5. Lumbar Spine Flashcards
what is the SID for lumbar spine views
110cm
what is the kV for lumbar spine views
75-85kV
do you use grids for lumbar spine views
yes
what is the breathing instruction for lumbar spine views
suspend respiration on expiration
what is the CP for AP/PA lumbar spine view
for open and tight collimation
open collimation = perpendicular to the iliac crest
tight collimation = perpendicular to the lower costal margin midline, L3
what is the patient positioning for the AP/PA Lumbar spine views
in terms of rotation, what needs to be flexed
4 things
supine
check no rotation from end of the table
hips/knees flexed
no thorax/pelvis rotation = ASIS equidistant from the table
what is the image critique for AP/PA lumbar spine views in terms of positioning
in terms of what 3 thing shows no rotation, spinous processes and which joint spaces need to be open
5 things
no rotation = transverse process, SI joints and sacrum symmetrical
spinous process at midline
open intervertebral joint spaces
what is the image critique for AP/PA lumbar spine views in terms of area of interest
6 things
lumbar vertevral bodies
intervertebral joints
spinous and transverse processes
T12-S1
SI joint
Sacrum
what is the CP for Posterior/anterior oblique lumbar spine view
perpendicular to L3 of lower costal margin
3-5cm above iliac crest, 5cm medial to upside ASIS
what is the patient positioning for the Posterior/anterior oblique Lumbar spine views
in terms of patient body position, arms and body rotation
3 things
Recumbent or erect
Arm on side for exam raised on pillow
Body rot 45* towards affected side, use 45* sponge
what is the image critique for Posterior/anterior oblique lumbar spine views in terms of positioning
2 things
Zygapophyseal joints & pedicle centered on vert body
what is the image critique for Posterior/anterior oblique lumbar spine views in terms of area of interest
4 things
L1-L4/S1
Pedicle
Zygapophyseal joint (PO = downside, AO = upside)
Scottie dog elements
what is the CP for lateral lumbar spine view
for open and tight collimation
what is the angle if the spine isnt parallel
Perpendicular to spine long axis
Open collimation = Iliac crest (L4-5)
Tight collimation = 4cm above iliac crest lower costal margin (L3)
5-8* caudal angle if spine not parallel
what is the patient positioning for the lateral Lumbar spine views
in terms of patient body position, what needs to be flexed, sponge position
Recumbent/erect
Hips/knees flexed
Sponge under spine/waist so its parallel to table top
what is the image critique for lateral lumbar spine views in terms of positioning
3 things
Vertebral column parallel to IR
Intervertebral foramina & joint space open
No rotation
what is the image critique for lateral lumbar spine views in terms of area of interest
4 things
T12/L1 - distal Sacrum
L1-4 vert bodies
spinous processes
intervertebral joints & foramina
what is the CP for lateral L5-S1 lumbar spine view
what angle is used if spine isnt parallel
perpendicular to 4cm inferior to iliac crest, 5cm post to ASIS
5-8* caudal angle if spine not parallel
what is the patient positioning for the lateral L5-S1 Lumbar spine views
3 things
Recumbent/erect
Hips/knees flexed
Support under waist = spine & table parallel
what is the image critique for lateral L5-S1 lumbar spine views in terms of area of interest
3 things
Open L5-S1 vert bodies
intervertebral joint spaces & foramina
what is the image critique for lateral L5-S1 lumbar spine views in terms of positioning
3 things
Intervertebral joint spaces & foramina open
No rotation
what is the CP for AP axial L5-S1 lumbar spine view
what is the difference between the male and female angulation
30(male)-35 (Female) cranial
Midline ASIS level
what is the patient positioning for the AP axial L5-S1 Lumbar spine views
Supine
Legs extended, support under knees
Check no rotation from end of table
what is the image critique for AP axial L5-S1 lumbar spine views in terms of area of interest
2 things
L5-S1 joint space
SI joints
what is the patient positioning for the AP axial L5-S1
Lumbar spine views
in terms of what shows no pelvic rotation
1 things
No pelvic rotation = SI joints equidistant from spine
what is the CP for AP axial sacrum view
15* cranial
5cm superior to pubic symphysis
what is the patient positioning for the AP axial sacrum view
in terms of patient body position, hips, knees, IR centering, pelvis
4 things
Supine
Hips/knees flexed
MSP centred at table/IR midline
No pelvis rot = ASIS equidistant from table
what is the patient positioning for the AP axial sacrum view
2 things
Sacrum un-superimposed
Sacral foramina visible
what is the image critique for AP axial sacrum view
2 things
Sacrum not foreshortened
Sacral foramina visible
what is the CP for AP axial coccyx view
10* caudally
5cm superior to symphysis pubis
what is the patient positioning for the AP axial coccyx view
in terms of table alignment, rotation, knees
4 things
Supine
Support under knees
MSP aligned w/ table midline
No rotation
what is the patient positioning for the AP axial coccyx view
2 things
Coccyx un-superimposed
No rotation
what is the image critique for AP axial coccyx view in terms of area of interest
2 things
Coccyx not foreshortened
Coccyx region free of gas/stool
what is the CP for lateral sacrum & coccyx view
perpendicular 8-10cm posterior to ASIS
what is the patient positioning for the lateral sacrum & coccyx view
in terms of patient body, hips, knees, sponge placement, IR alignment
Recumbent
Hips/knees flexed
Sponge under spine/waist so its parallel to table top
Sacrum centred to table/IR midline
what is the image critique for lateral sacrum & coccyx view in terms of positioning
No rotation = GSNs & femoral heads superimposed
what is the image critique for lateral sacrum & coccyx view in terms of area of interest
3 things
Lateral profile of entire sacrum & coccyx
Lateral view of L5-S1 intervertebral joint
Femoral heads superimposed
what is the CP for AP axial S1 view
30-35* cranial
5cm below ASIS level
what is the patient positioning for the AP axial S1 view
in terms of patient body position, IR alignment, pelvis
Supine
MSP aligned to table/IR midline
No pelvis rot = ASIS equidistant from table
what is the image critique for AP axial S1 view in terms of positioning
in terms of spinous process, rotation, alae, SI joints\
4 things
No rotation
L5 spinous process in centre of vertebral body
Symmetrical Alae
SI joints equidistant from vertebrae midline
what is the image critique for AP axial S1 view in terms of area of interest
2 things
SI joints
L5-S1 intervertebral joints spaces
