Elbow Projections
Patient Preparation
- Explain the procedure to the patient.
- Remove any jewelry or metallic objects from the elbow/arm.
- Position the patient comfortably at the table.
- Use lead shielding as appropriate.
BASIC PROJECTIONS
1. Anteroposterior (AP) Projection — Elbow
Positioning:
- Patient seated at table, arm extended.
- Supinate the hand so the palm faces upward.
- Shoulder, elbow, and wrist in the same plane.
Central Ray (CR):
- Perpendicular to IR.
- Directed to mid-elbow joint.
SID:
- 100–110 cm (40–44 inches).
Collimation:
- Include distal humerus and proximal forearm.
2. Lateral Projection — Elbow
Positioning:
- Elbow flexed 90°, lateral surface of elbow on IR.
- Hand in lateral position (thumb up).
- Ensure humerus and forearm in true lateral alignment.
Central Ray (CR):
- Perpendicular to IR.
- Directed to mid-elbow joint.
SID:
- 100–110 cm (40–44 inches).
Collimation:
- Include distal humerus and proximal forearm.
OTHER PROJECTIONS
3a. AP Oblique Projection — Elbow
Positioning:
- Patient seated at table, arm extended.
- Medial rotation: Pronate hand internally, rotate elbow medially 45°.
- Lateral rotation: Supinate hand, rotate elbow laterally 45°.
Central Ray (CR):
- Perpendicular to IR.
- Directed to mid-elbow joint.
SID:
- 100–110 cm (40–44 inches).
Collimation:
- Include distal humerus and proximal forearm.
3b. Radial Head Projection — Elbow
Positioning:
- Elbow flexed 90°, hand in lateral position.
- Rotate hand internally and externally as needed to profile radial head.
Central Ray (CR):
- Perpendicular to IR.
- Directed to radial head.
SID:
- 100–110 cm (40–44 inches).
Collimation:
- Include radial head, capitulum, and proximal radius/ulna.
3c. Radial Head and Coronoid Process Projection — Elbow
Positioning:
- Elbow flexed 90°, hand in lateral position.
- Adjust rotation to visualize both radial head and coronoid process.
Central Ray (CR):
- Perpendicular to IR.
- Directed to mid-elbow joint.
SID:
- 100–110 cm (40–44 inches).
Collimation:
- Include distal humerus, radial head, coronoid process, and proximal forearm.
Common Pathologies Demonstrated
- Fractures of distal humerus, proximal radius, or ulna.
- Dislocations of elbow joint.
- Radial head or coronoid process fractures.
- Osteoarthritis or degenerative changes.
- Soft tissue swelling or foreign bodies.