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Optimization of the fixed-flexion knee radiograph
Purpose:
To develop a user-friendly method of achieving optimal radiographs for measurement of joint space width of the knee with minimal radiation exposure. In order to accomplish this the X-ray technologist must (1) be able to identify the anterior and posterior rims of the tibial plateau at a variety of X-ray head angles and (2) be able to choose the direction to adjust the head angle to get a better view based on the criteria for acceptable radiographs.
Methods:
We have developed a training manual and materials to instruct investigators and radiology technologists in a method that uses a commercially available Plexiglas positioning frame (Synaflexer) and standard X-ray equipment to achieve optimal X-rays with regard to tibial plateau alignment of the knee. This should be accomplished with four or fewer radiographs.
Results:
Optimized radiographs for joint space width measurements are achieved without the need for fluoroscopy or foot maps.
Conclusions:
This method is readily understood and instituted by radiology technologists in the field.
