Chest/ribs additional views and pelvis/femur additional views

Question 1

name 2 additional chest xrays you could do?

Answer 1

apilordotic and lateral decubitus

Question 2

why would you do an apicolordotic cxr

Answer 2

for ?apical tuberculosis or ?Pancoast tumor (CA in lung apex)

Question 3

why would you do a decubitus cxr

Answer 3

?pneumothorax or ?pleural effusion and also if the patient can only do supine imaging.

Question 4

how do you position a trolley pt. if you’ve already done an AP sitting cxr and have a ? left lung pneumothorax

Answer 4

you would do a right lateral decubitus image, so the left lung will be on the up side, to get visualization of free air in the left lung which should rise to the top.

Question 5

how would you do a decubitus image if the patient had ?left side pleural effusion

Answer 5

you would do a left lateral decubitus, and position the patient with their left side down, to better show the fluid level in the lung.

Question 6

what views do you do for ribs

Answer 6

AP 45 deg oblique

Question 7

what is demonstrated in oblique ribs

Answer 7

the posterior and lateral ribs

Question 8

if you are imaging upper ribs. when would you hold the breath

Answer 8

on inspiration. (expiration if viewng lower ribs)

Question 9

clinical indication for rib xrays

Answer 9

?fx ?metastatic lesion

Question 10

how to position for lateral sternum (?fx or mets)

Answer 10

position pt left side to bucky. ensure MSP parallel with bucky. hands and shoulders are back. hold breath. rasie the chin if kyphotic. there will be an increased OID so cone small.

Question 11

for Apicolordotic chest, how do we positoin the patient

Answer 11

have them with back to bucky, and angle their body so they are leaning back 15-20 degrees. this should move the clavicles superior to look for pathology in the lung apex.

Question 12

name the additional views of the pelvis

Answer 12

pelvic inlet, outlet, 45 deg judet view.

Question 13

what angle is used for inlet pelvis and outlet pelvis views

Answer 13

inlet- 25-40deg caudal

outlet- 40 deg (up to 60) cranial

Question 14

what is demonstrated in the inlet view and outlet

Answer 14

inlet- the pelvic brim and ilium, posterior displacement of pelvic ring
outlet- the pubic rami, SIJ, sacrum, the anterior and posterior pelvic brim should superimpose

Question 15

what can a pelvis inlet view assess

Answer 15

diastasis of the pubic symphysis, pelvic trauma, posterior displacements of pelvic ring.

Question 16

how can diastasis occur

Answer 16

MVC, childbirth, direct pressure on the joint

Question 17

what does a pelvis outlet view assess

Answer 17

vertical shift of the pelvis and proximal or distal displacement of the anterior and posterior pelvic ring.

Question 18

what positioning consideration must you have for pelvis inlet views

Answer 18

legs internally rotated to get greater trochanters in profile laterally.

Question 19

what do judet views demonstrate

Answer 19

the anterior and posterior acetabular rims, and anterior/posterior column. for ?acetabular fx

Question 20

for a right hip judet series, you should always do a right hip up and right hip down (LPO and RPO). What do each demonstrate

Answer 20

LPO (right hip up)- demonstrates the posterior acetabular rim, and the anterior column medially.

RPO- demonstrates the anterior acetabular rim, and posterior column medially.

Question 21

what is the other name for an LPO and an RPO?

Answer 21

LPO- obturator oblique view

RPO- iliac oblique view.

Question 22

what are the femur views?

Answer 22

AP- hip down and knee up

LAT- hip down and knee up.

Question 23

what is other name for diastasis

Answer 23

an open book fx