1. Positioning Review of Upper and Lower Extremities
Reference
Images in this presentation are from:
Merrill’s Atlas of Radiographic Positioning and Procedures.
Eugene Frank, Bruce Long, Barbara Smith

2. Fingers PA
Fifth Digit
Second Digit
Third Digit
Fourth Digit
CR - PIP

3. Lateral
Fifth Digit
Second Digit
Third Digit
Fourth Digit

4. Thumb AP
CR – MCP

5. Lateral

6. Hand AP
CR – 3rd MCP

7. PA Oblique

8. Lateral
Fan Lateral
Extension Lateral

9. Wrist PA CR – Mid Carpal 1. Scaphoid = Navicular 2. Lunate= Semilunar
3. Triquetrum = Triquetral, Triangular
4. Pisiform
5. Trapezium = Greater Multangular
6. Trapezoid = Lesser Multangular
7. Capitate = Os Magnum
8. Hamate = Unciform
CR – Mid Carpal

10. Lateral

11. PA Oblique

12. AP Oblique

13. Ulna Deviation – Ulna Flexion

14. Stecher Method – Cassette raised

15. Stecher Method – Tube angled

16. Carpal Tunnel (Tangential Projection) - Gaynor-Hart Method

17. Forearm AP

18. Lateral

19. Elbow AP
Epicondyles are parallel to the IR

20. Lateral
Epicondyles are perpendicular to the IR

21. Medial (Internal) Rotation Oblique

22. Lateral (External) Rotation Oblique

23. Distal Humerus – Partial Flexion AP
Patient may be unable to extend elbow due to dislocation or injury.
2 views are needed in this case, one for distal humerus and one for proximal forearm.
Distal humerus: humerus is on table in same plane
may need to support forearm
Supinate hand
Proximal Forearm: Patient may be standing or may have to elevate cassette under arm
forearm is on cassette
CR is perpendicular to elbow jt.

24. Proximal Forearm – Partial Flexion AP

25. Humerus AP

26. Lateral

27. Transthoracic Lateral

28. Lower Extremity

29. Toes AP – Perpendicular CR
CR - 3rd MTP

30. AP Axial

31. AP Oblique – Medial Rotation

32. Foot AP Axial
CR - Base of 3rd metatarsal

33. AP Oblique – Medial Rotation

34. Lateral - Mediolateral

35. Ankle AP

36. Lateral - Mediolateral

37. Medial Rotation (Internal) Oblique for bony structures

38. 15-20 degree Medial Rotation for Ankle Mortise Joint

39. Lateral (External) Rotation Oblique

40. Stress Method Inversion Stress Everson Stress
For verification of ligament tear
Inversion Stress
Everson Stress

41. Calcaneus Axial – Plantodorsal
CR - base of 3rd metatarsal

42. Lateral Calcaneus
CR - 1” distal to medial malleoulus

43. Lower Leg AP

44. Lateral

45. Knee AP – Sthenic Patient
CR - 1/2” distal to apex of patella

46. AP - Hypersthenic Patient

47. AP - Asthenic Patient

48. Lateral

49. AP Oblique - Lateral (External) Rotation

50. AP Oblique – Medial (Internal) Rotation

51. Bilateral knees – weight- bearing

52. Patella PA
CR - mid patella

53. Lateral Patella

54. Settegast Method for Patella “Sunrise or Skyline View”
Typical tube angle is degrees

55. Hughston Method for Patella
Lower leg forms degree angle from table

56. Intercondylar Fossa - PA Axial Projection (Holmblad Method)
Femur is at 20 degree angle
“Tunnel” projection

57. Camp-Coventry Method
If knee is flexed 40 degrees, the tube is angled 40

58. Femur
AP Projection (for distal femur)

59. AP Projection (for proximal femur)

60. Lateral femur to include knee

61. Lateral Projection (for proximal femur)