Deck 6: Image Analysis of the Lower Extremity
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Deck 6: Image Analysis of the Lower Extremity
1
For a lateral fourth toe projection, the
1)foot is rotated laterally until the toe is in a lateral projection.
2)adjacent toes are drawn away from the affected toe.
3)long axis of the digit is aligned with the transverse axis of the collimated field.
4)central ray is centered to the PIP joint.
A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 3, and 4 only
1)foot is rotated laterally until the toe is in a lateral projection.
2)adjacent toes are drawn away from the affected toe.
3)long axis of the digit is aligned with the transverse axis of the collimated field.
4)central ray is centered to the PIP joint.
A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 3, and 4 only
1, 2, and 4 only
2
An axial calcaneus projection with the patient's foot in plantar flexion and the central ray angled 40 degrees proximally demonstrates a(n)
1)elongated calcaneal tuberosity.
2)foreshortened calcaneal tuberosity.
3)open talocalcaneal joint space.
4)closed talocalcaneal joint space.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only
1)elongated calcaneal tuberosity.
2)foreshortened calcaneal tuberosity.
3)open talocalcaneal joint space.
4)closed talocalcaneal joint space.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only
2 and 4 only
3
If the medial talar dome were positioned distal to the lateral talar dome on a lateral foot projection, which of the following is true?
A) The patient's heel was elevated off the IR.
B) The patient's proximal tibia was elevated.
C) The patient's forefoot and toes were elevated off the IR.
D) The patient's distal lower leg was elevated.
A) The patient's heel was elevated off the IR.
B) The patient's proximal tibia was elevated.
C) The patient's forefoot and toes were elevated off the IR.
D) The patient's distal lower leg was elevated.
The patient's proximal tibia was elevated.
4
An AP first toe projection that was obtained with the foot and toe rotated 45 degrees medially demonstrates
1)equal soft tissue width on both sides of each of the phalanges.
2)more midshaft concavity on one side of the phalanges than on the opposite side.
3)twice as much soft tissue on one side of the phalanges as on the opposite side.
4)convexity on one side of the phalanges and concavity on the opposite side.
A) 1 and 2 only
B) 1 and 4 only
C) 2 and 3 only.
D) 3 and 4 only
1)equal soft tissue width on both sides of each of the phalanges.
2)more midshaft concavity on one side of the phalanges than on the opposite side.
3)twice as much soft tissue on one side of the phalanges as on the opposite side.
4)convexity on one side of the phalanges and concavity on the opposite side.
A) 1 and 2 only
B) 1 and 4 only
C) 2 and 3 only.
D) 3 and 4 only
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5
For an AP ankle projection, the
1)intermalleolar line is aligned at a 15- to 20-degree angle with the IR.
2)lateral malleolus is positioned more posterior than the medial malleolus.
3)long axis of the foot is positioned perpendicular to the IR.
4)central ray is centered at the level of the medial malleolus.
A) 2 and 4 only
B) 2, 3, and 4 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4
1)intermalleolar line is aligned at a 15- to 20-degree angle with the IR.
2)lateral malleolus is positioned more posterior than the medial malleolus.
3)long axis of the foot is positioned perpendicular to the IR.
4)central ray is centered at the level of the medial malleolus.
A) 2 and 4 only
B) 2, 3, and 4 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4
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6
Which of the following pertains to the positioning setup for an AP oblique foot projection on a patient with a high longitudinal arch?
1)Rotate the patient's foot 60 degrees.
2)Angle the central ray 15 degrees proximally.
3)Align the long axis of the foot with the long axis of the collimated field.
4)Center the central ray to the third metatarsal base.
A) 1 and 3 only
B) 3 and 4 only
C) 1, 2, and 4 only
D) 1, 3, and 4 only
1)Rotate the patient's foot 60 degrees.
2)Angle the central ray 15 degrees proximally.
3)Align the long axis of the foot with the long axis of the collimated field.
4)Center the central ray to the third metatarsal base.
A) 1 and 3 only
B) 3 and 4 only
C) 1, 2, and 4 only
D) 1, 3, and 4 only
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7
The IP and MTP joint spaces on toe projections are open and demonstrated without distortion when the
1)central ray is aligned parallel with them.
2)central ray is aligned perpendicular to them.
3)joints are aligned parallel with the IR.
4)joints are aligned perpendicular to the IR.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only
1)central ray is aligned parallel with them.
2)central ray is aligned perpendicular to them.
3)joints are aligned parallel with the IR.
4)joints are aligned perpendicular to the IR.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only
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8
On a lateral foot projection with accurate positioning, the
1)medial talar dome is demonstrated slightly superior to the lateral dome.
2)tibiotalar joint space is open.
3)talar domes are superimposed.
4)distal fibula is superimposed by the posterior half of the distal tibia.
A) 1 and 3 only
B) 2 and 4 only
C) 2, 3, and 4 only
D) 3 and 4 only
1)medial talar dome is demonstrated slightly superior to the lateral dome.
2)tibiotalar joint space is open.
3)talar domes are superimposed.
4)distal fibula is superimposed by the posterior half of the distal tibia.
A) 1 and 3 only
B) 2 and 4 only
C) 2, 3, and 4 only
D) 3 and 4 only
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9
Where should the central ray be centered for an AP axial projection of the foot?
A) Third metatarsophalangeal joint
B) Base of the third metatarsal
C) Anterior talus
D) Intermediate cuneiform
A) Third metatarsophalangeal joint
B) Base of the third metatarsal
C) Anterior talus
D) Intermediate cuneiform
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10
An AP axial foot projection obtained with the foot laterally rotated demonstrates
1)a closed medial-intermediate cuneiform joint space.
2)closed tarsometatarsal joint spaces.
3)the calcaneus with increased talar superimposition.
4)a decrease in metatarsal base superimposition.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 1, 2, and 4 only
1)a closed medial-intermediate cuneiform joint space.
2)closed tarsometatarsal joint spaces.
3)the calcaneus with increased talar superimposition.
4)a decrease in metatarsal base superimposition.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 1, 2, and 4 only
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11
A lateral foot projection obtained in a patient whose leg was externally rotated (heel off IR) demonstrates
1)more than 0.5 inch (1 cm) of the cuboid posterior to the navicular.
2)the fibula situated too posterior to the tibia.
3)the lateral talar dome anterior to the medial talar dome.
4)an obscured tibiotalar joint space.
A) 1 and 2 only
B) 2 only
C) 3 only
D) 2 and 4 only
1)more than 0.5 inch (1 cm) of the cuboid posterior to the navicular.
2)the fibula situated too posterior to the tibia.
3)the lateral talar dome anterior to the medial talar dome.
4)an obscured tibiotalar joint space.
A) 1 and 2 only
B) 2 only
C) 3 only
D) 2 and 4 only
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12
How can the positioning setup procedure be adjusted for an AP axial foot projection to demonstrate uniform image density throughout the toes and foot areas?
1)Position the toes at the anode end of the x-ray tube.
2)Use a kVp above 75.
3)Use a grid.
4)Place a contact shield over the toes.
A) 1 only
B) 2 and 3 only
C) 1 and 4 only
D) 4 only
1)Position the toes at the anode end of the x-ray tube.
2)Use a kVp above 75.
3)Use a grid.
4)Place a contact shield over the toes.
A) 1 only
B) 2 and 3 only
C) 1 and 4 only
D) 4 only
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13
For an AP oblique second toe projection, the toe is rotated _____ degrees _____.
A) 30; laterally
B) 45; laterally
C) 30; medially
D) 45; medially
A) 30; laterally
B) 45; laterally
C) 30; medially
D) 45; medially
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14
An AP ankle projection obtained with the patient's leg in lateral rotation will demonstrate which of the following?
1)A closed medial mortise
2)Decreased talar and fibular superimposition
3)An open lateral mortise
4)The sinus tarsi
A) 1 only
B) 1 and 2 only
C) 2, 3, and 4 only
D) 4 only
1)A closed medial mortise
2)Decreased talar and fibular superimposition
3)An open lateral mortise
4)The sinus tarsi
A) 1 only
B) 1 and 2 only
C) 2, 3, and 4 only
D) 4 only
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15
Which of the following positioning setup procedures must be completed to obtain open tarsometatarsal and navicular-cuneiform joint spaces on an AP axial foot projection?
1)The patient's foot is positioned flat against the IR.
2)The foot, ankle, and lower leg are aligned.
3)The central ray is angled 10 to 15 degrees proximally.
4)A compensating filter is placed over the toes.
A) 1 and 3 only
B) 3 only
C) 1, 2, and 3 only
D) 1 and 4 only
1)The patient's foot is positioned flat against the IR.
2)The foot, ankle, and lower leg are aligned.
3)The central ray is angled 10 to 15 degrees proximally.
4)A compensating filter is placed over the toes.
A) 1 and 3 only
B) 3 only
C) 1, 2, and 3 only
D) 1 and 4 only
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16
Which aspect of the foot is placed parallel with the IR for a routine lateral foot projection?
A) Plantar
B) Dorsal
C) Lateral
D) Medial
A) Plantar
B) Dorsal
C) Lateral
D) Medial
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17
An AP oblique foot projection with accurate positioning demonstrates
1)open first and second intermetatarsal joint spaces.
2)open joint spaces around the cuboid.
3)slight superimposition of the fourth and fifth metatarsal bases.
4)the long axis of the foot aligned with the long axis of the collimated field.
A) 1 and 2 only
B) 1 and 3 only
C) 1, 3, and 4 only
D) 2 and 4 only
1)open first and second intermetatarsal joint spaces.
2)open joint spaces around the cuboid.
3)slight superimposition of the fourth and fifth metatarsal bases.
4)the long axis of the foot aligned with the long axis of the collimated field.
A) 1 and 2 only
B) 1 and 3 only
C) 1, 3, and 4 only
D) 2 and 4 only
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18
What joint spaces are open on an AP oblique foot projection with accurate positioning?
1)Second through fifth intermetatarsal joints
2)Navicular-cuneiform
3)Joint spaces surrounding the cuboid
4)Tarsometatarsal
A) 1 and 3 only
B) 3 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4
1)Second through fifth intermetatarsal joints
2)Navicular-cuneiform
3)Joint spaces surrounding the cuboid
4)Tarsometatarsal
A) 1 and 3 only
B) 3 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4
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19
Which of the following pertains to a lateral foot projection that demonstrates the lateral talar dome distal to the medial talar dome?
1)The patient was imaged with the distal tibia elevated.
2)More than 0.5 inch (1 cm) of the cuboid is demonstrated posterior to the navicular.
3)The lateral talar dome is also anterior to the medial talar dome.
4)The fibula would be situated too far posterior to the tibia.
A) 1 only
B) 1 and 2 only
C) 3 and 4 only
D) 1, 2, 3, and 4
1)The patient was imaged with the distal tibia elevated.
2)More than 0.5 inch (1 cm) of the cuboid is demonstrated posterior to the navicular.
3)The lateral talar dome is also anterior to the medial talar dome.
4)The fibula would be situated too far posterior to the tibia.
A) 1 only
B) 1 and 2 only
C) 3 and 4 only
D) 1, 2, 3, and 4
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20
Which of the following is true with respect to axial calcaneal projections?
1)The image demonstrates an open talocalcaneal joint space.
2)The foot is flexed 90 degrees to the lower leg and rotated slightly laterally.
3)A 40-degree central ray is directed proximally.
4)The central ray is centered to the distal fifth metatarsal.
A) 1 and 3 only
B) 1 and 2 only
C) 3 and 4 only
D) 1, 3, and 4 only
1)The image demonstrates an open talocalcaneal joint space.
2)The foot is flexed 90 degrees to the lower leg and rotated slightly laterally.
3)A 40-degree central ray is directed proximally.
4)The central ray is centered to the distal fifth metatarsal.
A) 1 and 3 only
B) 1 and 2 only
C) 3 and 4 only
D) 1, 3, and 4 only
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21
A 15- to 20-degree internally rotated AP oblique ankle projection with poor positioning demonstrates an open distal lateral mortise superimposing the calcaneus. How was the patient mispositioned for such an image to be obtained?
A) The foot was plantarflexed.
B) The leg was not adequately internally rotated.
C) The central ray was centered too caudally.
D) The proximal lower leg was elevated.
A) The foot was plantarflexed.
B) The leg was not adequately internally rotated.
C) The central ray was centered too caudally.
D) The proximal lower leg was elevated.
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22
Why should the foot be dorsiflexed to a 90-degree angle with the lower leg for a lateral ankle projection?
1)It places the tibiotalar joint in a neutral position.
2)It prevents the patient from rotating posteriorly.
3)It allows the anterior pretalar fat pad to be used to detect joint effusion.
4)It positions the talar domes on top of each other.
A) 1 and 3 only
B) 1, 2, and 3 only
C) 3 only
D) 1 and 4 only
1)It places the tibiotalar joint in a neutral position.
2)It prevents the patient from rotating posteriorly.
3)It allows the anterior pretalar fat pad to be used to detect joint effusion.
4)It positions the talar domes on top of each other.
A) 1 and 3 only
B) 1, 2, and 3 only
C) 3 only
D) 1 and 4 only
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23
A 15- to 20-degree internally rotated AP oblique ankle projection with accurate positioning demonstrates which of the following joints as open spaces?
1)Tibiotalar
2)Talofibular
3)Lateral mortise
4)Medial mortise
A) 1 and 4 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 2, and 3 only
1)Tibiotalar
2)Talofibular
3)Lateral mortise
4)Medial mortise
A) 1 and 4 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 2, and 3 only
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24
A cephalic central ray angulation is required on an AP knee projection when the
1)examination is performed with the patient in an upright position.
2)patient's anterior tibial margin is demonstrated distal to the posterior tibial margin on the resulting image.
3)the patient's ASIS to imaging table measurement is 22 cm.
4)the knee is flexed and a curved IR is used.
A) 2 and 3 only
B) 4 only
C) 2 and 4 only
D) 1, 2, and 4 only
1)examination is performed with the patient in an upright position.
2)patient's anterior tibial margin is demonstrated distal to the posterior tibial margin on the resulting image.
3)the patient's ASIS to imaging table measurement is 22 cm.
4)the knee is flexed and a curved IR is used.
A) 2 and 3 only
B) 4 only
C) 2 and 4 only
D) 1, 2, and 4 only
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25
For a 15- to 20-degree internally rotated AP oblique ankle projection, the
1)central ray is centered at the level of the medial malleolus.
2)foot is dorsiflexed to a 90-degree angle with the lower leg.
3)long axis of the lower leg is aligned with the long axis of the collimated field.
4)leg is internally rotated until the intermalleolar line is parallel with the IR.
A) 1 and 2 only
B) 2 and 4 only
C) 1 and 3 only
D) 1, 2, 3, and 4
1)central ray is centered at the level of the medial malleolus.
2)foot is dorsiflexed to a 90-degree angle with the lower leg.
3)long axis of the lower leg is aligned with the long axis of the collimated field.
4)leg is internally rotated until the intermalleolar line is parallel with the IR.
A) 1 and 2 only
B) 2 and 4 only
C) 1 and 3 only
D) 1, 2, 3, and 4
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26
A lateral ankle projection demonstrates the fibula too anterior to the tibia, and a narrowed talocalcaneal joint. How are the talar domes positioned on this projection?
1)Medial dome anterior
2)Medial dome proximal
3)Lateral dome anterior
4)Lateral dome proximal
A) 1 and 2 only
B) 2 and 3 only
C) 3 and 4 only
D) 1 and 4 only
1)Medial dome anterior
2)Medial dome proximal
3)Lateral dome anterior
4)Lateral dome proximal
A) 1 and 2 only
B) 2 and 3 only
C) 3 and 4 only
D) 1 and 4 only
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27
For an externally rotated AP oblique knee projection with accurate positioning, the
1)fibular head is demonstrated free of tibial superimposition.
2)lateral femoral condyle is demonstrated in profile.
3)fibular head, neck, and shaft are superimposed by the tibia.
4)medial condyle is shown in profile.
A) 1 and 2 only
B) 1 and 4 only
C) 2 and 3 only
D) 3 and 4 only
1)fibular head is demonstrated free of tibial superimposition.
2)lateral femoral condyle is demonstrated in profile.
3)fibular head, neck, and shaft are superimposed by the tibia.
4)medial condyle is shown in profile.
A) 1 and 2 only
B) 1 and 4 only
C) 2 and 3 only
D) 3 and 4 only
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28
For an externally rotated AP oblique knee projection, the
1)leg is externally rotated until an imaginary line connecting the femoral epicondyles is at a 45-degree angle with the IR.
2)leg is internally rotated until an imaginary line connecting the femoral epicondyles is at a 45-degree angle with the IR.
3)central ray is aligned parallel with the tibia plateau.
4)central ray is centered at a level 0.75 inch (2 cm) distal to the medial femoral epicondyles.
A) 1 and 4 only
B) 1 and 3 only
C) 2 and 4 only
D) 1, 3, and 4 only
1)leg is externally rotated until an imaginary line connecting the femoral epicondyles is at a 45-degree angle with the IR.
2)leg is internally rotated until an imaginary line connecting the femoral epicondyles is at a 45-degree angle with the IR.
3)central ray is aligned parallel with the tibia plateau.
4)central ray is centered at a level 0.75 inch (2 cm) distal to the medial femoral epicondyles.
A) 1 and 4 only
B) 1 and 3 only
C) 2 and 4 only
D) 1, 3, and 4 only
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29
A lateral knee projection obtained with the patella positioned too close to the IR (leg externally rotated) will demonstrate the
1)fibula with increased tibial superimposition.
2)fibula with decreased tibial superimposition.
3)medial femoral condyle anterior to the lateral femoral condyle.
4)medial condyle distal to the lateral femoral condyle.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only
1)fibula with increased tibial superimposition.
2)fibula with decreased tibial superimposition.
3)medial femoral condyle anterior to the lateral femoral condyle.
4)medial condyle distal to the lateral femoral condyle.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only
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30
A lateral ankle projection with accurate positioning demonstrates
1)an open tibiotalar joint.
2)a narrowed talocalcaneal joint.
3)1 inch (2.5 cm) of the fifth metatarsal base.
4)the fibula in the posterior half of the tibia.
A) 1, 2, and 3 only.
B) 2 and 4 only.
C) 1, 3, and 4 only.
D) 1, 2, 3, and 4
1)an open tibiotalar joint.
2)a narrowed talocalcaneal joint.
3)1 inch (2.5 cm) of the fifth metatarsal base.
4)the fibula in the posterior half of the tibia.
A) 1, 2, and 3 only.
B) 2 and 4 only.
C) 1, 3, and 4 only.
D) 1, 2, 3, and 4
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31
For a lateral ankle projection, the
1)medial and lateral malleoli are positioned directly on top of each other.
2)lateral foot surface is aligned parallel with the IR.
3)lower leg is parallel with the imaging table.
4)central ray is centered to the medial malleolus.
A) 2 and 4 only
B) 1 and 3 only
C) 2, 3, and 4 only
D) 1, 2, 3, and 4
1)medial and lateral malleoli are positioned directly on top of each other.
2)lateral foot surface is aligned parallel with the IR.
3)lower leg is parallel with the imaging table.
4)central ray is centered to the medial malleolus.
A) 2 and 4 only
B) 1 and 3 only
C) 2, 3, and 4 only
D) 1, 2, 3, and 4
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32
If the patient is unable to extend the knee fully, an open femorotibial joint is accomplished by aligning the central ray perpendicular to the anterior surface of the lower leg and then
A) decreasing the angle 3 to 5 degrees and centering to the femorotibial joint.
B) increasing the angle 3 to 5 degrees and centering to the femorotibial joint.
C) centering to the femorotibial joint.
A) decreasing the angle 3 to 5 degrees and centering to the femorotibial joint.
B) increasing the angle 3 to 5 degrees and centering to the femorotibial joint.
C) centering to the femorotibial joint.
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33
If the medial femoral condyle is situated anterior to the lateral femoral condyle on a lateral knee projection with poor positioning, which of the following is true?
1)The fibular head demonstrates increased tibia superimposition.
2)The adductor tubercle will be located on the anterior condyle.
3)The distal surface of the anterior condyle will appear flatter.
4)The fibular head will demonstrate a decrease in tibial superimposition.
A) 1 and 2 only
B) 2 and 3 only
C) 2 and 4 only
D) 2, 3, and 4 only
1)The fibular head demonstrates increased tibia superimposition.
2)The adductor tubercle will be located on the anterior condyle.
3)The distal surface of the anterior condyle will appear flatter.
4)The fibular head will demonstrate a decrease in tibial superimposition.
A) 1 and 2 only
B) 2 and 3 only
C) 2 and 4 only
D) 2, 3, and 4 only
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34
For a lateral knee projection,
1)an imaginary line connecting the femoral epicondyles is aligned parallel with the IR.
2)a patient with long femora and a narrow pelvis does not require an angled central ray.
3)a grid is used if the knee measures over 10 cm.
4)the central ray is centered 1 inch (2.5 cm) distal to the medial femoral epicondyles.
A) 1 and 2 only
B) 2 and 4 only
C) 2, 3, and 4 only
D) 1, 2, 3, and 4
1)an imaginary line connecting the femoral epicondyles is aligned parallel with the IR.
2)a patient with long femora and a narrow pelvis does not require an angled central ray.
3)a grid is used if the knee measures over 10 cm.
4)the central ray is centered 1 inch (2.5 cm) distal to the medial femoral epicondyles.
A) 1 and 2 only
B) 2 and 4 only
C) 2, 3, and 4 only
D) 1, 2, 3, and 4
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35
For an AP projection of the knee with accurate positioning,
1)an imaginary line connecting the femoral epicondyles is aligned parallel with the IR.
2)the intercondylar eminence is centered within the intercondylar fossa.
3)the fibular head is demonstrated about 0.5 inch (1.25 cm) distal to the tibial plateau.
4)the femoral condyles are symmetrical.
A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4
1)an imaginary line connecting the femoral epicondyles is aligned parallel with the IR.
2)the intercondylar eminence is centered within the intercondylar fossa.
3)the fibular head is demonstrated about 0.5 inch (1.25 cm) distal to the tibial plateau.
4)the femoral condyles are symmetrical.
A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4
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36
A lateral knee projection with accurate positioning demonstrates
1)superimposed femoral condyles.
2)the fibular head without tibial superimposition.
3)an open femorotibial joint space.
4)one-fourth of the distal femur and proximal lower leg.
A) 1 and 3 only
B) 2 and 4 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4
1)superimposed femoral condyles.
2)the fibular head without tibial superimposition.
3)an open femorotibial joint space.
4)one-fourth of the distal femur and proximal lower leg.
A) 1 and 3 only
B) 2 and 4 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4
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37
An AP knee projection obtained with the knee internally rotated demonstrates
1)a larger appearing medial femoral condyle than lateral condyle.
2)a larger appearing lateral femoral condyle than medial condyle.
3)the fibular head with increased tibial superimposition.
4)the fibular head with decreased tibial superimposition.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only
1)a larger appearing medial femoral condyle than lateral condyle.
2)a larger appearing lateral femoral condyle than medial condyle.
3)the fibular head with increased tibial superimposition.
4)the fibular head with decreased tibial superimposition.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only
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38
An AP knee projection obtained with the central ray angled too cephalically demonstrates
1)symmetrical femoral condyles.
2)a foreshortened fibular head.
3)the fibular head at a position less than 0.5 inch (1 cm) distal to the tibial plateau.
4)a narrowed or closed femorotibial joint space.
A) 1, 3, and 4 only
B) 1, 2, and 4 only
C) 2 and 3 only
D) 1, 2, 3, and 4
1)symmetrical femoral condyles.
2)a foreshortened fibular head.
3)the fibular head at a position less than 0.5 inch (1 cm) distal to the tibial plateau.
4)a narrowed or closed femorotibial joint space.
A) 1, 3, and 4 only
B) 1, 2, and 4 only
C) 2 and 3 only
D) 1, 2, 3, and 4
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39
A lateral knee projection demonstrates the medial femoral condyle anterior and proximal to the lateral femoral condyle. How was the positioning setup mispositioned for such an image to be obtained?
1)The central ray was angled too caudally.
2)The central ray was angled too cephalically.
3)The patient's patella was positioned too close to the IR.
4)The patient's patella was positioned too far away from the IR.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only
1)The central ray was angled too caudally.
2)The central ray was angled too cephalically.
3)The patient's patella was positioned too close to the IR.
4)The patient's patella was positioned too far away from the IR.
A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only
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40
The placement of the patella in relationship to the femorotibial joint space on an AP knee projection is affected by
1)patellar subluxation.
2)knee rotation.
3)knee flexion.
4)foot inversion.
A) 2 only
B) 1 and 3 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4
1)patellar subluxation.
2)knee rotation.
3)knee flexion.
4)foot inversion.
A) 2 only
B) 1 and 3 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4
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41
If the patient is unable to dorsiflex the foot to a vertical position for an axial calcaneus projection, the
A) central ray should be angled less than the routinely required amount.
B) central ray should be angled until it is aligned with the third metatarsal base and the distal fibula.
C) image will demonstrate an open talocalcaneal joint as long as a 40-degree angle is used.
D) image will demonstrate a foreshortened calcaneal tuberosity unless the central ray angle is increased over the routinely required angulation.
A) central ray should be angled less than the routinely required amount.
B) central ray should be angled until it is aligned with the third metatarsal base and the distal fibula.
C) image will demonstrate an open talocalcaneal joint as long as a 40-degree angle is used.
D) image will demonstrate a foreshortened calcaneal tuberosity unless the central ray angle is increased over the routinely required angulation.
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42
For a tangential knee projection (Merchant method),
1)an imaginary line connecting the femoral epicondyles is aligned parallel with the imaging table.
2)the medial condyles demonstrate more height than the lateral condyles.
3)the femorotibial joints are open.
4)the patient is instructed to relax the leg muscles.
A) 1 and 4 only
B) 1 and 2 only
C) 2 and 3 only
D) 1, 2, 3, and 4
1)an imaginary line connecting the femoral epicondyles is aligned parallel with the imaging table.
2)the medial condyles demonstrate more height than the lateral condyles.
3)the femorotibial joints are open.
4)the patient is instructed to relax the leg muscles.
A) 1 and 4 only
B) 1 and 2 only
C) 2 and 3 only
D) 1, 2, 3, and 4
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43
The tangential knee projection (Merchant method) can also be described as a(n) _____ projection.
A) inferosuperior
B) mediolateral
C) superoinferior
D) AP
A) inferosuperior
B) mediolateral
C) superoinferior
D) AP
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44
An accurately positioned lateral foot projection demonstrates all of the following except
A) superimposed talar domes.
B) the distal metatarsals at the center of the exposure field.
C) contrast and density adequate to demonstrate the anterior pretalar and posterior pericapsular fat pads.
D) open tibiotalar joint space.
A) superimposed talar domes.
B) the distal metatarsals at the center of the exposure field.
C) contrast and density adequate to demonstrate the anterior pretalar and posterior pericapsular fat pads.
D) open tibiotalar joint space.
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45
An accurately positioned AP knee projection demonstrates all of the following except the
A) medial and lateral femoral epicondyles in profile.
B) fibular head 1 inch (2.5 cm) distal to the tibial plateau.
C) superimposed tibial condylar margins.
D) intercondylar eminence in the center of the intercondylar fossa.
A) medial and lateral femoral epicondyles in profile.
B) fibular head 1 inch (2.5 cm) distal to the tibial plateau.
C) superimposed tibial condylar margins.
D) intercondylar eminence in the center of the intercondylar fossa.
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46
A poorly positioned AP knee projection demonstrating a larger lateral femoral condyle than medial condyle
A) was obtained with the patient's leg externally rotated.
B) may also demonstrate the fibular head without tibial superimposition.
C) will also demonstrate a closed knee joint.
D) will also demonstrate the fibular head 1 inch (2.5 cm) distal to the tibial plateau.
A) was obtained with the patient's leg externally rotated.
B) may also demonstrate the fibular head without tibial superimposition.
C) will also demonstrate a closed knee joint.
D) will also demonstrate the fibular head 1 inch (2.5 cm) distal to the tibial plateau.
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47
A less than optimal AP oblique foot projection demonstrates closed lateral cuneiform-cuboid, navicular-cuboid, and third through fifth intermetatarsal joint spaces. The fourth metatarsal tubercle is demonstrated without fifth metatarsal superimposition. Which of the following is true?
A) The patient's foot was overrotated.
B) The patient had a high longitudinal arch and a 45-degree oblique was obtained.
C) A 10- to 15-degree proximal central ray angle was used for the projection.
D) The patient had a low longitudinal arch and a 30-degree oblique was obtained.
A) The patient's foot was overrotated.
B) The patient had a high longitudinal arch and a 45-degree oblique was obtained.
C) A 10- to 15-degree proximal central ray angle was used for the projection.
D) The patient had a low longitudinal arch and a 30-degree oblique was obtained.
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48
A less than optimal AP axial toe projection demonstrates more soft tissue width on the lateral side than on the medial side of the phalanges. Which of the following is true about this projection?
A) The toe needs to be rotated laterally to obtain an optimal projection.
B) If the patient is unable to move, the central ray angle needs to be adjusted medially to obtain an optimal projection.
C) The projection will also demonstrate closed IP and MTP joint spaces.
D) The projection will also demonstrate less midshaft concavity on the lateral side of the phalanges compared with the medial side.
A) The toe needs to be rotated laterally to obtain an optimal projection.
B) If the patient is unable to move, the central ray angle needs to be adjusted medially to obtain an optimal projection.
C) The projection will also demonstrate closed IP and MTP joint spaces.
D) The projection will also demonstrate less midshaft concavity on the lateral side of the phalanges compared with the medial side.
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49
A less than optimal axial calcaneus projection demonstrates an obscured talocalcaneal joint space and an elongated calcaneus tuberosity. The projection was obtained with the
A) patient's foot dorsiflexed beyond the required vertical position.
B) central ray angled less than the routinely required amount.
C) patient's foot in plantar flexion.
D) leg and ankle medially rotated.
A) patient's foot dorsiflexed beyond the required vertical position.
B) central ray angled less than the routinely required amount.
C) patient's foot in plantar flexion.
D) leg and ankle medially rotated.
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50
A 5- to 7-degree central ray angulation is used for a lateral knee projection
1)to project the medial condyle anterosuperiorly.
2)on a patient with a narrow pelvis and long femora.
3)to offset the reduction in medial inclination that occurs when the patient is in a lateral recumbent position.
4)to achieve an open femorotibial joint space.
A) 1 and 2 only
B) 2 and 3 only
C) 1, 3, and 4 only
D) 2, 3, and 4 only
1)to project the medial condyle anterosuperiorly.
2)on a patient with a narrow pelvis and long femora.
3)to offset the reduction in medial inclination that occurs when the patient is in a lateral recumbent position.
4)to achieve an open femorotibial joint space.
A) 1 and 2 only
B) 2 and 3 only
C) 1, 3, and 4 only
D) 2, 3, and 4 only
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51
Proper elevation of the distal lower leg and vertical placement of the foot's long axis (heel is not rotated side to side) for the PA axial knee projection (Holmblad method)
1)superimposes the proximal surfaces of the intercondylar fossa.
2)places the patellar apex superior to the intercondylar fossa.
3)superimposes the lateral and the medial surfaces of the intercondylar fossa.
4)superimposes the anterior and the posterior margins of the tibial plateau.
A) 1 and 2 only
B) 4 only
C) 3 and 4 only
D) 2, 3, and 4 only.
1)superimposes the proximal surfaces of the intercondylar fossa.
2)places the patellar apex superior to the intercondylar fossa.
3)superimposes the lateral and the medial surfaces of the intercondylar fossa.
4)superimposes the anterior and the posterior margins of the tibial plateau.
A) 1 and 2 only
B) 4 only
C) 3 and 4 only
D) 2, 3, and 4 only.
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52
A less than optimal lateral foot projection demonstrating the lateral talar dome proximal to the medial talar dome
A) will also demonstrate more than 0.5 inch (1.25 cm) of the cuboid posterior to the navicular bone if the patient has a high longitudinal arch.
B) was obtained with the proximal lower leg elevated.
C) was obtained with the leg externally rotated.
D) will also demonstrate the fibula too posterior on the tibia.
A) will also demonstrate more than 0.5 inch (1.25 cm) of the cuboid posterior to the navicular bone if the patient has a high longitudinal arch.
B) was obtained with the proximal lower leg elevated.
C) was obtained with the leg externally rotated.
D) will also demonstrate the fibula too posterior on the tibia.
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53
A poorly positioned 45-degree AP oblique ankle projection demonstrates the calcaneus obscuring the distal aspect of the lateral mortise and the distal fibula. How should the positioning setup be adjusted to obtain an optimal projection?
A) Increase the degree of internal leg rotation.
B) Decrease the degree of internal leg rotation.
C) Dorsiflex the foot to a 90-degree angle with the lower leg.
D) Center the central ray more distally on the ankle.
A) Increase the degree of internal leg rotation.
B) Decrease the degree of internal leg rotation.
C) Dorsiflex the foot to a 90-degree angle with the lower leg.
D) Center the central ray more distally on the ankle.
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54
Positioning the femur at a 60- to 70-degree angle with the imaging table for the PA axial knee projection (Holmblad method)
1)superimposes the proximal surfaces of the intercondylar fossa.
2)places the patellar apex superior to the intercondylar fossa.
3)superimposes the lateral and the medial surfaces of the intercondylar fossa.
4)superimposes the anterior and posterior margins of the tibia plateau.
A) 1 only
B) 1 and 2 only
C) 3 and 4 only
D) 1, 2, and 3 only
1)superimposes the proximal surfaces of the intercondylar fossa.
2)places the patellar apex superior to the intercondylar fossa.
3)superimposes the lateral and the medial surfaces of the intercondylar fossa.
4)superimposes the anterior and posterior margins of the tibia plateau.
A) 1 only
B) 1 and 2 only
C) 3 and 4 only
D) 1, 2, and 3 only
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55
An optimal AP axial foot projection demonstrates all of the following except
A) an open medial-intermediate cuneiform joint space.
B) uniform density across the phalanges, metatarsals, and tarsals.
C) the calcaneus without talar superimposition.
D) open TMT joint spaces.
A) an open medial-intermediate cuneiform joint space.
B) uniform density across the phalanges, metatarsals, and tarsals.
C) the calcaneus without talar superimposition.
D) open TMT joint spaces.
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56
When the legs are flexed 30 degrees for the tangential knee projection (Merchant method), the central ray should be angled
A) 75 degrees.
B) 45 degrees.
C) 60 degrees.
D) perpendicular to the lower leg.
A) 75 degrees.
B) 45 degrees.
C) 60 degrees.
D) perpendicular to the lower leg.
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57
If a PA axial knee projection (Holmblad method) is obtained with the patient's heel rotated internally, which of the following are true?
1)The proximal surfaces of the intercondylar fossa are not superimposed.
2)The lateral and the medial surfaces of the intercondylar fossa are not superimposed.
3)The patella is rotated laterally.
4)The tibia is demonstrated without fibular head superimposition.
A) 1 and 3 only
B) 2 and 3 only
C) 2, 3, and 4 only
D) 1 and 4 only
1)The proximal surfaces of the intercondylar fossa are not superimposed.
2)The lateral and the medial surfaces of the intercondylar fossa are not superimposed.
3)The patella is rotated laterally.
4)The tibia is demonstrated without fibular head superimposition.
A) 1 and 3 only
B) 2 and 3 only
C) 2, 3, and 4 only
D) 1 and 4 only
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58
An optimal mortise (15- to 20-degree) AP oblique ankle projection demonstrates the
A) distal fibula without talar superimposition.
B) medial mortise as an open space.
C) fibula without tibial superimposition.
D) sinus tarsus.
A) distal fibula without talar superimposition.
B) medial mortise as an open space.
C) fibula without tibial superimposition.
D) sinus tarsus.
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59
If the curves of the posterior knees are not accurately positioned just above the bend of the "axial viewer" for a tangential knee projection (Merchant method), the
1)patellae may be projected into the patellofemoral joint spaces.
2)tibial tuberosities may be demonstrated within the joint spaces.
3)soft tissue from the anterior thighs is projected into the joint spaces.
4)knees are flexed more or less than 45 degrees.
A) 1 and 4 only
B) 1 and 2 only
C) 2 and 3 only
D) 1, 2, and 4 only
1)patellae may be projected into the patellofemoral joint spaces.
2)tibial tuberosities may be demonstrated within the joint spaces.
3)soft tissue from the anterior thighs is projected into the joint spaces.
4)knees are flexed more or less than 45 degrees.
A) 1 and 4 only
B) 1 and 2 only
C) 2 and 3 only
D) 1, 2, and 4 only
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60
An AP knee projection on a patient with an ASIS to tabletop measurement of 17 cm was obtained using a perpendicular central ray. The resulting image will demonstrate
A) an open knee joint.
B) an elongated fibular head.
C) the fibular head more than 0.5 inch (1.25 cm) from the tibial plateau.
D) the anterior tibial margin distal to the posterior tibial margin.
A) an open knee joint.
B) an elongated fibular head.
C) the fibular head more than 0.5 inch (1.25 cm) from the tibial plateau.
D) the anterior tibial margin distal to the posterior tibial margin.
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61
An internally rotated AP oblique knee projection demonstrates the tibia partially superimposed over the fibular head. How should the positioning setup be adjusted to obtain an optimal projection?
A) Increase the degree of internal rotation.
B) Decrease the degree of internal rotation.
C) Adjust the central ray angulation 5 degrees caudally.
D) Fully extend the knee.
A) Increase the degree of internal rotation.
B) Decrease the degree of internal rotation.
C) Adjust the central ray angulation 5 degrees caudally.
D) Fully extend the knee.
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62
A less than optimal PA axial knee projection (Holmblad method) demonstrating the medial and lateral aspects of the intercondylar fossa without superimposition
A) will also demonstrate the tibia without fibular head superimposition if the heel was rotated medially.
B) will also demonstrate a laterally situated patella if the heel was rotated laterally.
C) was obtained because the knee was underflexed.
D) was obtained because the femur was positioned vertically.
A) will also demonstrate the tibia without fibular head superimposition if the heel was rotated medially.
B) will also demonstrate a laterally situated patella if the heel was rotated laterally.
C) was obtained because the knee was underflexed.
D) was obtained because the femur was positioned vertically.
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63
An optimal lateral knee projection demonstrates
A) contrast and density to visualize the posterior pericapsular fat pads.
B) the tibia without fibular head superimposition.
C) 45 degrees of knee flexion.
D) superimposed femoral condyles.
A) contrast and density to visualize the posterior pericapsular fat pads.
B) the tibia without fibular head superimposition.
C) 45 degrees of knee flexion.
D) superimposed femoral condyles.
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64
A less than optimal tangential knee projection (Merchant method) demonstrating the tibial tuberosities within the patellofemoral joint spaces
A) was obtained because the posterior knee curve was positioned too far below the bend of the axial viewer.
B) was obtained because the knee was bent more than 45 degrees.
C) will result when the patient has large calves and the axial viewer's angle is not decreased.
D) will also demonstrate soft tissue from the patient's anterior thighs projected onto the patellae and patellofemoral joint spaces.
A) was obtained because the posterior knee curve was positioned too far below the bend of the axial viewer.
B) was obtained because the knee was bent more than 45 degrees.
C) will result when the patient has large calves and the axial viewer's angle is not decreased.
D) will also demonstrate soft tissue from the patient's anterior thighs projected onto the patellae and patellofemoral joint spaces.
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65
A less than optimal lateral knee projection that demonstrates the medial femoral condyle anterior to the lateral femoral condyle will also demonstrate
A) the fibula superimposed by the tibia.
B) the abductor tubercle on the anterior femoral condyle.
C) an open patellofemoral joint.
D) an unobscured suprapatellar fat pad.
A) the fibula superimposed by the tibia.
B) the abductor tubercle on the anterior femoral condyle.
C) an open patellofemoral joint.
D) an unobscured suprapatellar fat pad.
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66
A cross-table lateromedial knee projection demonstrates the medial femoral condyle distal to the lateral femoral condyle. To obtain an optimal projection,
A) rotate the x-ray tube column to align the central ray more cephalically.
B) adjust the central ray angulation posteriorly.
C) adduct the patient's leg.
D) internally rotate the patient's leg.
A) rotate the x-ray tube column to align the central ray more cephalically.
B) adjust the central ray angulation posteriorly.
C) adduct the patient's leg.
D) internally rotate the patient's leg.
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67
Which of the following statements is true about an optimal tangential knee projection (Merchant method)?
A) A patellar subluxation is demonstrated as long as the patellae are positioned directly above the intercondylar sulcus.
B) The lateral femoral condyle demonstrates more height than the medial femoral condyle.
C) To demonstrate a patellar subluxation, the quadriceps femoris must be tightly contracted.
D) The central ray and axial view angulation, when added, should equal 100 degrees.
A) A patellar subluxation is demonstrated as long as the patellae are positioned directly above the intercondylar sulcus.
B) The lateral femoral condyle demonstrates more height than the medial femoral condyle.
C) To demonstrate a patellar subluxation, the quadriceps femoris must be tightly contracted.
D) The central ray and axial view angulation, when added, should equal 100 degrees.
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68
An accurately positioned PA axial knee projection (Holmblad method) demonstrates all of the following except
A) superimposition of the proximal intercondylar fossa surfaces.
B) the intercondylar eminence and tubercles in profile.
C) the patellar apex within the intercondylar fossa.
D) the fibular head 0.5 inch (1.25 cm) distal to the tibial plateau.
A) superimposition of the proximal intercondylar fossa surfaces.
B) the intercondylar eminence and tubercles in profile.
C) the patellar apex within the intercondylar fossa.
D) the fibular head 0.5 inch (1.25 cm) distal to the tibial plateau.
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69
An externally rotated AP oblique knee projection that was taken with the knee rotated more than 45 degrees will demonstrate the
A) fibular head aligned with the anterior edge of the tibia.
B) fibula without tibial superimposition.
C) fibula located in the center of the tibia.
D) lateral condyle in profile.
A) fibular head aligned with the anterior edge of the tibia.
B) fibula without tibial superimposition.
C) fibula located in the center of the tibia.
D) lateral condyle in profile.
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