Positioning Of SI Joints, Sacrum, And Coccyx

Question 1

Routine protocol for SI joints

Answer 1

• 35 degree AP/PA axial projection

- 25-30 degree AP obliques (bilateral)

Question 2

AP axial projection SI joints (aka upshot)

Answer 2

• 30 degree angle for males, 35 degree angle for females cephalad
• 110 SID
• start at 22 X 14 lightfield and then put angle on tube
• line up tube and detector (tube down and over to get it lined up)
• drape pt
• make sure pt is centered in lightfield
• palpate ASIS to make sure pt is straight, go to head of table to make sure too
• center crosshair between ASIS and greater trochanters (or could put first finger of peace sign on ASIS and second finger is where center (-) crosshair would go)
• collimate 2 fingers in from ASIS side to side
• bottom of light at trochanters, no light lower
• move tube to check for diverging rays, bottom of light should end at trochanters and top near crests
• make sure tube and detector are lined up
• maker in top lateral
• shield legs
• breathe in, breathe all the way out and hold

Question 3

AP oblique SI joints (LPO)

Answer 3

• 110 SID
• 10 X 14 lightfield
• put foot touching table bent and under knee of straight leg
• move up onto hips to make 25-30 degree angle (don’t need sponge but it could help)
• maker in upper lateral corner
• two fingers medial from ASIS is (I) crosshair
• center on ASIS (-) crosshair
• whatever SI joint is in the light is the one we are imaging
• make sure tube and detector are lined up
• drape pt
• side to side collimation should be about 3 fingers total lightfield
• breathe in, breathe all the way out and hold

Question 4

AP axial sacrum

Answer 4

• 18 X 20 lightfield
• angle tube 15 degrees cephalad
• 110 SID
• center crosshair between ASIS and trochanter (-)
• bottom of light at trochanters
• palpate ASIS to make sure straight and centered in light
• two fingers medial from ASIS side to side
• pull tube out and if you have light the length of your hand and abit of wrist then you know you have enough light
• 2 fingers above ASIS is top of light (when you pull out tube and check diverging rays)
• drape pt
• make sure tube and detector are lined up
• marker in top lateral
• shield legs
• breathe in, breathe all the way out and hold

Question 5

AP axial coccyx

Answer 5

• 12 X 12 lightfield
• 110 SID
• angle tube 10 degrees caudad (dial just before 15 degrees)
• center between ASIS and trochanter
• palpate ASIS, make sure pt is centered in light
• drape patient
• go to head of table to make sure the light is dead center in the middle of patient
• no light below trochanter
• shield patient
• maker in top corner
• make sure tube and detector are lined up
• breathe in, breathe all the way out and hold

Question 6

(Left) Lateral sacrum and coccyx

Answer 6

• 110 SID
• 18 X 25 lightfield
• get pt lying on left side
• make sure hips and shoulders are stacked in 90 degrees
• drape pt
• center about 7 fingers posterior to ASIS
• lengthwise, want it to be the length of your hand
• palpate trochanter and light cant go lower than that
• top of light 2 fingers below crests
• center between midcoronal plane and back half of pt
• make sure the (I) crosshair is parallel with the table
• marker anterior middle
• no light above crests
• shield long bones
• breathe in, breathe out and hold

Question 7

SC joints are found under

Answer 7

Upper extremity

Question 8

Ribs and sternum are found under

Answer 8

Chest