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Lower Extremity/Pelv

RadTech 108

QuestionAnswer
Toes AP *seated or supine on table *flex knees, separate feet @6", center toes to IR *CR-perpendicular through the 3rd Metatarsophalangeal joing *** to open jt spaces angle the CR 15 degrees
Toes AP Oblique *flex knee of affected side to rest the sole of the foot firmly on table *medially rotate the lower leg/foot, adjust plantar surface of foot to form 30-45 degree angle *CR-perpendicular entering 3rd metatarsophalangeal jt
Toes Lateral *lie in lateral recumbent position, separate unaffected toes *CR- perpendicular to IR entering the metatarsophalangeal jt (big toe) or PIP of the lesser toes
Lewis Method-Tangential *CR-perpendicular and tangential to the 1st metatarsophalangeal jt.
Holly method-Superioinferior *CR-perpendicular to the head of the 1st metatarsal
Foot AP or AP Axial *Supine, flex knee of affected side enough to rest foot firmly on table *Center to base of 3rd metatarsal, no rotation *CR-perpendicular to the IR and toward the base of the 3rd metatarsal OR 10 degrees toward the heel to the base of the 3rd metatarsal
Foot AP oblique *medial rotation, supine or seated to have foot flat on IR *Rotate medially, 30 degrees to the plane of the IR *CR-perpendicular to the base of the 3rd metatarsal
Foot Lateral *lie on table and turn toward the affected side with opposite leg behind *Center IR to mid foot, dorsiflex foot to form a 90 angle with lower leg *CR-perpendicular to the base of the 3rd metatarsal
Calcaneous Axial *supine with leg fully extended *Have pt hold ankle in rt angle dorsiflexion *CR-cephalic angle of 40 degrees, directed to midpoint of the IR, enters the base of the 3rd metatarsal
Calcaneous Lateral *supine and turned toward affected side *ankle centered on IR, with long axis of IR parallel w/plantar surface of the heel *CR-perpendicular, 1"distal to the medial malleolus
Ankle AP *Supine with leg fully extended *adjust affected ankle to anatomic position for a true AP, flex ankle and foot enough to place the foot vertical *CR-Perpendicular, through the ankle joint midway between the malleoli
Ankle Lateral *supine and turned toward affected side *long axis of IR parallel with long axis of pts leg, Dorsiflex foot and adjust to a lateral position *CR-perpendicular to the ankle joint, enters the medial malleolus
Ankle Oblique *supine leg extended *Dorsiflex foot to nearly a right angle, rotate pts LEG AND FOOT for all oblique, rotate HIP 45 degrees *CR-perpendicular to ankle joint
Ankle Mortise Oblique *supine *Rotate entire leg and foot together 15-20 degrees until intermalleolar plane is parallel with the IR *CR- perpendicular entering the ankle jt midway b/t the malleoli
Broden Method-AP Axial Oblique *dorsiflex ft enough to obtain a rt angle, rotate leg and foot medially *CR-4 images are obtained, angled @40,30,20,10. CR is directed 2 or 3 cm caudoanteriorly to the lateral malleolus
Tib/Fib AP *14x17, if both knee and ankle joints do not fit then take 2 images *Also can use IR diagonally *pelvis is NOT rotated, femoral condyles are parallel with IR and foot is vertical(flex ankle) *CR-perpendicular to center/midshaft of leg
Knee AP *may be taken with or without grid, Supine *IR under knee, locate knee, femoral epicondyle parallel with IR *CR-1/2"inch INFERIOR to apex of patella
Knee Lateral *turn to affected side *extend unaffected knee behind or in front, *Flex knee 20-30 degrees, epicondyles should be perpendicular t IR, patella perpendicular *CR- 1" distal to the medial epicondyle @ an angle of 5-7 degrees cephalad
Knee Oblique-Lateral & Medial Lateral-rotate affected limb externally 45 degrees Medial-rotate medially 45 degrees CR-1/2" INFERIOR to patellar apex
Pelvis AP *14x17, 40"SID *supine, medially rotate lower limbs @15-20 degrees to make femoral necks parallel with IR *center IR b/t ASIS and pubic symphysis *Upper border of IR 1-1 1/2 above crests *CR-perpendicular to midpoint of IR
Modified cleaves-AP Oblique Pelvis *"frogleg" *flex both hips and knees and draw feet up as much as possible, center IR 1" SUPERIOR to pubic symphysis *CR-perpendicular to midsagittal plane@ 1" superior to pubic symphysis
Original Cleaves-Axiolateral Pelvis *supine *same as modified cleaves *CR-parallel with femoral shafts, and angle varies b/t 25-45 degrees
Hip AP *supine, no pt rotation *medially rotate the lower limb 15-20 degrees to place femoral neck parallel with the plane of the IR, SUSPEND RESPIRATION *CR-perpendicular to the femoral neck, 2 1/2" distal on a line drawn perp. b/t the ASIS and pubic symphysi
Lauenstein and Hickey method- Lateral Hip *do not attempt if possible fracture *supine with pt rotated slightly toward the affected side, flex knee and draw thigh up to nearly a right angle of the hip bone *suspend respiration
Central ray of lauenstein and Hickey *CR- lauenstein-perpendicular through the hip jt. *CR- hickey- cephalic angle of 20-25 degrees
Dan Miller Method-Axiolateral of Hip *elevation of the pelvis is needed if pt is this and laying on a soft bed *flex knee and hip of unaffected side to elevate the thigh in a vertical position *medially rotate the foot and lower limb of the AFFECTED side 15-20 degrees
Central ray of Dan miller *right at the crouch *perpendicular to the long axis of the femoral neck *CR will enter midthigh and pass through the femoral neck @2" below the point of intersection
Friedman Method-Axiolateral of Hip *lateral recumbent of affected side *extend affected limb and adjust in a lateral position, roll the unaffected side posteriorly @ 10 degrees and support *CR- directed to the femoral neck @ an angle of 35 degrees cephalad
Clements-Nakayama- Axiolateral of Hip *performed when patient has bi-lateral hip fractures *CR- directed 15 degrees posteriorly and aligned perpendicular to the femoral neck and grid IR
Judet Method-RPO or LPO *describes two 45 degree posteriorly oblique positions that are useful in diagnosing fractures of the acetabulum *CR- perpendicular to IR and enters 2" inferior to ASIS of the affected side
Created by: gsmith0141
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