Radiographic Positioning: Radiographic Positioning of a Knee Arthrogram

KNEE ARTHROGRAM

SUPPLIES: See Arthrogram supplies on page 7.

SCOUT VIEWS: AP, Lateral, Tunnel, Tangential, Post Contrast

AP
1. Patient supine
2. Knee in true A.P. position.
3. Bucky
4. 40" SID
5. Center to Apex of patella.
6. Angle tube 5-7 degrees cephalad.
7. 10 x 12 film

Lateral
1. Patient in true lateral position with affected side closest to film flex knee slightly if possible.
2. Bucky
3. 40" SID
4. Angle tube 5-7 degree cephalad.
5. Center medial epicondyle.
6. 10 x 12 film

Tunnel (Homblad)
1. Patient up on knees with femurs forward 20-25 degrees, Central Ray: through bend of leg.
2. Bucky
3. 40" SID
4. 10 x 12 film

Transgential (Sunrise)
1. Patient sitting on table.
2. Patient's affected leg is placed so that the foot is flat on table.
3. Patient hold 8 x 10 extremity cassette behind knee.
4. Angle tube approximately 45-50 degrees cephalad to project shadow of knee on film.
5. Film is marked medially and laterally.

After the injection of double contrast, the Radiologist will take several films with the fluro unit. These films should be numbered or labeled. Upon the completion of fluoroscopy, further instructions will be given.

The Radiologist may request a "Hanging Lateral".

Hanging Lateral
1. Patient sits on edge of table with knees bent and lower legs hanging down.
2. The patient holds the grid between the knees.
3. The tube is positioned so that the Central Ray is horizontal and passing through the affected knee lateral to medial.
4. The patient is instructed to flex the knee back on a rolled towel placed behind the knee as the exposure is taken.

After injection, repeat all the views explained previously and marked pre-exercise. After checking pre-exercise films with radiologist, repeat the same series of films after exercising the knee. Mark these films post exercise. Show films to Radiologist before dismissing patient.