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Advanced procedures II (Sir Robert)
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What is the technique for the AP WB ankle?
60 kVp and 4 mAs
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What is the technique for the Camp Coventry Method?
70 kVp and 4 mAs
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What is the technique for the Rosenberg Method?
70 kVp and 5 mAs
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What is the technique for the Beclere Method?
70 kVp and 8 mAs
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What is the technique for the AP WB Knee?
70 kVp and 5 mAs
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What is the kVp for the sesamoid bones exam?
60 kVp-2 mAs
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Which knee projection requires the use of a special IR holding device?
Merchant
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Which patella projection should place the patient in a prone position with a 50-60 degrees flexion of the knee with a cephalic 45 degree CR
Houston
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A patient comes into the ED with a clinical history of a Lis-Frank injury. Which body part does that affect? Which projections would demonstrate this injury?
AP weight bearing foot series
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Which projection will best demonstrate evidence of Osgood -Schlatters disease?
AP and Lateral knee
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The profiled appearance of the adductor tubercle and excessive superimposition of the fibular head and neck on a mediolateral projection of the knee indicates?
underrotation of the knee toward the IR
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A radiograph of an AP medial oblique projection of the foot should demonstrate?
the 3-5 metatarsals free from superimposition
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How much flexion of the knee is recommended for the lateral projection of the patella?
5-10 degrees
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What is the main disadvantage of using 45 degrees of flexion for the mediolateral projection of the knee?
It puts the patella into the intercondylar sulcus
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Which CR angle should be used for a mediolateral projection of a knee on a short wide pelvis patient?
7-10 cephalic
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Which projection of the knee will best demonstrate the neck of the fibula without superimposition of the tibia?
oblique with medial rotation
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What CR angulation is recommended for an AP projection of the knee for a patient with an ASIS to tabletop measurment of 18 cm?
3-5 degrees caudal
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Which projection of the ankle will best demonstrate the open joint space of the lateral aspect of the ankle joint?
mortise
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How much rotation from AP will typically produce a mortise view of the ankle?
15-20 degrees
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Which joint surfaces of the ankle are most commonly open
medial and superior
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Where is the CR placed for a mediolateral projection of the calcaneus?
1 inch inferior to the medial malleolus
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How much CR anglulation to the long axis of the foot is required for the plantodorsal axial projection of the calcaneus?
40 degrees
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To properly visualize the joint space in an AP foot the CR must be at what angle?
it must be perpendicular to the metatarsals ( 15 degrees)
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A mediolateral radiograph of the knee that is over rotated towards the IR is recognized, how?
the fibular head will appear less superimposed by the tibia than a true lateral
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How much is the foot dorsiflexed for the tangential projection of the sesamoid bones?
15-20 degrees
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Which routine should be performed for the second toe?
Lateral -medio projection
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Extending the toes downward or pointing the foot is called?
plantarflexion
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Where is the adductor tubercle?
see image
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Where is the metatarsalphalangeal joint
see picture
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What do you use dorsiflexion for?
an ankle and a sesamoid bone projection
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To decrease the angle to the anterior surface of the foot to the lower leg is called?
dorsiflex
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What is another term for the intercondylar sulcus?
patellar surface
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The medial malleolus is part of what bone?
Tibia
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How many articular facets make up the subtalar joint?
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Where would the interphalangeal (IP) joint be found in the foot?
the first digit of the foot (the others are the DIP or PIP)
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Which term describes the top or the anterior surface of the foot?
dorsal
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Which bone in the foot has a prominant tuberosity most commonly fractured?
fifth metatarsal
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How many tarsal bones are found in the foot?
7
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Where should the CR be directed for the Beclere method?
1/2 inch distal to the apex of patella
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How should the CR be directed for the Beclere method?
perpendicular to the lower leg
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How much is the knee flexed in the Beclere method?
40-45 degrees
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What is the name of the AP projection of the intercondylar fossa?
The Beclere Method
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For both the Camp Coventry and Holmblad how is the CR directed?
perpendicular to the lower leg
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All three Holmblad methods require the patient to lean forward how far?
20 to 30 degrees forward
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Camp Coventry method is done prone with the knee flexed at what angle?
40 to 50 degree angle
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The Intercondylar fossa can be imaged PA or AP, what are the names of the two PA versions?
Camp Coventry and Holmblad Method
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Where is the CR directed in the Rosenberg ?
directly to midpoint between the knee joints at level 1/2 inch below apex of the patellae
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How much CR angle and what direction is the CR for the Rosenberg method?
10 degrees caudal
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How much are the knees flexed in the Rosenberg method?
45 degrees
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What is another name for the PA axial weight-bearing knee projection?
Rosenberg Method
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In an AP weight-bearing bilateral knee projection where is the CR directed?
CR perpendicular to IR directed to midpoint between knee joints at a level 1/2 inch below the apex of the patella
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For the stress view of the ankle from a true AP position which way is inversion and which way is eversion?
inversion is stressing the ankle medially and eversion is stressing the ankle laterally
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What are stress views of the ankles used for?
evaluate ankle joint for joint separation and ligament tear or rupture
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How much of the distal tib-fib should be visible on the weight-bearing lateral foot projection?
a minimum of 1 inch of distal tib-fib
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Where is the CR directed to for the weight-bearing bilateral AP feet projection?
midpoint between the feet at the level of the base of the metatarsals
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In the AP weight-bearing feet projection how much and which way is the CR angled?
15 degrees posteriorly
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The CR is perpendicular to the IR directed to what landmark on the sesamoid projection?
posterior aspect of the first MTP joint
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What is the minimum amount of distal metatarsals that should be visualized on a sesamoid projection?
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In the sesamoid tangential projection, how much angle from vertical is the foot dorsiflexed?
15 to 20 angle from vertical
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