The anteroposterior knee view for pediatrics is one of two views in order to examine the knee joint, patella, distal femur and proximal tibia and fibula. Depending on the child's age and the departmental protocol, additional views such as the skyline and intercondyler views may also be performed.
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Indications
This projection demonstrates the knee in its natural anatomical position. It is useful in diagnosing fractures, soft tissue effusions and joint space abnormalities in pediatric patients.
Patient position
the patient is supine with the affected leg extended
the affected knee is in contact with the image receptor and knee is not rotated
Technical factors
anteroposterior projection
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centering point
1.5 cm distal to the apex of the patella
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collimation
lateral to the skin margins
superior to include the distal femur
inferior to include the proximal tibia and fibula
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orientation
portrait
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detector size
18 cm x 24 cm
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exposure 1
50-60 kVp
1-2 mAs
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SID
100 cm
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grid
no
Image technical evaluation
Tibial and femoral condyles are symmetrical demonstrating no rotation of the knee. The medial aspect of the fibular head is seen to partly superimpose the tibia 2. A physical metal marker is ideal for pediatric imaging.
Practical points
Preparing the room beforehand (setting up the detector, exposure and preparing lead gowns) is important as pediatric patients may not remain still when their affected knee is moved onto the detector.
Immobilization techniques
It is important for the radiograph to be free from motion artifact and rotation to avoid repeated x-rays.
it may be necessary for the parent or radiographer to hold the patient in position
ideally the parent should be in the child's direct line of sight
techniques will vary based on the department
distraction techniques can be utilized to avoid scattered radiation to parents and staff 3
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