Chest appraisal DOGs Flashcards
1) demographics
check ld match on the request- check patient name, date of birth, hospital number, accession and attendance number, exam date and time
2) Anatomy requested
CXR - check a PA is requested
3) Markers and legends
minimum of a left or right marker on radiograph, legends may appear such as PA erect
4) Projections
- does the central ray pass T7?
- is SID correct?
5) Position/posture
- the patient semi erect/ erect?
- is all anatomy required visible? collimation: superior ly 5cm above the shoulder joint to allow proper visualisation of the upper airways, inferior to the inferior border of the 12th rib, lateral to the level of the acromioclavicular joints
position
relation to gravity (erect/gravity)
posture
anatomical position (pronation, flexion)
posture
- entire lung fields should be visible from the apices down to the lateral costophrenic angles.
- chin shouldn’t be superimposing any structures
- arms aren’t superimposed over lateral chest wall
- clavicles should be equidistant to the spinous processes
7) Structures
good inspiratory effort: able to count 5-7 anterior ribs from 1st rib to the semi-diaphragm at the mid-clavicle line. 9-10 posterior ribs from 1st rib to the semi-diapgram at the mid-clavicle line.
collimation
there should be four visible lines of collimation
image quality
air, fat, soft tissue and bone should be visible. also may see metal.
protection
recorded dose should be below the local DRL. ideal s-value: 160-240
exposure index
estimated exposure to the image detector
clinical history
always reviewed prior to evaluating the radiography using the ABCs system
ABC system
alignment, bone, cartilage (signs of dislocation and sublimation)
soft tissue
swelling, foreign bodies, raised fat pads, lipohaemarthrosis, effusion, surgical emphysema, pneumothorax, opacities, pleural effusion.
