TIBIA AND KNEE

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-Shailendra Raj Pandeya BMIT INTERN

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Antero-posterior(AP) Lateral

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Patient position Patient should lie on the x-ray table with both the limbs extended The ankle is supported in dorsiflexion The limb is rotated medially until both the malleoli are equidistant from the cassette Cassette is placed at the posterior aspect just below the planter aspect of heel

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Centre at the mid-shaft of the tibia being right angle to the axis of the tibia

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Patient position From the supine position, the patient rotates on to the affected side Leg is rotated further until the malleoli are superimposed Tibia should be parallel to the cassette

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Centre at the mid-shaft of the tibia being right angle to the axis of the tibia

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Patient position patient is either supine or seated on the x-ray table as in AP Palpate the head of fibula & lateral tibial condyle Rotate the limb medially to project the tibial condyle clear of the joint Than limb is supported Cassette is centered at level of head of fibula

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Vertical ray at the head of fibula

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synovial joint of Hinge verity where lower end of femur articulates with the upper end of tibia consists of lower part of femur i.e. femoral condyles, end of tibia i.e. tibial condyles & patella Movements ; flexion, extension & slight rotation

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Antero-posterior(AP) Lateral

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Patient position Patient should lie on the x-ray table with both the limbs extended Affected limb is rotated to centralize the patella between femoral condyles Sand bags are placed to immobilize the limb Cassette is placed at the posterior aspect insuring that it covers lower1/3 of the femur & upper 1/3 of the tibia

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Vertical ray is centered 2.5 cm inferior to the apex of patella

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Patient position Patient lies on the side to be examined, with the knee flexed at 45^ The other limb is kept away from the affected side and supported Limb is so adjusted that both the tibial condyles are superimposed Cassette is placed at the lateral aspect

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Vertical ray is centered to the middle of the superior border of the medial tibial condyle

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Skyline view (sunrise view) Tunnel view or Intercondyler notch

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Patient position Patient should sit on the x-ray table with knee flexed 30-45^ & supported with the pads below the knee A cassette is placed vertically held by the patient against the anterior distal femur Both the knee should be at the equal height form the table top

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Centered ray is passed through the midway between the apex of the patella

Supplementry…. Superio-inferior : 

Supplementry…. Superio-inferior

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Patient position Patient should either supine or seated on the x-ray table, with the affected knee flexed about 60^ A suitable pad is placed under the knee The limb is rotated to centralize the patella over the femur The cassette is placed on the top of the pad as close as possible to the posterior aspect of the knee If available curved cassette can be used

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Centre ray is passed immediately below the apex of patella, with certain cranial angulations 110^ - anterior aspect of notch 90^ - posterior aspect of the notch

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Any Question Or Query ?

Reference : 

Reference Clark’s Positioning In Radiography. A Typical Orthopedic Radiographic Procedure. Merrill's Atlas Of Radiography www.wikiradiography.com www.radiopolosis.com www.rtstudents.com

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Presenter:, Shailendra Raj Pandeya