Femur x ray AP and lateral femur x ray femur radiograph positioning — eTECH
Femur x ray, x ray femur ap lateral projection
AP PROJECTION
ANATOMIC STRUCTURES
Femur
Hip joint and knee joint
FILM SIZE
7 x 17 in. (18 x 43 cm), lengthwise or 14 x 17 in (35 x 43 cm), lengthwise
NOTE: The larger film is used if smaller film is unavailable
PATIENT POSITION
NOTE: This projection can be performed on a stretcher if the patient’s condition prevents movement to a Radiographic table. Use a grid cassette unless the thigh measures less than 10 cm Place patient supine (face up) on table with pillow under head. Place lead shield to protect gonads as much as possible, but do not cover any part of hip joint or femur
PART POSITION
Have patient extend both legs, making certain that pelvis is not rotated Align long axis of thigh with mid line of table
Abduct (away from midline) opposite leg enough to prevent superimposition
Have patient rotate entire leg medially internally) 15″ (to correct anteversion or foreshortening of femoral neck) Place support against leg to aid in maintaining medial rotation and immobilization. Center cassette (in Bucky tray) to midpoint of thigh, making sure to include hip joint and or knee joint
NOTE:
If the entire thigh femur bone x ray (including both joints) cannot be shown on one film, an ad ditional AP projection using a smaller cassette can be used to include the joint and adjacent portion of the thigh that was excluded on the initial radiograph. After the initialser of radiographs, it is usually necessary to include only the joint closer to the portion of the thigh in question
CENTRAL RAY
Direct central ray perpendicular to mid thigh
IMAGE CRITERIA
Entire femur, including joint nearer site of interest, should be seen on initial radiographs the other joint should also be demonstrated if hip joint is included: Neck of femur should be seen without foreshortening lesser trochanter should not be visualized (if more than tip of lesser trochanter is free of superimposition leg has not been internally rotated enough)
If knee joint is included: Patella should superimpose femur Proximal tibia should partially superimpose head of fibula
femur lateral view
LATERAL PROJECTION
ANATOMIC STRUCTURES
Femur
FILM SIZE
NOTE Do not use this projection for a patient significant displacement of fracture frag. to internal fixation, since this could cause Hip joint or knee joint (as required) knee of unaffected side to allow foot to rest on table to aid in support and immobilization. Flex knee of affected side enough to with a new or recent femoral fracture prior
7 x 17 in. (18 x 43 cm), lengthwise or 14 x 17 in (35 X 43 cm), lengthwise
NOTE: The larger film is used if the smaller film is unavailable
NOTE: Since both joints can seldom be included on one radiograph, a second radiograph should be performed to show the other joint on the initial examination. After the initial set of radiographs, it is usually necessary to include only the joint closer to the portion of the thigh in question.
PATIENT FEMUR X RAY POSITION
Place patient on table in lateral position with affected thigh on table. Place pillow under patient’s head.
Place lead shield to protect gonads as much as possible, being careful not to cover any part of hip joint or femur
PART POSITION
To include hip joint, have patient roll posteriorly (backward) about 15° (to prevent superimposition of hip joint). Support elevated side of body, and place opposite extremity posterior to (behind) affected extremity. Flex knee of unaffected side to allow foot to rest on table to aid in support and immobilization Flex knee of affected side enough to place patella surface perpendicular to plane of table.
To include knee joint, have patient remain in lateral position while crossing opposite extremity over affected extremity. Flex and draw knee up toward upper body to decrease superimposition of opposite femur (remembering to keep pelvis lateral). Place support under flexed knee to prevent patient from rolling backward or forward. Flex knee of affected extremity 45°, and adjust position to place patella perpendicular to plane of table.For both positions Align long axis of thigh to midline of table. Center cassette (in Bucky try to slightly above or below midthigh level (making certain to include joint nearer site of interest)
CENTRAL RAY
Direct central ray perpendicular to a point just above or below midthigh (depending on joint to be included) or to midpoint of cassette
IMAGE CRITERIA
Entire femur, including hip and knee joints,should be seen (especially on initial radiographs)If hip joint is included:
Pelvis and opposite extremity should not be superimposed
Greater and lesser trochanters should be superimposed by femur If knee joint is included:
Opposite extremity should not overlie affected thighFemoral condyles should be partially superimposed
Patella should be seen in profile with femoropatellar space open
EXCEPTION
In patients who have sustained trauma , femoral neck fracture or are unable to assume the lateral position, an alternative projection is the possible lateral Place the patient supine with the leg extended Place the cassette to either the lateral or medial side of the leg (must be on the lateral side to include the hip joint), and use a horizontal beam Remember to place the cassette low enough to include the posterior surface of the thigh. A grid cassette should be used unless the patients thigh measures less than 10 cm
Originally published at https://getetech.com on June 13, 2021.