Elbow Axiolateral, Coyle (Coronoid Process)

• Coronoid process in profile.
• Trochlea of the humerus.
• Open humeroulnar joint.
• Medial epicondyle.
• Distal third of the humerus.
• Proximal radius (partially overlapped).

• Verify patient identity using two identifiers.
• Remove watches, bracelets, and radiopaque items from the arm.
• Seat the patient at the end of the table.
• Flex the elbow 80 degrees with the palm flat against the IR.
• Adjust so humerus, elbow, and wrist sit in the same plane.

Radial head, with the CR exiting at the mid-elbow. Elbow flexed 80 degrees, palm flat on IR.

CR angled 45 degrees away from the shoulder, entering at the radial head.

kVp

60–75

mAs

3–6

SID

40" (102 cm)

Notes

Pairs with the radial-head Coyle when the elbow cannot extend for a standard lateral.

• Coronoid process of the ulna in profile, free of the radial head.
• Open humeroulnar joint space.
• Trochlea visible.
• Distal humerus and proximal forearm both included.
• Bone trabeculae sharp, no motion blur.
• Collimation: 3 inches proximal and distal to the joint.

1. 1 CR angled less than 45 degrees leaves the coronoid overlapped.
2. 2 Tube angled toward instead of away from the shoulder gives the radial-head view.
3. 3 Failure to flex 80 degrees distorts the joint space.
4. 4 Pronation past flat closes the humeroulnar space.

• Suspected coronoid process fracture.
• Patient unable to extend the elbow for a true AP oblique.
• Post-trauma assessment when other projections are inconclusive.
• Follow-up of coronoid fixation.