wrist, forearm, elbow

• PA wrist

  IR size: 8x10 screen LW

  patient position: seated, hand is pronated on the IR with forearm resting on the table, make a loose fist

  CR: perp to IR entering they midcarpal area

  Technique: 60 @ 2.5

  structures shown: carpals, radius, ulna, metacarpals
• PA oblique wrist

  IR size: 8x10 screen LW

  patient position: seated, hand is pronated with forearm resting on table. Ask the patient to make a loose fist and externally rotate the wrist to form a 45 degree angle to the IR

  CR: perp to the IR entering the midcarpal area

  SID: 40"

  Technique: 60 @ 2.5

  Structures: carpals, radius, ulna
• lateral position wrist

  IR size: 8x10 screen LW

  Patient position: seated, place medial border of the patients hand and wrist against the IR with the forearm resting on the table. Adjust the wrist to a true lateral position

  CR: perp to the IR entering the wrist joint

  SID: 40"

  Technique: 60 @ 4

  Structures: 1st metacarpal, trapezium, scaphoid, capitate, ulna, radius
• AP projection forearm

  IR size: 10x12 or 14x17 screen LW

  Patient position: seated with arm fully extended and hand supinated. The entire limb (shoulder, elbow, and wrist) should be in the same horizontal plane. Have the patient lean slightly lateral to achieve a true supinated position

  CR: perp to the IR entering the mid-forearm

  SID: 40"

  Technique: 66 @ 1.6

  Structures: radius, ulna, carpals, elbow joint, wrist joint
• Lateral projection forearm

  IR size: 10x12 or 14x17 screen LW

  Patient position: patient is seated with elbow flexed 90 degrees. The entire limb (shoulder, elbow, and wrist) should be in the same horizontal plane. Rotate the hand so the thumb is up to achieve a true lateral position

  CR: perp to the IR entering the mid-forearm

  SID: 40"

  Technique: 66 @ 1.6

  Structures: wrist joint, elbow joint, radius, ulna
• AP projection elbow

  IR size: 8x10 screen LW

  Patient position: seated, with arm fuly extended and hand supinated. The entire limb (shoulder, elbow, and wrist) should be in the same horizontal plane. Have the patient lean slightly lateral to achieve a true supinated position

  CR: perp to IR entering the elbow joint

  SID: 40"

  Technique: 60 @ 3.2

  Structures: humerus, lateral epicondyle, medial epicondyle, olecranon process, trochlea, coronoid tubercle, ulna, radius, radial tubercle, radial head, capitulum
• AP projection elbow partial flexion

  IR size: 8x10 screen LW

  Patient position: 1: seated with the upper arm resting on the IR and with elbow and shoulder in the same horizontal plane

  2: seated with the forearm resting on the IR and with elbow and wrist in the same horizontal plane

  CR:perp to the IR entering the elbow joint

  SID: 40"

  Technique: 60 @ 3.2

  Structures: humerus, radius, ulna, elbow joint
• AP oblique elbow lateral rotation

  IR size: 8x10 screen LW

  Patient position: seated with arm fully extended and hand supinated. The entire limb should be on the same horizontal plane. Have the patient lean laterally, rotating the hand until the 1st and 2nd digits touch the table, placing the elbow in a 45 degree lateral oblique position

  CR: perp to the IR entering the elbow joint

  SID: 40"

  Technique: 60 @ 3.2

  Structures: capitulum, lateral epicondyle, radial head, radial neck, radial tubercle, radius
• AP oblique elbow medial rotation

  IR size: 8x10 screen LW

  Patient position: patient is seated with arm fully extended placing the entire limb in the same horizontal plane. Pronate the hand placing the elbow in a 45 degree medial oblique

  CR: perp to the IR entering the elbow joint

  SID: 40"

  Technique: 60 @ 3.2

  Structures: humerus, medial epicondyle, trochlea, trochlear notch, coronoid process of the ulna, radius, ulna, radial head, olecranon process, olecranon fossa
• lateral elbow

  IR size: 8x10 screen LW

  Patient position: seated with elbow flexed 90 degrees. The entire limb should be in the same horizontal plane. Rotate the hand so the thumb is up to achieve a true lateral position

  CR: perpendicular to the IR entering the elbow joint

  SID: 40"

  Technique: 60 @ 3.2

  Structures: fat pads, coronoid process, radial head, trochlea sulcus, trochlear notch, olecranon process, epicondyles
• carpals

  A) trapezium

  B) trapezoid

  C) capitate

  D) hamate

  E) scaphoid

  F) lunate

  G) triquetrum

  H) pisiform

  
• forearm

  A) proximal radial ulnar joint

  B) olecranon process

  C) coronoid process

  D) coronoid tubercle

  E) body / shaft

  F) ulna

  G) ulnar notch on radius

  H) head

  I) styloid process

  J) distal radioulnar joint

  K) styloid process

  L) radius

  M) body / shaft

  N) radial tuberosity

  O) neck

  P) head

  Q) radial notch on the ulna

  
• proximal ulna

  A) olecranon process

  B) trochlear notch

  C) coronoid process

  D) radial notch

  
• elbow

  A) region of radial and coronoid fossa

  B) ridge of the capitulum

  C) trochlea

  D) coronoid process

  E) radial tuberosity

  F) neck

  G) head

  H) trochlear sulcus

  I) trochlear notch

  J) olecranon process

  K) epicondyle

  L) region of olecranon fossa

  
• elbow

  A) body / shaft

  B) coronoid fossa

  C) medial epicondyle

  D) humeral condyle

  E) trochlea

  F) trochlear sulcus

  G) ulna

  H) radius

  I) head of radius

  J) capitulum

  K) lateral epicondyle

  L) radial fossa

  
• wrist

  A) triquetrum

  B) pisiform

  C) ulnar collateral ligament

  D) lunate

  E) distal radioulnar joint

  F) radiocarpal joint

  G) scaphoid

  H) radial collateral ligament

  I) trapezium

  
• arthrology

  A) elbow joint - ginglymus (hinge) type

  B) proximal radioulnar joint - trochoidal (pivot) type

  
• indications

  fracture

  pain

  osteomyelitis

  foreign body

  ORIF

  osteoporosis

  osteoarthritis

  rheumatoid arthritis

  trauma

  FOOSH
• CR for PA wrist

  perpendicular to the IR entering the midcarpal area
• CR for PA oblique wrist

  perpendicular to the IR entering the midcarpal area
• CR for lateral wrist

  perpendicular to the IR entering the wrist joint
• CR for AP forearm

  perpendicular to the IR entering the mid-forearm
• CR for lateral forearm

  perpendicular to the IR entering the mid forearm
• CR for AP elbow

  perpendicular to the IR entering the elbow joint
• CR for AP elbow partial flex

  perpendicular to the IR entering the elbow joint
• CR for AP oblique elbow lateral rotation

  perpendicular to the IR entering the elbow joint
• CR for AP oblique elbow medial rotation

  perpendicular to the IR entering the elbow joint
• CR for lateral elbow

  perpendicular to the IR entering the elbow joint