Proximal Forearm - AP Projection (Partial Flexion) Holly Method

Proximal Forearm – AP Projection Partial Flexion

Holly Method

Holly described a method of obtaining the AP projection of the radial head. The patient is positioned as described for the distal humerus. The elbow is extended as much as possible, and the forearm is supported. The forearm should be supinated enough to place the horizontal plane of the wrist at an angle of 30 degrees from horizontal.

Image receptor: 8 X 10 inch

Patient Position

Let the patient seat at the end of the radiographic table with the hand supinated.

Part Position:

• Let the patient seat high enough to permit the dorsal surface of the forearm to rest on the table. If this position is not possible, elevate the limb on a support, place the IR in the vertical position behing the upper end of the forearm, and direct the central ray horizontally.
• Shield gonads

Central ray:

• Central ray is perpendicular to the elbow joint and long axis of the forearm.
• Adjust the IR so that the central ray passes to its midpoint.

Structure Shown:

This projection demonstrated the proximal forearm when the elbow cannot be fully extended.

Evaluation Criteria:

The following should be clearly demonstrated:

• The proximal radius and ulna without rotation or distortion
• Radial head, neck and tuberosity slightly superimposed over the proximal ulna.
• Partially open elbow joint
• Foreshortened distal humerus
• Trabecular detail on the proximal forearm.