PA Axial Intercondylar Fossa Standing Holmblad is a radiography positioning projection of the Lower Extremity. Standing facing IR, knee flexed ~70 degrees, CR perpendicular to lower leg. SID 40". The centering point is located intercondylar notch with patient standing and knee flexed ~70 degrees.. The central ray is perpendicular to the lower leg (no tube angle; the flexed-knee position provides the axial projection).. Image-quality criteria include intercondylar eminence clearly visualized in axial projection., intercondylar notch and fossa open and clearly defined.. Standard exposure ranges from 65 to 75 kVp, 5 to 10 mAs, at an SID of 40 inches (102 cm).
Anatomy demonstrated
- Intercondylar eminence of tibia.
- Intercondylar fossa and notch.
- Femoral condyles in profile.
- Tibial plateau in axial projection.
- Anterior and posterior tibial spines.
- Fibular head in relation to tibia.
Patient preparation
- Verify patient identity using two identifiers.
- Remove shoes and any radiopaque items from the leg.
- Position patient standing facing IR with affected knee forward.
- Flex knee 65 degrees and rest on IR or stepping stool.
- Ensure equal weight distribution on both feet.
Position & centering point
Intercondylar notch with patient standing and knee flexed ~70 degrees.
Central ray
Perpendicular to the lower leg (no tube angle; the flexed-knee position provides the axial projection).
Exposure / technique
- kVp
- 65–75
- mAs
- 5–10
- SID
- 40" (102 cm)
- Notes
- Standing weight-bearing Holmblad method requires precise knee flexion angle.
Image-quality criteria
- Intercondylar eminence clearly visualized in axial projection.
- Intercondylar notch and fossa open and clearly defined.
- Both femoral condyles visible in profile relationship.
- Tibial plateau included showing intercondylar area.
- Anterior and posterior tibial spines differentiated.
- Collimation 1 inch on sides, 1.5 inches proximal and distal.
Common errors / ARRT traps
- 1 Insufficient knee flexion (less than 65 degrees) opens joint too wide.
- 2 Excessive knee flexion obscures intercondylar notch visualization.
- 3 CR angle not perpendicular to lower leg distorts anatomy.
- 4 Lateral or medial rotation of leg distorts intercondylar view.
Clinical indications
- Intercondylar eminence fracture evaluation.
- Anterior or posterior cruciate ligament origin assessment.
- Osteochondritis dissecans of the intercondylar fossa.
- Weight-bearing intercondylar pathology evaluation.
Aligned to the 2025 ARRT Content Specifications.