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A properly positioned tangential projection of the wrist will demonstrate which of the following? 1) Flexor retinaculum anteriorly and the capitate posteriorly 2) Scaphoid and trapezium laterally 3) Scaphoid and trapezoid medially 4) Pisiform and hamate medially 5) Flexor retinaculum posteriorly and the capitate anteriorly 6) Pisiform and hamate laterally


A) 1, 3, and 4 only
B) 1, 2, and 4 only
C) 3, 5, and 6 only
D) 3, 4, and 5 only

E) C) and D)
F) All of the above

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B

For a carpal canal wrist image, the 1) wrist is hyperextended until the long axes of the metacarpals are vertical. 2) hand is rotated 10 degrees internally until the fifth metacarpal is perpendicular to the IR. 3) central ray is angled 25 to 30 degrees proximally. 4) central ray is centered to the palm of the hand.


A) 1 and 4 only
B) 2 and 3 only
C) 1, 2, and 3 only
D) 1, 2, 3, and 4

E) A) and B)
F) A) and C)

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Where are the soft tissue structures that can be used to indicate joint effusion located on the PA wrist projection?


A) Anteriorly
B) Medially
C) Laterally
D) Posteriorly

E) B) and D)
F) A) and B)

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A less than optimal PA finger projection demonstrates unequal soft tissue width and midshaft concavity on each side of the phalanges. The side of the phalanges with the greatest midshaft concavity is facing the shortest finger metacarpal. All of the following are true about this projection except that the


A) finger was internally rotated.
B) projection will demonstrate more soft tissue width on the lateral surface.
C) projection will demonstrate open IP and MP joints as long as the digit remains parallel with the IR.
D) projection will demonstrate less phalangeal concavity on the lateral surface.

E) A) and C)
F) A) and B)

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A PA oblique wrist projection with poor positioning demonstrates an obscured trapeziotrapezoidal joint space and excessive trapezoid and capitate superimposition. How should the positioning setup be adjusted for an optimal image to be obtained?


A) Externally rotate the wrist.
B) Internally rotate the wrist.
C) Ulnar-deviate the wrist.
D) Unflex the hand.

E) B) and D)
F) None of the above

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B

A PA wrist projection obtained with the hand flexed and the metacarpals at a 45-degree angle with the IR demonstrates 1) a closed radioulnar articulation. 2) foreshortened metacarpals. 3) a decrease in scaphoid foreshortening. 4) closed second through fifth carpometacarpal joint spaces.


A) 1 and 3 only
B) 1, 2, and 4 only
C) 2, 3, and 4 only
D) 1, 2, 3, and 4

E) B) and C)
F) A) and D)

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A PA hand projection obtained with the hand flexed demonstrates 1) foreshortened phalanges. 2) the thumb in a lateral projection. 3) closed IP joint spaces. 4) foreshortened metacarpals.


A) 1 and 3 only
B) 2 and 4 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4

E) A) and D)
F) A) and B)

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To take advantage of the anode heel effect when imaging a forearm,


A) a detailed screen is used.
B) the elbow is positioned at the anode end of the x-ray tube.
C) the wrist is positioned at the anode end of the x-ray tube.
D) a 55- to 65-kVp technique is used.

E) None of the above
F) All of the above

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What is the central ray angulation used for the PA axial, ulnar-deviated wrist projection: a proximal scaphoid fracture is suspected, and the patient is unable to ulnar-deviate the wrist?


A) 15 degrees
B) 20 degrees
C) 5 to 10 degrees
D) 20 to 25 degrees

E) B) and C)
F) A) and D)

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A PA wrist projection obtained in slight external rotation demonstrates 1) superimposition of the laterally located carpal bones. 2) a closed radioulnar articulation. 3) open lateral carpal joint spaces. 4) the radial styloid in profile.


A) 1 and 4 only
B) 2 and 3 only
C) 2, 3, and 4 only
D) 1, 2, and 4 only

E) A) and C)
F) B) and C)

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A lateral forearm projection obtained in a patient with the proximal humerus elevated and the wrist internally rotated demonstrates the 1) radial head posterior to the coronoid process. 2) pisiform anterior to the distal scaphoid. 3) capitulum distal to the medial trochlea. 4) pisiform distal to the distal scaphoid


A) 1 and 2 only
B) 1 and 4 only
C) 1 and 3 only
D) 3 and 4 only

E) None of the above
F) A) and B)

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A lateral wrist projection obtained with the wrist in slight internal rotation demonstrates the 1) distal scaphoid anterior to the pisiform. 2) radius posterior to the ulna. 3) distal scaphoid distal to the pisiform. 4) radius anterior to the ulna.


A) 1 and 2 only
B) 3 and 4 only
C) 1 and 4 only
D) 2 and 3 only

E) B) and C)
F) A) and C)

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A lateral elbow projection obtained with the distal forearm positioned too low and the proximal humerus positioned too high demonstrates the 1) radial head distal and posterior to the coronoid process. 2) radial head proximal and anterior to the coronoid process. 3) capitulum posterior and proximal to the medial trochlea. 4) capitulum anterior and distal to the medial trochlea.


A) 1 and 3 only
B) 1 and 4 only
C) 2 and 3 only
D) 2 and 4 only

E) None of the above
F) A) and D)

Correct Answer

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Which side of the arm is positioned against the IR for the lateral second finger projection?


A) Ulnar
B) Radial

C) A) and B)
D) undefined

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An AP elbow projection obtained with the elbow internally rotated demonstrates 1) the radial tuberosity in profile. 2) an open capitulum-radial joint space. 3) more than 0.25 inch (0.6 cm) of radial head and ulnar superimposition. 4) less than 0.25 inch (0.6 cm) of radial head and ulnar superimposition.


A) 1 and 3 only
B) 2 and 3 only
C) 2 and 4 only
D) 1, 2, and 3 only

E) None of the above
F) A) and C)

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B

A lateral hand projection obtained with the hand in slight external rotation demonstrates the 1) shortest of the second through fourth metacarpals anteriorly situated. 2) radius posterior to the ulna. 3) second metacarpal posterior to the other metacarpals. 4) pisiform posterior to the distal scaphoid.


A) 1 and 2 only
B) 1, 2, and 3 only
C) 3 and 4 only
D) 1, 2, and 4 only

E) B) and C)
F) B) and D)

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A lateral forearm projection with accurate positioning demonstrates 1) the distal scaphoid slightly distal to the pisiform. 2) the ulnar styloid in profile. 3) an open elbow joint space. 4) the radial tuberosity in profile.


A) 1, 2, and 3 only
B) 1 and 3 only
C) 2 and 4 only
D) 1, 2, 3, and 4

E) A) and B)
F) A) and C)

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An externally rotated PA oblique wrist projection with accurate positioning demonstrates 1) the trapezoid and trapezium without superimposition. 2) an open radioulnar articulation. 3) the ulnar styloid in profile. 4) superimposition of the medially located carpals.


A) 2 and 3 only
B) 2 and 4 only
C) 1, 3, and 4 only
D) 1, 2, 3, and 4

E) None of the above
F) A) and B)

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A PA wrist projection obtained with the wrist in a neutral position demonstrates 1) the scaphoid in partial foreshortening. 2) the center of the lunate positioned distal to the radioulnar articulation. 3) closed CM joints. 4) alignment of the long axis of the third metacarpal and radius.


A) 1 and 3 only
B) 2 and 4 only
C) 1, 2, and 4 only
D) 1, 2, 3, and 4

E) A) and C)
F) A) and D)

Correct Answer

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What is the central ray angulation used for the PA axial, ulnar-deviated wrist projection: a distal scaphoid fracture is suspected, and the patient is able to ulnar-deviate until the first metacarpal and radius are aligned?


A) 15 degrees
B) 20 degrees
C) 5 to 10 degrees
D) 20 to 25 degrees

E) A) and B)
F) B) and C)

Correct Answer

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