Knee - Rosenbergs

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Knee - PA Weightbearing (Rosenbergs)
Area Covered	Distal femur, proximal tibia and fibula, bilateral tibiofemoral joint spaces under the effects of gravity
Pathology shown	Joint space narrowing due to cartilage degeneration or other knee joint pathologies
Radiographic Anatomy	Knee Radiographic Anatomy
IR Size & Orientation	35 x 43cm Landscape
Film / Screen Combination	Regular (CR and DR as recommended by manufacturer)
Bucky / Grid	Moving or stationary grid
Filter	No
Exposure	66 kVp 12 mAs
FFD / SID	100cm
Central Ray	CR perpendicular to IR Directed to a midpoint between the knee joints at a level of the patella apices
Collimation	Collimate to bilateral knee joint region include distal femur and proximal tibia / fibula to see alignment of joints
Markers	Distal and Lateral Marker orientation PA
Shielding	Gonadal (check your department's policy guidelines)
Respiration	Not applicable
Positioning	Patient erect, standing on a step to place patient high enough for horizontal ray (Some X-ray tubes dont go all the way down to the ground, to counter this you raise the patient on a step) Patient facing the upright bucky Position feet straight ahead with weight evenly distributed on both feet (support handles may be required for some patients) Flex knees 45° with both patellae touching the IR CR perpendicular to IR, directed to a midpoint between the knee joints at a level of the patella apices
Critique PACEMAN	Positioning Area Covered Collimation Exposure
Special Notes	The maximum stresses in the knee joint occur between 30° and 60° of flexion; therefore, standard anteroposterior (AP) weight-bearing radiographs on extension are not ideal for evaluation of cartilage loss as indicated by joint space narrowing. The Rosenberg view was created to address this issue. The Rosenberg view is a 45-degree flexion, posteroanterior, weight-bearing view of the knee with the patellae touching the image receptor. The Rosenberg view is more sensitive and specific for joint space narrowing than the conventional extension weight-bearing anteroposterior views, and is useful for the assessment of knees with early degenerative change.