Lower Extremity Comp

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Author:
mbuckley
ID:
15407
Filename:
Lower Extremity Comp
Updated:
2010-04-20 23:20:41
Tags:
radiology lower extremity ankle foot calcaneus lower leg knee hip
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Description:
Comp for Lower Extremity
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  1. AP Foot
    10 x 12 (LW – divide in half)
    60 kVp 3.3 mAs 40" SID
    Pt seated or recumbent on table
    plantar surface resting flat on cassette
    angle CR 10 degrees posteriorly (toward heel) entering base of 3rd metatarsal
    direct CR to base of 3rd metatarsal
  2. Foot AP oblique
    10 x 12 (LW – divide in half)
    60 kVp 4.2 mAs
    Pt seated or recumbent on table
    rotate foot medially to place plantar surface 30 – 40 degrees to plane of IR
    use 45 degree sponge to prevent motion
    CR perp to IR
    directed to base of 3rd metatarsal
  3. Lateral Foot
    8 x10 (small foot) or 10 x 12 (large foot) (CW)
    60 kVp 5 mAs
    Pt seated or recumbent on table
    turn patient to a lateral position and flex knee ofaffected limb
    place opposite leg behind affected leg
    Dorsiflex the foot to place it in a true lateral
    Plantar surface of foot should be perp to IR
    CR perp to medial cuneiform
  4. Calcaneus - Plantodorsal (axial)
    8 x 10 – CW (divide in half using lead mask)
    70 kV 5 mAs
    pt seated or supine with leg fully extended
    Dorsiflex foot so plantar surface is near perp to IR
    Loop gauze, tourniquet, or tape around foot and ask
    pt to pull gently to hold plantar surface near perp to IR
    Angle CR 40 degrees cephalad and center to base of 3rd metatarsal
  5. Calcaneus - Lateral
    8 x 10 – CW (other half of cassette)
    60 kVp 5 mAs
    Place pt in a lateral recumbent position
    flex knee 45 degrees and place opposite leg behind affected leg
    Bring plantar surface perp to IR, placing foot and ankle in a true lateral position
    Dorsiflex foot so it forms a right angle with lower leg
    CR directed to 1" inferior to medial malleolus
  6. AP Ankle
    10 x 12 – CW (divide in half using lead mask)
    65 kVp 6.7 mAs
    Pt supine or seated on table
    leg extended and foot & ankle in true AP
    CR perp to midway between malleoli
  7. AP Ankle Mortise
    10 x 12 – CW (divide in half using lead mask)
    65 kVp 6.7 mAs
    Pt supine or seated on table
    Internally rotate entire leg and foot 15 - 20 degrees until intermalleolar line is perp to IR
    CR perp to midmalleoli
  8. Lateral Ankle
    10 x 12 lw
    65 kVp 6.7 mAs
    pt lateral recumbent
    Turn pt in a lateral position and flex knee 45 degrees
    place opposite leg behind affected leg
    dorsiflex foot
    CR perp to medial malleolus
  9. AP Knee
    8 x 10 – LW
    75 kV 10 mAs Bucky
    internally rotate leg just 3 – 5 degrees to place knee in a true AP
    align CR parallel to articular facets
    CR is directed ½” distal to apex of patella
    CR perp to IR
    5 degrees caudad for thin thighs
    5 degrees cephalad for thick thighs
  10. Medial Oblique Knee
    8 x 10 – LW
    75 kV 10 mAs Bucky
    internally rotate entire leg 45 degrees to place knee in a true AP
    align and center leg and knee to CR and to midline of IR
    direct CR to midpoint of the knee at a level ½” distal to apex of patella
    CR perp to IR
  11. Lateral - Mediolateral Knee
    8 x 10 - LW
    75 kV 10 mAs
    pt in a lateral position
    flex affected knee 20 - 30 degrees
    place unaffected leg behind pt (make sure to prevent overrotation)
    femoral epicondyles should be superimposed
    angle CR 5 - 7 degrees cephalad entering 1" distal to medial epicondyle
  12. AP Tibia/Fibula
    14 x 17 – diagonal
    70 kV 6.7 mAs
    Anode heel effect… place knee at cathode end
    patient supine with leg extended and pelvis, knee, & hip should be in a true AP projection
    be sure to include both joints
    CR perp to IR
    CR directed to midpoint of leg
  13. Lateral Tibia/Fibula
    14 x 17 – diagonal
    70 kV 6.7 mAs
    Anode heel effect… place knee at cathode end
    patient in a lateral recumbent position
    place opposite leg behind affected leg
    be sure to include both ankle and knee joints
    CR perp to IR
    CR directed to midpoint of leg
    collimate on both sides to skin margins
  14. AP Pelvis
    14 x 17 – CW
    80 kV 15 mAs
    Patient supine, lower limbs internally rotated 15-20 degrees
    CR directed midway between ASIS and symphysis pubis (approximately 2" inferior to level of ASIS)
    Collimate to cassette size
    Suspend respiration during exposure
  15. AP Unilateral Hip
    10 x 12 LW
    80 kV 15 mAs
    patient supine, internally rotate lower limb 15- 20 degrees
    CR directed 1-2" distal to midfemoral neck
    collimate to cassette size
    suspend respiration during exposure
  16. Unilateral "frog-leg" Hip (modified Cleaves method)
    10 x 12 CW
    80 kV 15 mAs
    patient supine, flex knee and hip
    abduct femur 45 degrees from vertical
    CR directed to midfemoral neck
    collimate to cassette size
    suspend respiration during exposure

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