Upper Extremity

Abstract

The type of upper extremity radiography is determined by the clinical indication. Table 23.1 shows indications and Table 23.2 contraindications for upper extremity radiography. Image criteria as required for radiological findings in upper extremity radiographs are listed in Table 23.3. In order to fulfil these image criteria, the field settings listed in Tables 23.4 and 23.5 should be achieved. These field settings go along with the patient preparation as listed in Table 23.6. Exposure parameter combinations for various age groups and upper arm diameters are listed in Tables 23.7, 23.8, and 23.9. The age groups in Table 23.8 refer to the standard age groups of the mathematical MIRD phantom family which has been used to calculate the normalized organ doses in this book. Table 23.9 shows radiation qualities (i.e. various combinations of tube voltage and total filtration) which may be applied in clinical practice. Please note that not all of these radiation qualities are recommended by the authors. The standard projections of upper extremity radiographies of the patient who is correctly positioned are depicted in Fig. 23.1. Also the optimal field (marked in green), the suboptimal field (marked in red), and the correct shielding are shown. Table 23.11, 23.12, and 23.13 outlines the virtual field settings on the skin surface of mathematical MIRD phantoms of various age groups and the resulting virtual radiographies with and without bone structures, respectively. Normalized organ doses resulting from these virtual field settings have been calculated for all age groups and have been listed in Tables 23.14, 23.15, 23.16, 23.17, 23.18, 23.19, 23.20, 23.21, 23.22, 23.23, 23.24, 23.25, 23.26, 23.27, and 23.28. Light green shaded table cells refer to optimal field settings and pink shaded table cells refer to suboptimal field settings. Please note that normalized organ doses have been provided also for exposure parameter combinations, which are not recommended by the authors.