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img crit posit leg 1
image critique positioning lower leg 1
Question | Answer |
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CR entry point for an AP axial foot | 10 degrees cephalad or 15 if weight bearing |
AP axial foot eval criteria | no rotation, equidistant midshafts of metatarsals 2-4, superimposed metatarsal bases 2-5, metatarslas tarsals and phalanges distal to talus included, open joint space between the medial and intermediate cuneiforms |
Oblique foot structures shown | interspaces of the cuboid and calcaneus, 4th and 5th metatarsals and lateral cuneiform and the talus and navicular |
Oblique foot eval criteria | metatarsal bases 3-5 not superimposed, lateral tarsals with less superimposition than AP, lateral TMT and intertarsal joints, sinus tarsi open, tuberosity of the 5th metatarsal, base of the 1st and 2nd metatarsals, equidistant shafts metatarsals 2-5 |
Lateral foot eval | metatarsals nearly superimposed, distal leg included, fibula overlaps posterior half of tibia, tibiotalar joint open with superimposed domes, sufficient density to differentiate tarsals |
Lateral foot positioning | plantar surface perpendicular to the IR with foot dorsiflexed |
Structures shown in an oblique ankle | open distal tibiofibular joint. |
AP ankle eval criteria | tibiotalar joint space open, joint centered, tibiofibular joint space closed, talus superimposeing fibula, medial talomalleolar joint open, both malleoli included, talus with proper density, soft tissue |
How can we determine rotation on a lateral ankle? | if the fibula is to far posterior the ankle is over rotated. If it is seen anterior it is under rotated |
Positioning for a mortise view of the ankle | internally rotate the lower limb 15-20 degrees |
Lateral ankle eval criteria | ankle joint centered, tibiotalar joint well demonstrated, talar domes superimposed, fibula seen over the posterior half of the tibia, distal tibia, fibula, talus and adjacent tarsals, fifth metatarsal demonstrated for jones fracture |
AP tib-fib eval | ankle and knee joints without rotation, tibiofibular articulations superimposed, fibular midshaft free of superimposition |
Lateral tib-fib eval | distal fibula lying over the posterior half of the tibia, slight overlap of tibia over proximal fibular head, ankle and knee joints without rotation, femoral condyles superimposed, tibial and fibular shafts not superimposed |
AP knee eval criteria | open femorotibial joint with equal joint spaces, knee fully extended, patella superimposed on the femur, no rotation, slight superimposition of fibular head, soft tissue around the knee joint, bony detail surrounding patella |
How can we determine direction of rotation on an AP knee? | Look for symmetric tibial plateaus, increased tibiofibular joint space indicates to much internal rotation. |
Lateral knee eval criteria | femoral condyles superimposed, open joint space between femoral condyles and tibia, patella in profile, open patellofemoral joint space, fibular head and tibia superimposed, knee flexed 20-30 degrees, |
An AP lateral oblique of the knee demonstrates what anatomy? | lateral rotation of femoral condyles, patella, tibial condyles, and fibular head. |
An AP medial oblique of the knee demonstrates what anatomy? | medial rotation of the femoral condyles, patella, tibial condyles, tibiofibular joint, and fibular head. |
The settegast method or “sunrise” knee is done to visualize what? | the patellofemoral joint and vertical fractures |
Eval criteria for a lateral oblique of the knee | medial femoral and tibial condyles seen, tibial plateaus, open knee joint, fibula superimposed over lateral half of tibia, patella projected slightly beyond the femoral condyle |
Eval criteria for a medial oblique of the knee | proximal tibiofibular joint open, posterior tibia, leteral condyles of the femur and tibia seen, both tibial plateaus, open knee joint, margin of patella projecting beyond the medial femoral condyle |