Wrist Carpal Tunnel View
4
Feb

Overview

The carpal tunnel tangential view images the pisiform and volar aspect of the carpal bones to evaluate for pisotriquetral pathology and space occupying lesions. The beam is angled tangentially to the carpal tunnel. This projection is used selectively for specific clinical questions.

Technique

Position the wrist in hyperextension with the beam angled tangentially to the carpal tunnel. Center to the pisiform and use a small focal spot for detail. Immobilize the wrist to reduce motion and ensure reproducibility.

Clinical Indications

Carpal tunnel view is indicated for suspected pisiform fractures ganglia or space occupying lesions causing median nerve compression. It complements standard wrist series and ultrasound or MRI for soft tissue evaluation. Use selectively due to patient discomfort in hyperextension.

Image Assessment

Assess pisiform integrity volar carpal contour and presence of calcified or radiopaque lesions. Correlate with clinical signs of median nerve compression. Recommend further imaging such as MRI for soft tissue characterization.

Elbow Radial Head View
4
Feb

Overview

The radial head view profiles the radial head and neck to detect subtle fractures and impaction injuries. The projection is obtained with the elbow flexed and the beam angled to profile the radial head. This view complements standard AP and lateral elbow radiographs.

Technique

Position the elbow in partial flexion and rotate the hand to profile the radial head. Use a small focal spot and tight collimation for detail. Immobilize the limb to minimize motion artifact.

Clinical Indications

Radial head views are indicated for trauma with lateral elbow pain and suspected radial head fracture. They help detect nondisplaced fractures that may be occult on standard views. CT or MRI may be used for complex or occult injuries.

Image Assessment

Evaluate radial head cortical continuity articular surface and neck for fracture lines. Assess for joint effusion and associated capitellar injury. Report findings relevant to orthopedic management.

Forearm AP and Lateral
4
Feb

Overview

AP and lateral forearm radiographs evaluate the entire radius and ulna including wrist and elbow joints. These views are essential for detecting shaft fractures and assessing alignment. Proper positioning ensures both joints are included for comprehensive assessment.

Technique

Obtain AP view with the palm up and the forearm flat on the detector. For lateral view flex the elbow 90 degrees and superimpose the radius and ulna. Use appropriate exposure and immobilize the limb to reduce motion.

Clinical Indications

Forearm series are indicated for trauma pain and suspected shaft fractures or dislocations. They assess for malrotation and joint involvement. CT is used for complex fractures and preoperative planning.

Image Assessment

Inspect cortical continuity alignment and joint congruity at the wrist and elbow. Evaluate for plastic deformation in pediatric patients and growth plate involvement. Document displacement and recommend orthopedic follow up when indicated.

Clavicle AP Axial
4
Feb

Overview

AP axial clavicle radiographs use tube angulation to better visualize medial and lateral clavicular ends. The axial projection reduces overlap with thoracic structures and improves detection of subtle fractures. It is useful in trauma and follow up imaging.

Technique

Apply a cephalad tube angle and center to the clavicle ensuring the entire bone is included. Use immobilization and appropriate exposure settings. Document angle used for reproducibility.

Clinical Indications

AP axial clavicle is indicated for suspected medial or lateral clavicle fractures and non union assessment. It complements standard AP views for comprehensive evaluation. Orthopedic consultation is guided by displacement and joint involvement.

Image Assessment

Evaluate cortical continuity and alignment at the sternoclavicular and acromioclavicular ends. Assess for shortening and comminution. Report findings and recommend further imaging if surgical planning is required.

Scapula AP and Lateral
4
Feb

Overview

AP and lateral scapula views evaluate the scapular body spine and glenoid for fractures and deformity. The AP view images the scapula en face while the lateral view profiles the scapular body. These projections are used in trauma and shoulder pathology assessment.

Technique

For AP scapula position the arm across the chest and center the detector to the scapula. For lateral scapula rotate the patient to project the scapula laterally with the arm raised. Use appropriate exposure and immobilize the patient.

Clinical Indications

Scapula views are indicated for trauma with shoulder girdle injury and persistent localized pain. They detect scapular body fractures and glenoid rim involvement. CT is used for complex fractures and surgical planning.

Image Assessment

Assess scapular body contour spine acromion and glenoid rim for cortical disruption. Evaluate for associated rib or clavicle injuries. Report findings relevant to orthopedic referral.

Clavicle AP with Cephalad Angle
4
Feb

Overview

AP clavicle with cephalad angulation projects the clavicle free of thoracic structures for improved visualization. A slight cephalad tube tilt reduces overlap with the ribs and scapula. This view enhances detection of subtle fractures and displacement.

Technique

Center the detector to the clavicle and apply a cephalad tube angle typically 15 to 30 degrees. Ensure the patient is upright or supine and immobilize the arm to reduce motion. Collimate to the clavicle to minimize dose.

Clinical Indications

This projection is indicated when standard AP views do not adequately visualize the clavicle. It helps assess fracture displacement and involvement of adjacent joints. Follow up radiographs monitor healing and alignment.

Image Assessment

Evaluate cortical continuity clavicular alignment and displacement. Inspect for shortening and involvement of the acromioclavicular or sternoclavicular joints. Report findings for orthopedic management.

Shoulder AP with Weights
4
Feb

Overview

AP shoulder views with weights in the hands accentuate inferior subluxation and rotator cuff arthropathy. The patient stands holding light weights to apply gentle traction. Comparison with non weighted views highlights dynamic changes.

Technique

Obtain standard AP shoulder radiographs with the patient holding equal weights in both hands. Ensure consistent exposure and positioning between weighted and non weighted views. Use caution in painful or unstable shoulders.

Clinical Indications

Weighted views are indicated for suspected chronic rotator cuff tear and inferior subluxation. They help demonstrate humeral head migration under load. MRI provides soft tissue detail when indicated.

Image Assessment

Compare humeral head position relative to the glenoid with and without weights. Assess for superior migration and joint space narrowing. Report findings relevant to surgical planning and rehabilitation.

Hip Cross Table Lateral
4
Feb

Overview

The cross table lateral hip view images the proximal femur and hip joint when the patient cannot abduct the leg. The detector is placed lateral to the hip and the beam directed horizontally. This projection is useful for trauma patients and postoperative assessment.

Technique

Keep the patient supine and place the detector parallel to the femoral neck on the unaffected side. Use a horizontal beam and ensure the contralateral limb is moved out of the field. Use appropriate exposure and immobilize the patient.

Clinical Indications

Cross table lateral is indicated for suspected femoral neck fractures in patients who cannot be positioned for frog leg views. It provides lateral visualization without moving the injured limb. CT may be used for occult fractures.

Image Assessment

Evaluate femoral head neck alignment cortical integrity and displacement. Assess for intra articular extension and joint congruity. Report findings relevant to urgent orthopedic management.

Pelvis Judet Views
4
Feb

Overview

Judet views are oblique pelvic radiographs that profile the anterior and posterior acetabular columns. They are obtained in two oblique positions to assess column integrity and fracture patterns. These views aid in initial assessment of acetabular trauma.

Technique

Rotate the patient 45 degrees to obtain iliac oblique and obturator oblique projections. Center the detector to the acetabulum and use appropriate exposure. Immobilize the patient and document positioning for comparison.

Clinical Indications

Judet views are indicated for suspected acetabular fractures and complex pelvic trauma. They help differentiate column involvement and guide surgical planning. CT is often used for definitive fracture mapping.

Image Assessment

Assess anterior and posterior column continuity acetabular roof and joint congruity. Look for intra articular fragments and displacement. Report findings to inform orthopedic management and operative approach.

Pelvis Outlet View
4
Feb

Overview

The outlet view projects the sacrum and pubic rami to evaluate vertical displacement of the pelvic ring. The beam is angled cephalad to visualize the sacral foramina and pubic symphysis. This projection is useful in trauma to assess vertical shear injuries.

Technique

Angle the tube cephalad typically 40 degrees and center to the pubic symphysis. Keep the patient supine and immobilized to avoid motion. Use appropriate exposure to penetrate pelvic structures.

Clinical Indications

Outlet views are indicated for suspected vertical pelvic displacement and sacral fractures. They complement inlet and AP views for comprehensive pelvic trauma evaluation. CT provides detailed assessment for surgical planning.

Image Assessment

Evaluate sacral alignment pubic symphysis height and vertical displacement of hemipelvis. Inspect for sacral fractures and sacroiliac widening. Document measurements and recommend advanced imaging when indicated.