LESSON 1

RADIOGRAPHIC POSITIONING AND TERMINOLOGY

ANATOMICAL POSITION SPECIAL PLANES:

• Standing upright/erect INTERILIAC PLANE
• Face and eyes directed forward Transects the pelvis at the top of
• Arms extended by the sides the iliac crest
• Palms turned forward Level: L4 spinous process
• Heels together Used in positioning:
• Toes pointing anteriorly Lumbar spine
Sacrum
BODY PLANES AND SPECIAL Coccyx
PLANES
SAGITTAL OCCLUSAL PLANE
Right and left Formed by biting surfaces of the
Midsagittal: equal right and left upper and lower teeth with jaws
Parasagittal: unequal right and left closed
Used in positioning:
CORONAL Odontoid process
Anterior and posterior Some head projections
Midcoronal/Midaxillary plane:
equal anterior and posterior SURFACE LANDMARKS:

HORIZONTAL
Right angle to the long axis of the
body
Cross-sectional/Transv erse/Axial
plane

OBLIQUE
At any angle among the three
LESSON 1
RADIOGRAPHIC POSITIONING AND TERMINOLOGY

SUPERIOR VS INFERIOR
SUPERIOR
Nearer to the head or situated
above

INFERIOR
Nearer to the feet or situated
below

ANATOMIC
CENTRAL VS PERIPHERAL
RELATIONSHIP TERMS:
CENTRAL
Midarea or main part of an organ
ANTERIOR VS POSTERIOR
ANTERIOR/VENTRAL
PERIPHERAL
Forward or front part of the body
Parts at or near the surface, edge
or organ
or outside of the body part

POSTERIOR/DORSAL/ NOTAL
MEDIAL VS LATERAL
Back part of the body or organ
MEDIAL
Parts toward the median plane or
CAUDAD VS CEPHALAD
toward the middle of the body
CAUDAD
Parts away from the head of the
LATERAL
body
Parts away from the median plane
or away from the middle part of
CEPHALAD
the body
Parts toward the head of the body
LESSON 1
RADIOGRAPHIC POSITIONING AND TERMINOLOGY

PROXIMAL VS DISTAL PROXIMAL VISCERAL

PROXIMAL Covering of an organ
Parts nearest the point of
attachment/origin IPSILATERAL VS CONTRALATERAL
IPSILATERAL
DISTAL Parts on the same side of the body
Parts farthest from the point of
attachment/origin CONTRALATERAL
Parts on the opposite side of the
EXTERNAL VS INTERNAL body
EXTERNAL
Parts outside of an organ/body PALMAR VS DORSUM (HAND)
PALMAR/VOLAR
INTERNAL Palm of the hand
Parts inside of an organ/body
DORSUM
SUPERFICIAL VS DEEP Back or posterior surface of the
SUPERFICIAL hand
Parts near the skin or surface
PLANTAR VS DORSUM (FEET)
DEEP PLANTAR
Parts far from the surface Sole of the foot

PARIETAL VS VISCERAL DORSUM

PARIETAL Top or anterior surface of the foot
Wall or lining of a body cavity
LESSON 1
RADIOGRAPHIC POSITIONING AND TERMINOLOGY

ANTEROPOSTERIOR (AP)
PROJECTION
A perpendicular CR enters the
front (anterior) body surface and
exit the back (posterior) body
surface

POSTEROANTERIOR (PA)
PROJECTION
A perpendicular CR enters the
back (posterior) body surface and
RADIOGRAPHIC POSITIONING
exit the front (anterior) body
TERMINOLOGY:
surface
MOST COMMONLY USED
• Relationship formed between
POSITIONING TERMS:
the central ray and the body
PROJECTION
– e.g. Axial & Tangential Projection
POSITION
VIEW
AXIAL PROJECTION
METHOD
There is a longitudinal angulation
of CR with the long axis of the
PROJECTION
body 10 degrees or more
• Path of the central ray as it goes
through the patient to the IR – e.g.
TANGENTIAL PROJECTION
AP or PA projection
CR is directed toward the outer
• The entrance and exit points in
margin of a curved body surface
the body
• Based on anatomical position
CR skims the surface of the body
LESSON 1
RADIOGRAPHIC POSITIONING AND TERMINOLOGY

To project the part free of POSITION

superimposition • Identifies the overall posture or
the general body position
LATERAL PROJECTION • The specific placement of the
CR enters one side of the body body part in relation to the
and exits the opposite side radiographic table/image receptor
• e.g. seated upright, supine,

UPRIGHT POSITION
Erect or marked by a vertical
position

SEATED-UPRIGHT POSITION
Sitting on a chair or stool
OBLIQUE PROJECTION
RECUMBENT POSITION
CR enters the body from a side
General term referring to lying
angle following an oblique plane
down in any position
e.g. AP or PA Oblique Projections

SUPINE POSITION
AP OBLIQUE PROJECTION
Lying on the back
CR enters the anterior surface and
exits posteriorly
PRONE POSITION
Lying face down
PA OBLIQUE PROJECTION
CR enters the posterior surface
TRENDELENBURG POSITION
and exits anteriorly
Supine position with head lower
than feet
LESSON 1
RADIOGRAPHIC POSITIONING AND TERMINOLOGY

FOWLERS POSITION CR horizontal and parallel with the

Supine position with head higher floor
than feet e.g. ventral, dorsal or lateral
decubitus
SIMS POSITION Used to demonstrate air-fluid
A recumbent position with the levels or free-air in the chest and
patient lying on the left anterior abdomen
side (semiprone) and the right LORDOTIC POSITION
knee and thigh partially flexed Achieved by having the patient
lean backward while in upright
LITHOTOMY POSITION position so that shoulders are in
A supine position with knees and contact with the IR
hip flexed and thighs abducted
and rotated externally Used for visualization of
pulmonary apices
LATERAL POSITION
Always named according to the VIEW AND METHOD:
side closest to the IR VIEW
Used to described the body part
OBLIQUE POSITION as seen by the IR Exact opposite of
Achieved when the entire body is projection
rotated so that the coronal plane is
not parallel with the radiographic METHOD
table or IR Named after individuals in
recognition of their development
DECUBITUS POSITION of a method to demonstrate a
Indicates that the patient is lying specific anatomic part
down e.g. Water, Caldwell, Townes
LESSON 1
RADIOGRAPHIC POSITIONING AND TERMINOLOGY

BODY MOVEMENT TERMINOLOGY: EVERSION VS INVERSION

ABDUCTION VS ADDUCTION EVERT/EVERSION
ABDUCT/ABDUCTION Outward turning of the foot at the
Movement of a part away from the ankle
central axis of the body
INVERT/INVERSION
ADDUCT/ADDUCTION Inward turning of the foot at the
Movement of a part toward the ankle
central axis of the body
SUPINATION VS PRONATION
EXTENSION VS FLEXION SUPINATE/SUPINATION
EXTENSION Rotation of the forearm so that the
Straightening a joint The normal palm is up
position of a joint
FLEXION PRONATE/PRONATION
Act of bending a joint Opposite of Rotation of the forearm so that the
extension palm is down

HYPEREXTENSION VS ROTATE/ROTATION
HYPERFLEXION turning or rotating of the body
HYPEREXTENSION around its axis e.g. medial or
Forced or excessive extension of a lateral rotation
limb or joints
CIRCUMDUCTION
HYPERFLEXION A turning away from the regular
Forced overflexion of a limb or standard or course
joints
LESSON 1
RADIOGRAPHIC POSITIONING AND TERMINOLOGY

TILT VS DEVIATION DEPRESSION

TILT Downward movement of a part of
Tipping or slanting a body part the body
slightly Related to the long axis of
the body

DEVIATION
A turning away from the regular
standard or course
Palmar dev.
Ulnar dev.

PROTRACTION VS RETRACTION
PROTRACTION
A movement of part of the body
anteriorly in a transverse plane

RETRACTION
A movement of part of the body
posteriorly in a transverse plane

ELEVATION VS DEPRESSION
ELEVATION
Upward movement of a part of the
body
 RADIOGRAPHIC POSITIONING AND PROCEDURES 1
2nd - 5th Digits OPTION: Rotate the second digit medially from the
prone position
PA Projection
→ part is closer to the IR for
1.
Lateral
improved recorded detail
2.
Oblique
and increased ability to see
3.

certain fractures.
PA PROJECTIONS 2ND - 5TH

→ Px. Seated at the end of

the radiographic table.
→ Digits are extended and
placed PARALLEL to the
IR.
→ Palmar surface down.
Separate digits slightly.
Center PIPJ to the IR.
→ Shield gonads from
scattered radiation.

CR: Perpendicular to the PIPJ

EC: - Open IP and MC joint

spaces w/o overlap of bones.

→ Fingernails, if visualized
and normal, centered
over the distal phalanx.
→ Concavity of the
phalangeal shafts.

LATERAL PROJECTIONS 2ND -

5TH
shall be included.
→ Px. Seated at the end of bones.
the radiographic table.
→ Digits are extended and
placed PARALLEL to the
IR.
(FIRST DIGIT) THUMB
→ Only the 2nd and 5th digit can
rest directly in the IR. AP PROJECTION
→ 2nd digit-hand in internal rotation.
→ Hand in EXTREME INTERNAL ROTATION.
→ Shield gonads from scattered
radiation.
PA PROJECTION
CR: Perpendicular to the PIPJ
→ Hand in LATERAL POSITION, thumb is abducted.
EC: Open IPJ spaces w/obstruction of proximal phalanx → The Dorsal surface of the digit is parallel to the IR.
and MCP.

→ Fingernail, if visualized and normal Concave,

anterior surfaces of the phalanges.
LATERAL POSITION
→ Hand in natural arched position,
PALMAR surface down. → Adjust the arching of the
hand.
PA OBLIQUE
PROJECTIONS 2ND-5TH
OBLIQUE POSITION
→ Px. Seated at the end of the → PALMAR surface down.
→ Normal placement position of the thumb.
→ radiographic table. Ulnar
side down
→ 45 degrees obliquity-
Lateral Rotation
→ Foam wedges are used to
CR: Perpendicular to the 1st MCPJ
support the digits in a position PARALLEL with
EC: area from the distal tip of the thumb to the
the film.
trapezium
CR: Perpendicular to the PIPJ
→ Open IP and MC joint spaces w/o overlap of
EC: Open IP and MC joint spaces. The entire digit
rotated at a 45-degree angle, including the distal → Soft tissue and bony trabeculation.
portion of the adjoining metacarpal. *PA thumb projection will be MAGNIFIED.
 RADIOGRAPHIC POSITIONING AND PROCEDURES 1
produce a magnified image.

FIRST CARPOMETACARPAL JOINT → Shows the CONCAVOCONVEX outline of the first

CMCJ.
RoBurF
→ Trapezium in concave, base of first MC convex.
1. Robert’s Method R - Robert Method ⊥
→ Gives a clearer image of the first CMCJ than the
L – 10o – 15o standard AP projection.
RL – 15o
FOLIO METHOD (PA Stress Projection)
2. Burman’s Method 45o
3. Folio Method PA Stress Method Useful for the diagnosis of ulnar collateral ligament
(UCL) rupture in the MCP joint of the thumb, also
known as a "skier's thumb”.
ROBERT METHOD / MODIFIED ROBERT'S METHOD
→ Place a round spacer between the proximal
CR: PERPENDICULAR/15 DEG thumb and distal thumbs wrapped with
Towards the wrist to the 1 CMCJ rubber bands.
→ Ask the Px. To pull thumbs apart. Keep
LONG AND RAFERT METHOD thumbnails parallel to the cassette.
→ Have the correct technical factors &
CR: 15 DEGREES PROXIMALLY to the 1st CMCJ before instructing the Px to pull thumbs apart.

LEWIS METHOD CR: Perpendicular to the midway between the 1 MCPJ

CR: 10-15 DEGREES PROXIMALLY to the 1st SS (structure shown): Demonstrates the MCPJ and
MCPJ metacarpal phalangeal angles bilaterally.

These projections are commonly performed to HAND (1ST DIGIT – THUMB)

demonstrate arthritic changes, fractures, displacement
of the first CMC joint, and Bennett’s fracture. 1. PA Projection
AP Projection
Demonstrate the first CMC joint free of superimposition
2.
Lateral Position (Extension, Flexion, Fan Lateral)
of the soft tissues of the hand.
3.
4. Oblique Position (NORGAARD METHOD)
NOTE: Purpose of CR angulation
PA Projection
It may help project the soft tissue of the hand
away from the first CMC joint.
1.
→ Rest px's forearm on
It can help open the joint space when the space the table.
is not shown with a perpendicular central ray. → The long axis of the
2.

film is parallel with

EC: the long axis of the
hand and forearm.
→ First CMC joint free of superimposition of the
→ Provides frontal
hand or other bony elements.
image of the carpals,
→ First metacarpal with the base in convex profile
metacarpals, and
Trapezium
phalanges.
→ PROVIDES OBLIQUE
IMAGE OF
THE THUMB.

CR: PERPENDICULAR to the 3rd MCPJ

BURMAN METHOD
AP projection of the carpometacarpal joint of the thumb
by radial shift of the carpal tunnel view.
SS: PA projection of the carpals, metacarpals, and
phalanges. (This indicates that the hand is rested flat on
the IR)
→ Interarticulations of the hand and DISTAL radius
and ulna.
→ Equal concavity of the metacarpal and phalangeal
shafts on both sides.
NOTE: AP projection is used if the px cannot the hand
enough to place the palmar surface on the cassette.

→ Hand internally PA OBLIQUE PROJECTION

rotated and
dorsiflexed. → 45 DEGREE
Thumb abducted. obliquity
→ Rotate the hand to → FOR IPJ: use a
place the first 45degree foam
digit in wedge. IF
HORIZONTAL METACARPALS IS
POSITION. OF PRIMARY
INTEREST:
CR: 45 DEGREES to the
Rotate the
1st CMCJ towards the
patient's hand
elbow. SID 18 inches to
medially
 RADIOGRAPHIC POSITIONING AND PROCEDURES 1
from lateral position so that fingertips CR: point midway between both hands at the level of the
touch the cassette. METACARPALS.

CR: PERPENDICULAR to the 3rd MCPJ SS: Used for

investigating fractures and pathologic conditions.
WRIST
→ minimal overlap of 3-4 and 4-5 metacarpal shafts.
→ Separation of 2nd and 3rd metacarpal shafts. PA Projection – flexed digits
→ Open IP and MCP
1.
AP Projection – elevated
joints.
digits
2.
NOTE: AP projection is
used if the px cannot the 3. Lateral Projection
hand enough to place the PA Oblique Projection
(Lateral Rotation)
4.
palmar surface on the
cassette. – “PA-LAST”
LANE, KENNEDY & AP Oblique Projection
KUSCHNER: Reverse (Medial Rotation) – “AMED-
5.

oblique projection to better TPH”

demonstrate severe PA Projection (Ulnar
metacarpal deformities or Deviation) – interspaces are
6.

fractures. more visible.

PA Projection (Radial
Deviation)
7.
LATERAL PROJECTION
st

PA Axial Projection
LATERAL IN EXTENSION (STETCHER METHOD) –
8.

“SSS 20o
→ Digits are extended,
THUMB at right angle SCAPHOID SERIES
(RAFERT-LONG METHOD) –
9.
to the cassette, → Ulnar
aspect down 4in1 “SS ⊥, 10o, 20o, 30o”
10. ClemenTs – NAKAYAMA
METHOD – “CR: 45o
LATERAL IN FLEXION distally” SS: Trapezium
11. TANGENTIAL Projection (Carpal Bridge) –
→ Px. relaxing the digits in natural arch of the hand dorsum ng wrist “MANO PO PROJECTION”
with perfect superimposition. 12. TANGENTIAL Projection (GAYNOR-HART
METHOD)

FAN LATERAL Preferred Synonyms

Proximal Row
→ Eliminates superimposition of the
phalanges for all except the Scaphoid Navicular
proximal part. Lunate Semilunar
Triquetrum Triquetral, cuneiform, or
triangular
CR: PERPENDICULAR to the 2nd MCPJ
Pisiform None
SS: Used to demonstrate ANTERIOR OR POSTERIOR
Distal Row
DISLOCATION OF FRACTURES IN THE
METACARPALS.
Trapezium Greater Multangular
Extension: Customary position for localizing foreign
bodies. Trapezoid Lesser Multangular
LEWIS: 5 degrees posteriorly; for fractures of fifth Capitate Os Magnum
metacarpals. Hamate Unciform

AP OBLIQUE PROJECTION

NORGAARD METHOD PA PROJECTION

→ Assists in detecting → Rest forearm and center wrist to

rheumatoid IR.
arthritis at → Flex digits to rest the wrist in
the second close contact with the cassette.
through fifth CR: ⊥ MIDCARPAL AREA
proximal SS: gives slight oblique projection of
phalanges the ulna.
and → When ULNA is under examination use PA
MCP joints. Projection.
→ STAPCZYNSKI - → Scaphoid with self-superimposition.
recommended this
projection for the demonstration of
fracture of the base of the fifth. metacarpal.
→ BALL-CATCHER'S POSITION AP PROJECTION
→ half-supinate position, 45 degrees medial rotation.
→ Rest forearm and center wrist to
 RADIOGRAPHIC POSITIONING AND PROCEDURES 1
IR, hand is supinated. PA PROJECTION (RADIAL
→ Have px lean laterally to prevent rotation. DEVIATION)
→ Elevate digits to rest the wrist in close contact
with the cassette. → Move the elbow towards the
CR: ⊥ MIDCARPAL AREA SS: Carpal interspaces are patient's body.
better demonstrated in AP than PA. → Cup one hand over the wrist
→ Oblique direction of the interspaces is more joint to hold it in
closely parallel with the divergence of the x-ray CR: ⊥ MIDCARPAL AREA
beam. SS: opens the interspaces between
→ Well demonstrated soft tissue and bony the carpals on the MEDIAL SIDE OF
trabeculation. THE WRIST.

Lateral Projection
PA AXIAL PROJECTION
→ Rest arm and forearm, flex elbow
(STETCHER METHOD)
90 degrees.
→ Elevate digits to rest the wrist in → The finger end elevated 20
close contact with the cassette. degrees to the horizontal or
CR: ⊥ WRIST JOINT central ray is directed 20
SS: Lateral projection of the proximal degrees towards the elbow.
metacarpals, carpals, and distal radius CR: ⊥ to the table to enter at the
and ulna SCAPHOID
→ Demonstrates anterior and posterior displacement SS: 20-degree angulation of the wrist places the
of fracture. scaphoid at right angles to the central ray.
- FIOLLE (PALMAR FLEXION) - first to → Scaphoid is projected without
describe carpe bossu (carpal boss) at the self- superimposition.
dorsal surface of the 3rd CMC joint. → BRIDGMAN - Suggested positioning the wrist in
ulnar deviation for this radiograph.

PA OBLIQUE PROJECTION SCAPHOID SERIES (RAFERT-LONG METHOD)

(LATERAL ROTATION)
→ Used in diagnosing scaphoid
→ From the pronated position, fractures using a four-image,
rotate the wrist laterally until it forms multiple-angle central ray
45 degrees. CR: ⊥ MIDCARPAL AREA series.
enters just distal to the radius. → Performed after routine wrist
SS: Carpals on the LATERAL SIDE of radiographs do not identify a
the wrist. fracture.
→ TRAPEZIUM and SCAPHOID PP (patient position):
Without moving the forearm,
turn the hand outward until the
AP OBLIQUE PROJECTION (MEDIAL ROTATION) wrist is in extreme ulnar deviation.
CR: ⊥ and multiple cephalad angle of 10, 20 and 30
→ Rest forearm on table, wrist degrees.
medially rotated from supine SS: Scaphoid is demonstrated with
until it forms 45 degrees. minimal superimposition.
CR: ⊥ MIDCARPAL AREA
SS: Best for PISIFORM
→ TRIQUETRUM, HAMATE, AND PA AXIAL OBLIQUE PROJECTION (CLEMENTS-
PISIFORM free of NAKAYAMA METHOD)
superimposition and in profile Used in diagnosing TRAPEZIUM
→ Demonstrates carpal on the → Fracture of SCAPHOID
MEDIAL SIDE. → LUNATE dislocation
→ Calcification and Foreign bodies in the dorsal

PA PROJECTION (ULNAR DEVIATION) TANGENTIAL PROJECTION (CARPAL BRIDGE)

→ Move the elbow away from the wrist.

patient's body. → Chip fractures in the dorsal
→ Turn the hand outward until aspect of carpal bone.
the wrist is in extreme ulnar PP: Hand at right angle to the
deviation. forearm.
CR: ⊥ SCAPHOID Lie palm upward on the IR.
Clear delineation sometimes
1.
2 Elevating the forearm on
requires a central ray angulation of sandbags or flexed in right-
2.

10 to 15 degrees proximally or other suitable support the IR in the angle

distally. position, place vertical position.
SS: Corrects FORESHORTENING OF THE SCAPHOID.
 RADIOGRAPHIC POSITIONING AND PROCEDURES 1
CR:1½ inches proximal to wrist joint, 45 degrees caudad. 2. Lateral Projection
SS: Dorsal surface of the carpals free of superimposition
by the metacarpal bases AP PROJECTION
→ Radial HNT is partially superimposed over the
TANGENTIAL PROJECTION (GAYNOR-HART METHOD) proximal ulna.
PP: elbow is extended, and hand is supinated, have the
→ Shows COMPRESSION OF THE MEDIAN NERVE, patient lean laterally.
as with CARPAL TUNNEL SYNDROME. PP: - Adjust the humeral epicondyles to be
Hyperextend the wrist, IR centered to the joint at the equidistant from the IR.
level of the RADIAL STYLOID PROCESS. CR: ⊥ to the midpoint of the forearm.
1. Forearm parallel with the long axis of the table. SS: Dorsal surface of the carpals free of superimposition
CR: 1 inch distal to the base of the third metacarpal. by the metacarpal bases
2530 degrees.
SS: Palmar aspect of the trapezium LATERAL PROJECTION
PP: Flex the elbow 90 degrees,
→ Tubercle of the trapezium
Epicondyles are perpendicular and superimposed.
→ Scaphoid, capitate, hamulus, triquetrum and
CR: ⊥ to the midpoint of the forearm.
entire pisiform.
SS: radius and ulna superimposed on distal end.
→ PISIFORM and HAMULUS in profile
→ The radial head partially superimposed on
coronoid process.
ELBOW
→ The elbow joint to proximal row of carpal bones.
AP Projection
→ RADIAL TUBEROSITY FACES ANTERIORLY.
1.
fractures.
PP: Wrist in the lateral position, resting on the ulnar
surface.
- 45 degrees obliquity
CR: 45 degrees distally to enter the ANATOMIC
SNUFFBOX of the wrist and pass through the
trapezium. SS: Trapezium projected free of the other
carpal bones with the exception of the articulation with
the scaphoid.
ELBOW
Three Fat pads:
Supinator fat pad – anterior and
parallel with the anterior aspect of the
proximal radius.
Anterior fat pad – lies on the anterior
humerus.
Posterior fat pad –largest, lies within
the olecranon fossa of the distal
humerus.
- Visualized only in lateral projection
of the elbow.
*Posterior fat pad is not visualized
radiographically on a normal elbow.
LATERAL PROJECTION
Elbow flexed 90 degrees Importance
Acc. To Griswold:
1. Olecranon process can be seen in
profile.
2. The elbow fat pads are least
compressed
PP: Flex the elbow 90 degrees,
- Epicondyles are PERPENDICULAR
AND SUPERIMPOSED.
CR: ┴ to the ELBOW JOINT SS: radius
and ulna superimposed on distal end.
- radial head partially superimposed
on coronoid process.

- RADIAL TUBEROSITY FACES

ANTERIORLY.

- OLECRANON PROCESS SEEN IN

PROFILE

SOFT TISSUE – flex the elbow 30-35

degrees only.
AP PROJECTION *partial flexion do not compress or
PP: elbow is extended and hand is stretch the soft tissue structures.
supinated.

- Px. leaning laterally, EPICONDYLES

PARALLEL to IR.

CR: ┴ to ELBOW JOINT

SS: Radial HNT is partially

superimposed over the proximal ulna

AP OBLIQUE PROJECTION (MEDIAL

ROTATION)
PP: extend the limb in position for AP
projection, center IR to the elbow joint.

- PRONATE the hand.

- adjust the elbow to place its anterior

surface at an angle of 45 degrees.

CR: ┴ to ELBOW JOINT

SS: CORONOID PROCESS free of
superimposition. - Elongated medial
humeral epicondyle.
 - hand PRONATED
CR: 45 deg. FROM the shoulder.

AP OBLIQUE PROJECTION (LATERAL

ROTATION)
PP: extend the limb in position for AP
projection, center IR to the elbow joint.
AP PROJECTION (PARTIAL FLEXION)
- Rotate the hand laterally to place the
USED WHEN THE PATIENT CANNOT
posterior surface of the elbow 45
FULLY EXTEND THE ELBOW FOR
degrees.
AN A.P. PROJECTION
CR: ┴ to ELBOW JOINT
PP: Obtain two AP projections—one
with forearm parallel to IR and one
SS: RADIAL H.N.T. free of
with humerus parallel to IR.
superimposition from ulna.
CR: ┴ to HUMERUS traversing the
- Open elbow joint.
elbow joint

Distal Humerus
SS: Distal humerus without rotation or
distortion
- Closed elbow joint

Proximal Forearm
- Proximal radius and ulna without
rotation or distortion
- Partially open elbow joint

HOLLY METHOD
AP projection of the RADIAL HEAD

- Positioned for distal humerus, wrist

AXIAL LATEROMEDIAL at an angle of 30 degrees from
PROJECTIONS (COYLE METHOD) horizontal.
For fractures and dislocation of the
elbow, particularly the RADIAL HEAD
and CORONOID PROCESS.

RADIAL HEAD
- Elbow flexed 90 degrees
- Hand PRONATED
CR: 45 deg. TOWARDS the shoulder.

CORONOID PROCESS
- Elbow flexed 80 degrees
AP PROJECTION - ACUTE FLEXION
(JONES METHOD)
Used when fractures around the
elbow are being treated using the
Jones orthopedic technique (complete
flexion).

PP: Center the IR proximal to the

epicondylar area of the humerus

CR:
DH: Perp. 2 inches above the
olecranon process

- Olecranon should be clearly

demonstrated

PF: Perp. To elbow at 2 inches distal PA AXIAL PROJECTION (ULNAR

to olecranon process SULCUS)
Demonstrates the epicondyles,
trochlea, ulnar sulcus, and olecranon
fossa

Radiohumeral bursitis (tennis elbow)

to detect otherwise obscured
calcifications located in the ulnar
sulcus.

PP: Elbow flexed 75 deg. Hand

supinated.
- 15 degrees between the central ray
and the long axis of the humerus.

LATERAL PROJECTION CR: ┴ to the ULNAR SULCUS

LATEROMEDIAL (FOUR POSITION
SERIES) SS: Soft tissue outside the distal
For demonstration of the entire humerus - Outline of the ulnar sulcus
circumference of the radial head free
of superimposition.
- Flex the elbow 90 degrees
- Make the ff. exposure:
1. Hand supinated
2. Hand in lateral
3. Hand pronated
4. Hand in extreme internally rotation

CR: ┴ to ELBOW JOINT

SS: Radial head is projected in

varying degrees of rotation PA AXIAL PROJECTION
(OLECRANON PROCESS)
GREENSPAN AND NORMAN PP: Adjust the arm at an angle of 45 to
METHOD 50 degree from the vertical position.
- Direct the CR 45 degrees towards
the shoulder if the structure is CR: ┴ to the olecranon process - to
positioned in any of those four. demonstrate the dorsum of the
olecranon process
20-degree angle
to demonstrate the curved extremity
and articular margin of the olecranon
process.

HUMERUS

AP PROJECTION
PP: IR 1½ inches above the humeral
head.
- Abduct the arm slightly, and
supinate the hand.
- Coronal plane passing through the
epicondyles should be parallel with
the IR

CR: ┴ to midporion of the humerus

SS: Entire length of the humerus.

- humeral head and tubercle in profile.
- outline of lesser tubercle is located
bet.
Humeral head and GT.

LATERAL PROJECTION
PP: Arm is internally rotated, elbow is
flexed 90 deg. and anterior hand is
placed over the hips.

- Epicondyles are SUPERIMPOSED

and PERPENDICULAR TO THE FILM.

CR: ┴ to midporion of the humerus

SS: Lesser tubercle in profile

- Greater tubercle is superimposed on
the humeral head.