Four Series Position Radial Head - Greenspan and Norman Method

Radial Head Four Position Series - Lateral Projection

Lateral Medial Rotation

Place the image receptor in position, and cover the unused section with a sheet of lead mask. For the demonstration of the entire circumference of the radial head free of superimposition, four projection with varying positions of the hand are performed.

Image Receptor:

8 X 10 inch for single projection and 24 x 30 cm for 2 in 1 projections

Patient Position

Let the patient seat low enough to place the entire arm in the same horizontal plane.

Part Position 4 Series Position - Radial Head

• Flex the elbow 90 degrees, center the joint to the unmasked image receptor, and place the joint in the lateral position.
• Make the first exposure with the hand supinated as much as possible.
• Shift the image receptor and make the second exposure with the hand in the lateral position, that is, with the thumb surface up.
• Shift the image receptor and make the 3rd exposure with the hand pronated.
• Shift again the image receptor, and make the 4th exposure with the hand in extreme internal rotation, that is, resting on the thumb surface.
• Shield gonads.

Central ray:

Perpendicular to the elbow joint.

Structure shown:

The radial head is projected in varying degrees of rotation.

Evaluation Criteria:

The following should be clearly demonstrated:

• The radial tuberosity facing anteriorly for the 1st and 2nd images and posteriorly for the 3rd and 4th images.
• Elbow flexed 90 degrees.
• Radial head partially superimposing the coronoid process but seen in all images.

Greenspan and Norman Method - Lateral Projection Radial Head

Greenspan and Norman reported that the radial head can be projected more clearly with reduce superimposition by directing the central ray 45 degrees medially (toward the shoulder).