Radiographic Anatomy and Positioning of upper extremity, ELBOW & HUMERUS. Indications, patient positioning, part positioning, Central beam direction, cassette size, collimating part, Tube distance. Buckey grid, exposure. Special Radiographic views of elbow and humerus. Images of radiographic positioning and radiographic film X rayed. Exposure factors had been taken under the Machine used (Allengers 500 mA) under Digital radiography.

1. RADIOGRAPHIC ANATOMY
&
POSITIONING 0F UPPER LIMB
1.ELBOW 2.HUMERUS
Prepared by: NAASIR Wani

2. ELBOW- AP
• INDICATION: Trauma, Dislocation, Pathological condition.
• PATIENT POSITION: Patient sits beside the X ray table with
the patient face directed away from the primary beam.
• POSITION OF THE ELBOW: The arm and forearm are fully
extended, the elbow in question is placed in supine position
in the middle of the half of cassette. Arm and forearm
should be in one level. Identification marker must be
present.
• CENTERING POINT AND THE DIRECTION OF THE X TUBE:
The vertical radiation beam is directed towards 01cm below
the epicondyles of the humerus.

3. ELBOW-->AP
VIEW
• Distance: 100cm
• Exposure factor:
• MAS 08-10 KVP 45-50
• Collimation: Yes
• Cassette size- 8x10''

4. ELBOW- LATERAL
• INDICATION: Trauma, Arthritis, Pathological condition.
• PATIENT POSITION: The patient sits beside the X Table with the face directed
away from the primary beam.
• POSITION OF THE ELBOW: The elbow is fixed making an right angle btw the
arm and forearm. The elbow is placed in the middle of the other half of the
cassette. Sand bag is placed on the arm for immobilization. Identification marks
must be present.
• CENTERING AND THE DIRECTION OF THE X TUBE: The vertical beam of
radiation is directed to the lateral epicondyle of the humerus.

5. ELBOW-->
LAT VIEW
• Distance: 100cm
• Exposure factor:
• mAs 10-12 kvp 45-50
• Collimation: Yes
• Cassette size: 8x10''

6. ELBOW- AXIAL
• INDICATION: Its an additional projection to check the healing process of
supracondylar fracture or trauma to the olecranon process.
• PATIENT POSITION; The patient sits beside the X ray table with the face of the
patient directed away from the radiation.
• POSITION OF THE ELBOW; the elbow is fully flexed and the palm of the hand
facing the shoulder, the posterior side of the palm rest on the film.
• CENTERING POINT AND THE DIRECTION OF THE X TUBE; The vertical beam of
radiation is directed to a point 5cm distal to the olecranon process. The beam is
angled roughly 45degree towards the long axis of humerus

7. ELBOW->AXIAL
VIEW
• Distance: 100cm
• Exposure factor:
• mAs 10-12 Kvp 48-55
• Collimation: Yes
• Cassette size: 8x10''

8. AP POSITION OF ELBOW WITH ARM
IN CONTACT
• INDICATION: Supra-condylar fracture.
• Since this type of fracture needs careful handling because of the importance of
vessels and nerves which passes in the elbow region.
• Four projections are taken to demonstrate supra-condylar fracture:
• A) Elbow arm in contact with the film.
• B) Elbow forearm in contact with the film.
• PATIENT POSITION: the patient sits beside X table, with face directed away from
the prim X beam.
• POSITIONING OF THE ELBOW: Arm is placed in contact with the film.
Identification marker must be present.
• CENTERING POINT AND THE DIRECTION OF THE X TUBE: The vertical
central X beam is directed 1cm below the condyles of the humerus.

9. ELBOW->AP ARM
IN CONTACT
• Distance: 100cm
• Exposure factor:
• MAS 10-12 KVP 48-55
• Collimation- Yes
• Cassette size: 10x12''

10. HUMERUS-AP
• INDICATION; trauma or any pathological condition.
• PATIENT POSITION; the patient should be seated upright or in the standing
position with the back of the shoulder resting on the buckey. The patient should
suspend respiration for the exposure.
• POSITION OF HUMERUS; slightly abduct the arm and supinate the hand. The
coronal planes of the epicondyles and the large receptor plane should be parallel.
• DIRECTION AND CENTERING OF X RAY BEAM: Perpendicular to the image
receptor and directed to the middle portion of the humerus and centre to the
large receptor.

11. HUMERUS--> AP
• Distance: 100cm
• Exposure factor:
• MAS 10-12 KVP 48-52
• Collimation: Yes
• Cassette size: 10x12''

12. HUMERUS- LATERAL
• INDICATION; To exclude fracture or displaced fracture.
• PATIENT POSITION; The patient should be seated upright or in a standing
position with the back of their shoulder resting on the buckey.
• PART POSITION; Internally rotate the arm and then flex the elbow about
90degree. Place the hand over hip unless contraindicated due to pain or fracture.
• DIRECTION AND CENTERING OF X BEAM; Perpendicular to the image
receptor at the middle portion of the humerus and centre of the image receptor.

13. HUMERUS-LAT
• Distance- 100cm
• Exposure Factor:
• MAS 10-12 KVP 52-55
• Collimation- Yes
• Cassette size– 10x12''

14. THANKYOU
NAASIR MOHIDIN WANI
BSC MEDICAL IMAGING TECHNOLOGY (Radio)
STUDENT OF SHARDA UNIVERSITY (2018014297)