Elbow

1. What technique is used for the elbow?

a. 50-55kV
b. 55-60kV
c. 70-75kV
d. 85-90kV
2. For an AP elbow, how much should the radial head be superimposed over the
ulna?
a. ¼
b. ⅓
c. ½
d. ⅛
3. Where is the coronoid on the elbow?
a. Lateral to trochlea, medial to radial head
b. Medial to trochlea, lateral to capitulum
c. Lateral to radial head, proximal to trochlea
d. Medial to radial head, distal to trochlea
4. Where is the trochlea on the elbow?
a. Distal to coronoid, lateral capitulum
b. Proximal to coronoid, lateral to capitulum
c. Proximal to coronoid, medial to capitulum
d. Distal to the olecranon process, medial to coronoid
5. Where is the capitulum on the elbow?
a. Proximal to radial head, lateral to trochlea
b. Distal to radial head, medial to trochlea
c. Proximal to coronoid, lateral to radial head
d. Distal to coronoid, medial to trochlea
6. Where is the radial head on the elbow?
a. Proximal to capitulum, lateral to coronoid
b. Distal to capitulum, lateral to coronoid
c. Distal to capitulum, medial to trochlea
d. Proximal to trochlea, lateral to coronoid
7. Which 2 anatomies are part of the humerus?
a. Trochlea, coronoid
b. Trochlea, radial head
c. Trochlea, capitulum
d. Coronoid, radial head
8. Which 2 anatomies are part of the forearm?
a. Trochlea, coronoid
b. Trochlea, radial head
c. Trochlea, capitulum
d. Coronoid, radial head
9. Where should you center for an AP elbow?
 a. 1” distal to the epicondylar line
b. Level of epicondylar line
c. 1.5” distal to epicondylar line
d. 1” superior to epicondylar line
10. What specific AP elbow positioning error was involved in the image below?

a. Internal rotation
b. External rotation
c. Distal forearm was elevated
d. Proximal humerus was elevated
11. What specific AP elbow positioning error was involved in the image below?

a. Internal rotation
b. External rotation
c. Distal forearm was elevated
d. Proximal humerus was elevated
12. The technologist attempted an AP elbow and it showed the radius crossing
over the ulna. What is the positioning error?
a. Internal rotation only
b. Internal rotation with hand pronated
c. External rotation only
d. External rotation with hand pronated
13. How can this AP elbow positioning error be improved for the repeat?

a. Externally rotated arm with palm facing toward the ceiling

b. Externally rotate hand only
c. Internally rotate hand only
d. Internally rotate arm with palm facing toward the ceiling
14. What is the specific positioning error in the image below?

a. Internal rotation
b. External rotation
c. Distal forearm was elevated
 d. Proximal humerus was elevated
15. What should be in profile for an externally rotated AP elbow oblique
projection?
a. Olecranon, trochlea, coronoid
b. Olecranon, trochlea, trochlea coronoid process joint
c. Radial head, capitulum
d. Radial head, capitulum, radial tuberosity, radial ulnar joint
16. What should be in profile for an internally rotated AP elbow oblique
projection?
a. Olecranon, trochlea, coronoid
b. Olecranon, trochlea, trochlea coronoid process joint
c. Radial head, capitulum
d. Radial head, capitulum, radial tuberosity, radial ulnar joint
17. What is the specific positioning error for the internal oblique elbow in the
image below?

a. Not enough internal rotation

b. Not enough external rotation
c. Flexion
d. Extension
18. What is the positioning error for the external oblique elbow in the image
below?
 a. Olecranon is not in the olecranon fossa
b. Capitulum radial joint space is closed
c. Forearm not positioned parallel to the IR
d. All the above
19. What is the positioning error for the external oblique elbow in the image
below?

a. Not enough internal rotation

b. Not enough external rotation
c. Flexion
d. Extension
20. For a lateral elbow radiograph, the radial head ended up being proximal to the
coronoid process and the capitulum posterior to the trochlea. How can this be
fixed?
a. Distal forearm was elevated, so bring wrist down
b. Distal forearm was depressed, so bring wrist up
c. Shoulder was elevated, so bring shoulder down
d. Shoulder was depressed, so bring shoulder up
21. How is the patient positioned, and how should it be fixed for the repeat?

a. Radial head is proximal to coronoid process = distal forearm is

depressed = elevate the distal forearm
b. Radial head is distal to coronoid process = distal forearm is depressed
= elevate the distal forearm
c. Trochlea is proximal to capitulum = proximal humerus is elevated =
depress the proximal humerus
d. Trochlea is distal to capitulum = proximal humerus is depressed =
raise the proximal humerus
22. If the radial head was shown too far anterior to the coronoid process for the
lateral elbow radiograph, how was the patient positioned?
a. Proximal humerus was elevated
b. Proximal humerus was depressed
c. Distal forearm was elevated
d. Distal forearm was depressed
23. If the distal forearm on a lateral elbow was depressed how would the
radiograph look like?
a. Coronoid would be distal to radial head
b. Trochlea would be posterior to capitulum
c. Trochlea would be anterior to capitulum
d. None of the above
24. The radial head is distal to the coronoid process, and the capitulum is too far
anterior to the medial trochlea. How should this be fixed?
a. Distal forearm was elevated, so bring wrist down
b. Distal forearm was depressed, so bring wrist up
c. Shoulder was elevated, so bring shoulder down
d. Shoulder was depressed, so bring shoulder up
25. In the radiograph, explain where the anatomies are in relation to each other
 a. Trochlea is proximal to capitulum
b. Trochlea is distal to capitulum
c. Coronoid is proximal to radial head
d. Coronoid is distal to radial lead
26. How would you fix this on the repeat?

a. Lower the proximal humerus

b. Raise the proximal humerus
c. Lower the distal radius
d. Raise the distal radius
27. In the radiograph, explain where the anatomies are in relation to each other
 a. Capitulum is proximal to trochlea
b. Trochlea is proximal to capitulum
c. Radial head is lateral to coronoid
d. Radial head is posterior to coronoid
28. How is the patient positioned if the radial tuberosity is seen posteriorly on a
lateral elbow?
a. Wrist is rotated internally
b. Wrist is rotated externally
c. Distal forearm is elevated
d. Distal forearm is depressed
29. How is the patient positioned if the radial tuberosity is seen on the anterior
surface of the arm on a lateral elbow radiograph?
a. Wrist is rotated internally
b. Wrist is rotated externally
c. Distal forearm is elevated
d. Distal forearm is depressed
30. What can be improved for the repeat for the lateral elbow?

a. Externally rotate wrist

 b. Internally rotate wrist
c. Raise proximal humerus
d. Depress proximal humerus
31. What are the 3 concentric arcs that are shown on the lateral elbow?
a. Radial head, ulnar head, capitulum
b. Trochlea, capitulum, trochlear sulcus
c. Trochlea, capitulum, radial head
d. Trochlea, capitulum, capitilular sulcus
32. What is true about the fat pads on an elbow?
a. If the posterior fat pad of the elbow is not visible radiographically, it
suggests that a nonobvious radial head or neck fracture is present
b. If the posterior fat pad of the elbow is visible radiographically, it
suggests that a nonobvious radial head or neck fracture is present
c. Anterior fat pad is invisible on a lateral elbow
d. None of the above
33. True or false: If the elbow is flexed correctly at 90 degrees and appears
normal, the posterior fat pad is visible
a. True
b. False
c. False, the posterior fat pad is only visible if invisible fracture is present
d. None of the above
34. True or false: Trauma or infection makes the anterior fat pad more difficult to
see on a lateral elbow radiograph
a. True
b. False, it’s shown if pathology is present
c. False, it’s not shown if pathology is present
d. None of the above
35. A patient with a possible fracture of the radial head enters the emergency
room. When the technologist attempts to place the arm in the AP oblique-
lateral rotation position, the patient is unable to extend or rotate the elbow
laterally. Which other positions can be used to demonstrate the radial head
and neck without superimposition on the proximal ulna?
a. Position for a lateral elbow, CR at radial head, angle 45 degrees
towards the body
b. Position for a lateral elbow, CR in mid-elbow joint, angle 45 degrees
away from the body
c. Position for a lateral elbow, CR at radial head, angle 20 degrees
toward the body
d. None of the above
36. A patient has a basic elbow series performed. The AP projection indicates a
possible deformity or fracture of the coronoid process. However, the patient is
unable to pronate the upper limb for the AP oblique-medial rotation projection
because of an arthritic condition. What other projection could be performed to
demonstrate the coronoid process?
 a. Position for a lateral elbow, CR at radial head, angle 45 degrees
towards the body
b. Position for a lateral elbow, CR in mid-elbow joint, angle 45 degrees
away from the body
c. Position for a lateral elbow, CR at radial head, angle 20 degrees
toward the body
d. None of the above
37. Match the following type of casts to its corresponding technical factor
adjustment.
1. Small/medium dry plaster a) Increase by 5-7kV
2. Large dry plaster b) Increase by 8-10kV or 100%
3. Fiberglass mAs (2x mAs)
c) Increase by 3-4kV or 30%
mAs
38. Arthrography is a radiographic study of:
a. Fat pads, stripes
b. Epiphyses of long bones
c. Medullary aspect of long bones
d. Soft tissues structures within certain synovial joints
39. Match the following type of views with the anatomy that are best visualized on
the elbow projection.
1. AP (2) a) Coronoid process
2. Lateral elbow (2) b) Radial head & radial
3. Internal oblique (1) tuberosity w/o superimposition
4. External oblique (2) c) Olecranon process
d) Coronoid tubercle
e) Trochlear notch
f) Capitulum & lateral
epicondyle
g) Olecranon process seated in
olecranon fossa
40. A radiograph of an AP oblique-medial rotation reveals that the coronoid
process is not in profile and the radial head is only partially superimposed
over the ulna. What specific positioning error was involved?
a. Insufficient medial rotation
b. Excessive medial rotation
c. Excessive extension of elbow
d. Excessive flexion of elbow
41. A patient has a Colles’ fracture reduced, and a large plaster cast is placed on
the upper limb. The orthopedic surgeon orders a postreduction study. The
original technique, used before the cast placement, involved 60kV and 5mAs.
What new technique measurements should be used with a wet past cast?
a. 65kV or 5mAs
b. 65kV and 5mAs
 c. 68-70kV and 10mAs
d. 68-70kV or 10mAs
42. A patient comes in with a fiberglass cast on their ankle. The orthopedic
surgeon orders a postreduction study. The original technique, used before the
cast placement, involved 60kV and 3mAs. What new technique
measurements should be used with a wet past cast?
a. 63kV or 4mAs
b. 63kV and 4mAs
c. 70kV or 6mAs
d. 67kV or 3mAs