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Radiographic positioning of the forearm Radiographic examination of the forearm is performed using anteroposterior (AP) and lateral projections. Both projections of the forearm demonstrate the elbow joint, the radius and the ulna, and the proximal row of slightly distorted carpal bones. Technical factors
Positioning for an AP projection of the forearm
Evaluation criteria
Positioning for a lateral projection of the forearm
Evaluation criteria
Radiographic positioning of the elbow Routine radiographic examination of elbow is performed using the AP, AP oblique, and lateral projections. AP oblique projections include medial (internal) rotation and lateral (external) rotation views. The lateral projection (lateromedial view) is obtained by flexing the elbow 90º. Diagnosis of certain important joint pathological processes (such as possible visualization of the posterior fat pad) depends on 90º flexion of the elbow joint. By doing this, the olecranon process can be seen in profile, and the elbow fat pads are the least compressed. Also, by allowing a partial or complete extension, the olecranon process elevates the posterior elbow fat pad and simulates joint pathology. Technical factors
Positioning for an AP projection
Evaluation criteria
Positioning for a lateral projection
Evaluation criteria
Positioning for an AP oblique projection medial (internal) rotation
Evaluation criteria
Positioning for an AP oblique projection lateral (external) rotation
Evaluation criteria
AuntMinnie.com contributing writer November 21, 2002 Related Reading The twists and turns of hand and wrist x-ray positioning, October 15, 2002 Digit imaging requires diligent positioning, September 17, 2002 Patient positioning techniques for a lower gastrointestinal series, June 27, 2002 Patient positioning tips for a premium UGI series, April 17, 2002 Positioning techniques for quality esophagrams, March 20, 2002 Copyright © 2002 AuntMinnie.com In what position should the hand be for an AP medial rotation oblique elbow position?Elbow AP Oblique Medial (Internal) Rotation
Place the arm on the table with elbow straight. Ideally, the upper arm, elbow, and forearm are all resting on the table. Position of part Extend the upper limb and place elbow in the center of the image receptor, hand prone.
How much rotation of the distal humerus is required for the AP medial oblique projection of the elbow?How much rotation of the humeral epicondyles is required for the AP medial oblique projection of the elbow: 45 degrees.
How many degrees should the elbow be angled for an AP oblique projection in medial rotation?An AP oblique radiograph requires the elbow to be oriented 45 degrees in internal rotation. A lateral radiograph of the elbow requires the elbow to be flexed 90 degrees with the forearm and humerus laying flat on the table and the image receptor, ulnar side down on the receptor, and thumb/radial side up.
What is the proper patient position for the AP projection of the forearm?Positioning for an AP projection of the forearm
Ensure that both the wrist and elbow joints are included. Ask the patient to lean laterally until the forearm is in a true supinated position, and adjust the humeral epicondyles so they are equidistant from the cassette.
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