Pediatric forearm (AP view)
The anteroposterior forearm view for pediatrics is a standard projection to assess the radius and ulna.
This view demonstrates the elbow joint in its natural anatomical position allowing for assessment of suspected dislocations or fractures and localizing foreign bodies within the forearm.
However, this view should not be considered when evaluating occult wrist or elbow injuries due to beam divergence. Beam divergence at the edges of the image should be acknowledged when assessing anatomy 1.
- patient is seated alongside the table
- the fully extended forearm is supinated and kept in contact with the image receptor
- ensure all dorsal aspects of the forearm from wrist to elbow are kept in contact with the receptor
- anteroposterior projection
- mid forearm region
- distal to the wrist joint
- proximal to elbow joint
- 24 cm x 30 cm
- 50-55 kVp
- 1.6-2 mAs
- 110 cm
Image technical evaluation
- the trochlea and capitellum can be seen in profile.
- the wrist is in AP position, with minimal superimposition of the distal radius and ulna.
- the arm should be extended appropriately, evidenced by the radial head being seen in profile.
Preparing the room beforehand (setting up the detector, exposure and preparing lead gowns) is extremely beneficial for forearm imaging as young children may begin to cry the moment their affected arm is brought away from their body.
To prevent malrotation/motion artifact in the radiograph, parental holding at the proximal half of the child’s arm and distal part of the hand may be required. Other alternative methods such as distraction techniques may be ideal to avoid scattered radiation to parents and staff 3.
- 1. Martensen KM. Radiographic Image Analysis. Saunders. ISBN:B00EDQ25XC. Read it at Google Books - Find it at Amazon
- 2. A paediatric X‐ray exposure chart. (2014) Journal of Medical Radiation Sciences. 61 (3): 191. doi:10.1002/jmrs.56 - Pubmed
- 3. Ng JHS, Doyle E. Keeping Children Still in Medical Imaging Examinations- Immobilisation or Restraint: A Literature Review. (2019) Journal of medical imaging and radiation sciences. 50 (1): 179-187. doi:10.1016/j.jmir.2018.09.008 - Pubmed