Anatomy Technical FOPH BBFF Monteggia Galeazzi Essex-Lop. Fat Pads Peds Elbow Supracond. Lat....
6
Anatomy Technical FOPH BBFF Monteggia Galeazzi Essex-Lop. Fat Pads Peds Elbow Supracond. Lat. condyle Med. epicon. 4 © 2013 Ken L w.schreibman.info Elbow & Forearm Trauma ASRT @ RSNA 1 of 99 Elbow CT: Positioning We don’t scan patients with their elbow down at their side Excess radiation across torso NEVER scan patients with their elbow laying on their abdomen Elbow moves with patient breathing Makes it impossible to get good reformats Instead get - WRONG WAY CT Scout
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Transcript of Anatomy Technical FOPH BBFF Monteggia Galeazzi Essex-Lop. Fat Pads Peds Elbow Supracond. Lat....
AnatomyTechnicalFOPH
BBFFMonteggiaGaleazziEssex-Lop.
Fat PadsPeds Elbow
Supracond.Lat. condyleMed. epicon.
4
© 2013 Ken L Schreibman, PhD/MDwww.schreibman.info
Elbow & Forearm Trauma ASRT @ RSNA
1 of 99
Elbow CT: Positioning
We don’t scan patients with their elbow down at their side
Excess radiation across torsoX-ray scatter decreases res.
NEVER scan patients with their elbow laying on their abdomenElbow moves with
patient breathingMakes it impossible
to get good reformatsInstead get terrible
images like this
- WRONG WAY
CT Scout
AnatomyTechnicalFOPH
BBFFMonteggiaGaleazziEssex-Lop.
Fat PadsPeds Elbow
Supracond.Lat. condyleMed. epicon.
4
© 2013 Ken L Schreibman, PhD/MDwww.schreibman.info
Elbow & Forearm Trauma ASRT @ RSNA
2 of 99
Elbow CT: Positioning - RIGHT WAYElbow over head!
Avoids torso radiationAvoids scatter from torso
Supine = OK Prone/Decubitus = OK
Optimal PositionElbow straightHead bent out of field
However the patient is most comfortable
AnatomyTechnicalFOPH
BBFFMonteggiaGaleazziEssex-Lop.
Fat PadsPeds Elbow
Supracond.Lat. condyleMed. epicon.
4
© 2013 Ken L Schreibman, PhD/MDwww.schreibman.info
Elbow & Forearm Trauma ASRT @ RSNA
3 of 99
Elbow CT: Positioning - BEST WAY
S,Y 30yoMCT Scout
Straight arm & elbowPerpendicular to
CT scanning planeEasier reformattingYields highest
resolution reformats
SagittalReformat
CoronoidFracture
AnatomyTechnicalFOPH
BBFFMonteggiaGaleazziEssex-Lop.
Fat PadsPeds Elbow
Supracond.Lat. condyleMed. epicon.
4
© 2013 Ken L Schreibman, PhD/MDwww.schreibman.info
Elbow & Forearm Trauma ASRT @ RSNA
4 of 99
Elbow CT: PositioningThis is the position to avoid!
with arm parallel to CT scanning plane
- With a cast…
CT ScoutT,B 65yoF
SagittalReformat
Streak artifacts from scanning
length of forearm limits resolution
AnatomyTechnicalFOPH
BBFFMonteggiaGaleazziEssex-Lop.
Fat PadsPeds Elbow
Supracond.Lat. condyleMed. epicon.
4
© 2013 Ken L Schreibman, PhD/MDwww.schreibman.info
Elbow & Forearm Trauma ASRT @ RSNA
5 of 99
Elbow CT: PositioningThis is a better position
with arm oblique to CT scanning plane
- With a cast…
CT ScoutR,A 27yoF
SagittalReformat
CoronoidFracture
Minimizes forearmstreak artifacts
Minimizes radiation to patient’s head
AnatomyTechnicalFOPH
BBFFMonteggiaGaleazziEssex-Lop.
Fat PadsPeds Elbow
Supracond.Lat. condyleMed. epicon.
4
© 2013 Ken L Schreibman, PhD/MDwww.schreibman.info
Elbow & Forearm Trauma ASRT @ RSNA
6 of 99
Elbow CT:Reformat in 6 planes
3 planes relative to distal humerus3 planes relative to proximal forearmOff Sagittal reference image:
1) Axial to Humerus2) Axial to Forearm3) Coronal to Radius4) Coronal to Ulna
Off Axial Humerus reference:5) Parallel to Inter-Epicondyle Line6) Perpendicular to Epicondyle Line
If elbow is straight, only need 3!
UW 2-page Protocol Sheets
www.radiology.wisc.edu
PositioningReformattingReformatting
