Landmark FTC, FTA, FTP

Massive quadri-angular tubercle that extends to the top of the lateral face of the femoral diaphysis (see Figs 15.1 & 15.2). It has three edges: superior, anterior and posterior.

The palpator stands behind the standing subject. The subject’s leg is slightly flexed and in abduction (the foot can be put on a support).

First place a thumb on the iliac crest (blue line) and put the little finger along the axis of the thigh. Locate the greater trochanter in this area.

A more accurate palpation can then be performed with the three first fingers.

The thumb and middle fingers pinch the greater trochanter on the center of its posterior (FTP) and anterior (FTA) edges respectively.

Then place the forefinger in the middle of the virtual line traced between the thumb and middle finger.

The FTC landmark is pinpointed by the index finger between FTP and FTA.

Observe the femur from a lateral (slightly posterior) view (in this view the femoral head is partly hidden behind the greater trochanter).

Locate the center of the anterior (FTA) and posterior (FTP) edges (blue lines) of the greater trochanter. The FTC landmark is located at the center of the line running between FTA and FTP.

Landmark FAM

Bony protuberance situated on the superior edge of the medial condyle of the femur (see Figs 15.1 & 15.2).

Subject lying: The subject is lying supine, knee flexed, with the palpator at the subject’s knee.

Subject standing: The palpator kneels and places the subject’s foot on a thigh to flex the subject’s knee.

Place one hand flat on the distal medial aspect of the thigh. In the center of this area locate the tendon of the adductor magnus muscle and follow it distally (blue arrow).

This tendon attaches on a (usually well-developed) tubercle (FAM) above the medial epicondyle.

Select the tubercle tip by orienting your finger pulp distally.

Observe the femur from a posteromedial view.

FAM is at the center of a protuberance above the medial condyle.

Turn to a posterior view to verify that the selected point is on the superior angle of the condyle.

Landmark FME

This surface shows a small tubercle for the medial collateral ligament of the knee (see Figs 15.1 & 15.2).

Subject lying: The subject is lying supine, knee flexed, with the palpator at the subject’s knee.

Subject standing: The palpator kneels and places the subject’s foot on a thigh to flex the subject’s knee.

Place the middle finger on FAM (see p. 118) and the thumb on the distal edge of the medial condyle along the virtual line running distally from FAM (blue arrow).

Place the index finger midway between the thumb and the middle finger, and move it slightly forwards (towards the patella).

The index finger should locate a small tubercle (FME).

Observe the distal epiphysis from a medial view.

Find the center of the medial condyle at the intersection of the following virtual lines:

In relation to this intersection, the landmark (FME in red) to select is found slightly forwards.

Verify the validity of the landmark by turning the bone to a posterior view. Check that the selected point is on the apex of the condyle.

Landmark FMS

Sulcus located behind and below the medial epicondyle (see Figs 15.1 & 15.2).

Subject lying: The subject is lying supine, knee flexed, with the palpator at the subject’s knee.

Subject standing: The palpator kneels and puts the subject’s foot on a thigh to flex the subject’s knee.

Place the middle finger on FAM (see p. 118) and the thumb on the distal edge of the medial condyle along the virtual line running distally from FAM (blue line).

Place the tip (see p. 4) of the forefinger midway between the thumb and the middle finger.

Then roll the forefinger (see finger-rolling, p. 4) backwards until its pulp center reaches the skin.

Select the point just distal to the pulp center.

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