Knee (horizontal beam lateral view)
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The horizontal beam lateral view (cross-table lateral) is an orthogonal view of the AP view of the knee requiring little to no patient movement and is hence the lateral projection of choice for acute knee injuries.
Indications
This view is the ideal projection to assess for lipohaemarthrosis as it demonstrates the region of subpatellarsuprapatellar bursa and associated fat pads for possible displacement or presence of fluid levels from knee pathology 1. Knee pathology can include fracture or dislocation of the femur, tibia, fibula or patella.
Patient position
- the patient is supine on the table/bed
-
affectaffected knee is flexed slightly ≈ 30° (to the best of patient's ability) - the detector is placed against the medial side of the knee running parallel to the affected leg, often held by the patient or sandbags
- the long axis of the femur is running perpendicular to the beam
Technical factors
- lateromedial projection
-
centring point
- centre to the knee joint 1.5-2.0 cm distal to the apex of the patella or at the tibial tuberosity if the patella is affected by certain injury patterns
-
collimation
- superior to include the distal femur
- inferior to include the proximal tibia/fibula
- anterior to include the skin margin
- posterior to include skin margin
-
orientation
- landscape
-
detector size
- 35 cm x 43 cm
-
exposure
- 60-70 kVp
- 7-10 mAs
-
SID
- 100 cm
-
grid
- no
Image technical evaluation
A true horizontal beam lateral projection will have the following characteristic:
- superimposition of the medial and lateral condyles of the distal femur
- an open patellofemoral joint space
- slight superimposition of the fibular head with the tibia
Practical points
The distal femoral condyles have distinct features that can be used for differentiation and hence positional errors that can be corrected.
The medial condyle has a medial adductor tubercle, located superior to the medial epicondyle, a bony protuberance that acts as the attachment point the adductor minimus and the hamstrings part of the adductor magnus.The lateral condyle has the condylopatellar sulcus also known as the lateral notch, a groove in the lateral femoral condyle. The easy way to remember is femoral is flat.
Correcting rotational errors
- medial adductor tubercle is posterior to the lateral condyle
- rotate the knee externally to bring it anterior
- medial adductor tubercle is anterior to the lateral condyle
- rotate the knee internally to bring it posteriorly
Abduction and adduction
- medial condyle is proximal to the lateral condylar
- perform adduction
- medial condyle is distal to the lateral condyle
- perform abduction
-<p>The <strong>horizontal beam lateral view</strong> <strong>(cross-table lateral) </strong>is an orthogonal view of the AP view of the knee requiring little to no patient movement and is hence the lateral projection of choice for acute knee injuries.</p><h4>Indications</h4><p>This view is the ideal projection to assess for <a href="/articles/lipohaemarthrosis">lipohaemarthrosis</a> as it demonstrates the region of subpatellar bursa and associated fat pads for possible displacement or presence of fluid levels from knee pathology <sup>1</sup>. Knee pathology can include fracture or dislocation of the femur, tibia, fibula or patella.</p><h4>Patient position</h4><ul>- +<p>The <strong>horizontal beam lateral view</strong> <strong>(cross-table lateral) </strong>is an orthogonal view of the AP view of the knee requiring little to no patient movement and is hence the lateral projection of choice for acute knee injuries.</p><h4>Indications</h4><p>This view is the ideal projection to assess for <a href="/articles/lipohaemarthrosis">lipohaemarthrosis</a> as it demonstrates the <a title="Suprapatellar bursa" href="/articles/suprapatellar-bursa">suprapatellar bursa</a> and associated fat pads for possible displacement or presence of fluid levels from knee pathology <sup>1</sup>. Knee pathology can include fracture or dislocation of the femur, tibia, fibula or patella.</p><h4>Patient position</h4><ul>
-<li>affect knee is flexed slightly ≈ 30° (to the best of patient's ability)</li>- +<li>affected knee is flexed slightly ≈ 30° (to the best of patient's ability)</li>
-</ul><h4>Practical points</h4><p>The distal femoral condyles have distinct features that can be used for differentiation and hence positional errors that can be corrected.</p><p>The medial condyle has a <a title="Adductor tubercle" href="/articles/adductor-tubercle-1">medial adductor tubercle</a>, located superior to the medial epicondyle, a bony protuberance that acts as the attachment point the <a href="/articles/adductor-minimus-muscle">adductor minimus</a> and the hamstrings part of the <a href="/articles/adductor-magnus-muscle">adductor magnus</a>.<br>The lateral condyle has the condylopatellar sulcus also known as the lateral notch, a groove in the lateral femoral condyle. The easy way to remember is femoral is flat.</p><h6>Correcting rotational errors </h6><ul>- +</ul><h4>Practical points</h4><p>The distal femoral condyles have distinct features that can be used for differentiation and hence positional errors that can be corrected.</p><p>The medial condyle has a <a href="/articles/adductor-tubercle-1">medial adductor tubercle</a>, located superior to the medial epicondyle, a bony protuberance that acts as the attachment point the <a href="/articles/adductor-minimus-muscle">adductor minimus</a> and the hamstrings part of the <a href="/articles/adductor-magnus-muscle">adductor magnus</a>.<br>The lateral condyle has the condylopatellar sulcus also known as the lateral notch, a groove in the lateral femoral condyle. The easy way to remember is femoral is flat.</p><h6>Correcting rotational errors</h6><ul>
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