg flexion
Lateral scaphoid
BURMAN SUG -palmar flexion (rotate scaphoid in dorsovolar pos)
CARPAL BOSSU/
CARPAL BOSS
FOILLE - palmar flexion
Lat side (SCAPHOID &
TRAPEZIUM)
PAO 45 deg
LAT ROT - Aff side UP
(Ulnar dev - scaphoid only)
Med side (PISIFORM,
TRIQUETRUM & HAMATE)
APO 45deg - MED ROT
Aff side DOWN
correct scaphoid foreshortening
PA -ULNAR DEV
PA -ULNAR DEV
[CR,SS]
⊥ or 10-15prox/dist
SCAPHOID-open carpal
spaces (lat side)
Open carpal interspaces
(med side)
PA -RADIAL DEV
STECHER (PA AXIAL)
20deg support
[CR]
20deg twd elbow
20deg twd dgits
Clench fist (NO CR)
Stecher M w/ ulnar dev
BRIDGMAN METHOD
RAFERT-LONG (PA&
PA AXIAL) X-ULNAR DEV -4images
[CR]
⊥; 10deg; 20deg; 30deg cephalad
Addt’l to evaluate sus widening of scapholunate interval (Bilat) “function view”
CLENCH FIST VIEW
Scaphoid Views
STECHER (PA AXIAL)
BRIDGMAN METHOD-ud
RAFERT-LONG (PA&
PA AXIAL)-4images-ud
CLENCH FIST VIEW
ZITTER’S 25deg
Trapezium/ Trapezium Fx
CLEMENTS-NAKAYAMA
(PA AXIAL OB)
45 deg sponge+ ulnar dev
CR 45deg distally - ANATOMICAL SNUFFBOX
CLEMENTS-NAKAYAMA
(PA AXIAL OB) or
(No UD) Rotate elbow end of IR & arm 20deg away from CR
45 deg sponge+ ulnar dev
45deg distally - ANATOMICAL SNUFFBOX
CLEMENTS-NAKAYAMA
(PA AXIAL OB) or
(No UD) Rotate elbow end of IR & arm 20deg away from CR
Carpal Bridge
LETINO (TAN)
LETINO (TAN)
[PP,CR,SS]
90deg to FA
45deg caudad - 1.5” prox wrist jt
Famous Landmarks Connect Cities
CARPAL BRIDGE
Fx Scaphoid & FB
Lunate disloc
Calcif (dorsum)
Chip fx (dorsal)
MODIFIED LETINO [PP,CR]
FA elev SB; wrist flexed @ R<
45deg twd wrist
CARPAL CANAL/TUNNEL
GAYNOR-HART
(TAN (I-S)
GAYNOR-HART (TAN (I-S)
[SS]
Carpal canal/tunnel
(Carpal sulcus + flexor retinaculum)
carpal tunnel syndrome
fx of hook of PHT
GAYNOR-HART (TAN (I-S)
[CR]
20-30deg to LA of hand
-1” dist to 3rd MCP base
MCQUILLEN MARTENSEN
CR
15deg twd palm
CARPAL CANAL
(cant assume Gaynor)
SUPEROINFERIOR (TAN)
CARPAL CANAL Views
GAYNOR-HART (TAN (I-S) - 20-30deg to LA of hand
MCQUILLEN MARTENSEN
CR 15deg twd palm
TEMPLETON AND ZIM
CR 40 deg tws fingers
MARSHAL SUGGESTION
(For limited dorsiflexion)
45deg sponge
SS if FA in pronation
- Crosses radius over ulna @ Prox third
- Rotate humerus medially
FA Lateral
SSS-R
SSS-R
SI R&U @ distal end
SI RH over Coronoid P.
SI Humeral Epicondyles
Radial Tuberosity facing ant
EJ.R.U
Ant & post displ fx
LATERAL-FA
[RP] Elbow
⊥ Elbow Jt/ midway b/w the epicondyles
Elbow AP
[HE]
HE & ant surface ll - IR
Elbow LAT
HE
HE ⊥-IR
Elbow Lat [SS]
OLECRANON PROCESS
SI HE, RT facing ant, RH
partially SI Coronoid P
GRISWOLD (2 Reasons 90deg) - elbow
- OLECRANON PROCESS
2.Elbow Fat Pads least compressed
APO (MED ROT) - elbow
45deg
C.O.Me.T
CORONOID PROCESS, Medial epicondyle, TROCHLEA
APO (LAT ROT)
45 deg
CRL
CAPITULUM,
RH &N &
Lateral epicondyle
HOLLY (AP-RH)
dist humerus
H-wrist 30 deg
JONES (AP)
ACUTE FLEXION-DIST HUMERUS
[SS]
OLECRANON PROCESS
JONES (AP)
PROX FLEXION-PROX FA
[SS]
EJ more open
LAT (RH) latermed
[positions]
E-90deg
1. Supinated
2. In lat
3. Pronated
4. Int Rot
LAT (RH) latermed
[SS]
RT facing ant (1st and 2nd)
RT facing post (3rd and 4th)
GREENSPAN & NORMAN (RH)
[CR]
45deg medially (twd the shoulder)
COYLE (AXIOLAT)
[CR]
45deg twd(ceph) shoulder (RH)
45deg away (cau) fr shoulder (CP)
COYLE (AXIOLAT)
[FLEXION]
RH 90deg
CP 80deg
RADIOHUMERAL BURSITIS (TENNIS ELBOW)
PA AXIAL
(rp:ulnar sulcus)
PA AXIAL - elbow
[PP,CR,RP]
Humerus to FA 75deg flexion
15deg fr CR
Perp ulnar sulcus
PA AXIAL (rp:ulnar sulcus)
[SS]
Epicondyles ;trochlea. Ulnar sulcus,
olecranon fossa
RADIOHUMERAL BURSITIS (TENNIS ELBOW)
detect obscured calcif
AP-humerus [HE]
HE ll-IR (Ext Rot)
Humeral Head & GT
SUPRACONDYLAR FX
-MC (pedia)-dist humerus
AP-humerus
LAT (Latermed) [HE,PP]
HE ⊥-IR; flex 90deg
Mediolateral - hand holding
broken arm
LESSER TUBERCLE, GT SI
over HH
LATERAL- Humerus
