CLINICAL - Radiographic Positioning

Question 1

In what position should you place your patient for a radiograph of the lateral thorax?

Answer 1

Lateral recumbency

Question 2

Where should you position the wedges and sandbags for a radiograph of the lateral thorax?

Answer 2

Extend the hindlimbs caudally and place a rectangle wedge between the forelimbs and hindlimbs
Place a sandbag over the forelimbs and hindlimbs
Place a sandbag over the neck
Place a sloped wedge under the thorax and part of abdomen

Question 3

What are the anatomical landmarks for a radiograph of the lateral thorax?

Answer 3

Centre: Caudal to the scapula and midway up the thorax
Cranial: Thoracic inlet
Caudal: Caudal rib cage
Lateral: Dorsal and ventral skin surfaces

Question 4

In what position should you place your patient for a radiograph of the dorsoventral thorax?

Answer 4

Sternal recumbency

Question 5

Where should you position the wedges and sandbags for a radiograph of the dorsoventral thorax?

Answer 5

Support the head on a rectangle wedge with a sandbag over the neck
Abduct the forelimbs and place a sandbag over each forelimb
Can use sloped wedges to help align the thorax

Question 6

What are the anatomical landmarks for a radiograph of the dorsoventral thorax?

Answer 6

Centre: Caudal to the scapula and midway up the thorax
Cranial: Thoracic inlet
Caudal: Last few ribs
Lateral: Lateral skin surfaces

Question 7

In what position should you place your patient for a radiograph of the lateral abdomen?

Answer 7

Lateral recumbency

Question 8

Where should you position the wedges and sandbags for a radiograph of the lateral abdomen?

Answer 8

Extend the hindlimbs caudally and place a rectangle wedge between the forelimbs and hindlimbs
Place a sandbag over the forelimbs and hindlimbs
Place a sandbag across the neck
Place a sloped wedge under the thorax and part of abdomen

Question 9

What are the anatomical landmarks for a radiograph of the lateral abdomen?

Answer 9

Centre: Midway between the last rib and ilium
Cranial: Include the last few ribs
Caudal: Greater trochanter
Lateral: Dorsal and ventral skin surfaces

Question 10

In what position should you place your patient for a radiograph of the ventrodorsal abdomen?

Answer 10

Dorsal recumbency in a trough

Question 11

Where should you position the wedges and sandbags for a radiograph of the ventrodorsal abdomen?

Answer 11

Position the hindlimbs in a frog leg position
Pull the forelimbs forward and secure them with sandbags
DO NOT PLACE SANDBAG OVER THE NECK

Question 12

What are the anatomical landmarks for a radiograph of the ventrodorsal abdomen?

Answer 12

Centre: Between the last rib and umbilicus
Cranial: Include the last few ribs
Caudal: Pelvic inlet
Lateral: Lateral skin surfaces

Question 13

How would you position your patient for a radiograph of the mediolateral shoulder?

Answer 13

1. Place your patient in lateral recumbency (side of interest down)
2. Pull unaffected limb caudodorsally along the body using a tie and sandbag
3. Leave the affected limb in a neutral position
4. Extend the head and neck out of the field of vision and place sandbag over the neck

Question 14

What are the anatomical landmarks used to radiograph the mediolateral shoulder?

Answer 14

Centre: Acromion process
Cranial: Distal half of the scapula
Caudal: Proximal half of the humerus
Lateral: Skin surfaces

Question 15

How would you position your patient for a radiograph of the craniocaudal shoulder?

Answer 15

1. Place your patient in sternal recumbency
2. Place unaffected limb on foam wedges
3. Extend the affected limb forward
4. Place a triangular wedge behind the elbow of the affected limb and secure this with a sandbag
5. Turn the head away from the affected limb and out of the field of vision

Question 16

What are the anatomical landmarks used to radiograph the craniocaudal shoulder?

Answer 16

Centre: Acromion process
Cranial: Distal half of the scapula
Caudal: Proximal half of the humerus
Lateral: Skin surfaces

Question 17

In what two positions can you radiograph a mediolateral elbow?

Answer 17

Neutral position
Flexed position

Question 18

How would you position your patient for a radiograph of the mediolateral elbow in the neural position?

Answer 18

1. Place your patient in lateral recumbency (with the side of interest down)
2. Pull unaffected limb caudodorsally along the body using a tie and sandbag
3. Leave the affected limb in a neutral position
4. Extend the head and neck out of the field of vision and place sandbag over the neck

Question 19

How would you position your patient for a radiograph of the mediolateral elbow in the flexed position?

Answer 19

1. Place your patient in lateral recumbency (with the side of interest down)
2. Pull unaffected limb caudodorsally along the body using a tie and sandbag
3. Place a triangular foam wedge under the carpus to flex the elbow at 45°
4. Extend the head and neck out of the field of vision and place sandbag over the neck

Question 20

What is the benefit of radiographing the mediolateral elbow in the flexed position?

Answer 20

Allows you to highlight the anconeal process

Question 21

What are the anatomical landmarks used to radiograph the mediolateral elbow?

Answer 21

Centre: Humeral mediolateral condyle
Cranial: Distal third of the humerus
Caudal: Proximal radius and ulna
Lateral: Skin surfaces

Question 22

How would you position your patient for a radiograph of the craniocaudal elbow?

Answer 22

1. Place your patient in sternal recumbency
2. Place unaffected limb on foam wedges
3. Extend the affected limb forward
4. Turn the head away from the affected limb and out of the field of vision
5. Place a triangular foam wedge behind the shoulder of the affected limb and stabilise this wedge with a sandbag to allow you to fully extend and straighten the elbow of the affected limb
6. Place a sandbag over the carpus

Ensure the olecranon process is in line with the humerus

Question 23

What are the anatomical landmarks used to radiograph the craniocaudal elbow?

Answer 23

Centre: Humeral epicondyles
Cranial: Distal third of the humerus
Caudal: Proximal third of the radius and ulna
Lateral: Skin surfaces

Question 24

How would you position your patient for a radiograph of the mediolateral carpus and paw?

Answer 24

1. Place your patient in lateral recumbency (side of interest down)
2. Pull unaffected limb caudodorsally along the body using a tie and sandbag
3. Leave affected limb in a neutral position
4. Extend the head and neck out of the field of vision and place a sandbag over the neck

Question 25

What are the anatomical landmarks used to radiograph the mediolateral carpus and paw?

Answer 25

Centre: Carpal joint Cranial: Distal third of radius and ulna Caudal: Length of the paw Lateral: Skin surfaces

Question 26

How would you position your patient for a radiograph of the dorsopalmer carpus and paw?

Answer 26

1. Place your patient in sternal recumbency 2. Place unaffected limb on foam wedges 3. Extend the affected limb forward 4. Turn the head away from the affected limb and out of the field of vision 5. Place a triangular foam wedge behind the shoulder of the affected limb and stabilise this wedge with a sandbag to allow you to fully extend and straighten the carpus of the affected limb

Question 27

What are the anatomical landmarks used to radiograph the dorsopalmer carpus and paw?

Answer 27

Centre: Carpal joint Cranial: Distal third of radius and ulna Caudal: Length of the paw Lateral: Skin surfaces

Question 28

How would you position your patient for a radiograph of the lateral pelvis?

Answer 28

1. Place your patient in lateral recumbency 2. Place a triangular foam wedge under the sternum and a rectangular foam wedge between the hindlimbs to prevent rotation 3. Place a sandbag over the neck

Question 29

What are the anatomical landmarks used for a radiograph of the lateral pelvis?

Answer 29

Centre: Greater trochanter Cranial: Wing of the ilium Caudal: Tuber ishium Lateral: Skin surfaces

Question 30

How would you position your patient for a radiograph of the flexed pelvis?

Answer 30

1. Place your patient in dorsal recumbency in a trough with the entire pelvis positioned beyond the edge of the trough onto the table 2. Allow the hindlimbs to falll naturally to either side of the pelvis (like froglegs) 3. Secure the forelimbs by placing sandbags across the axillae 4. Place small foam wedges under either side of the pelvis to help stabilise if necessary

Question 31

What are the anatomical landmarks used to radiograph a flexed pelvis?

Answer 31

Centre: Midline at the level of the greater trochanter Cranial: Level of the wings of the ilium Caudal: Level of the ishium Lateral: Skin surfaces

Question 32

How would you position your patient for a radiograph of the extended pelvis?

Answer 32

1. Place your patient in dorsal recumbency in a trough with the entire pelvis positioned beyond the edge of the trough onto the table 2. Extend the hindlimbs caudally, rotating the stifles inward 3. Ask an assistant to place table around the hindlimbs, just above the stifle 4. Place a foam wedge in between the hindlimbs and a sandbag over the top of the tarsi 5. | Palpate to ensure the greater trochanters are at the same height

Question 33

What are the anatomical landmarks used for a radiograph of the extended pelvis?

Answer 33

Centre: Midline at the level of the greater trochanter Cranial: Level of the wing of the ilium Caudal: Just distal to the stifles Lateral: Skin surfaces

Question 34

How would you position your patient for a radiograph of the mediolateral stifle?

Answer 34

1. Place your patient in lateral recumbency (side of interest down) 2. Move the unaffected limb craniodorsally along the body using ties and sandbags 3. Angle the tibia of the affected limb so the stifle and tarsus joints are 90° from eachother 4. Place a sandbag over the neck

Question 35

What are the anatomical landmarks used for a radiograph of the mediolateral stifle?

Answer 35

Centre: Tibial crest *(palpate the distal patellar ligament, the small depression behind it and slightly further behind will be the tibial crest) * Cranial: Distal third of the femur Caudal: Proximal third of the tibia Lateral: Skin surfaces

Question 36

How would you position your patient for a radiograph of the craniocaudal stifle?

Answer 36

1. Place your patient in sternal recumbency 2. Extend the affected limb caudally 3. Prop up the unaffected limb on foam wedges and secure the tail out of the field of vision using a sandbag 4. Place a foam wedge in front of the hip of the affected limb, securing this wedge with a sandbag. This allows you to fully extend and straighten the stifle of the affected limb 6. Place a wedge under the tarsal joint and a sandbag over the tarsal joint of the affected limb for stabilisation

Question 37

What are the anatomical landmarks used for a radiograph of the craniocaudal stifle?

Answer 37

Centre: Tibial crest Cranial: Distal third of the femur Caudal: Proximal third of the tibia Lateral: Skin surfaces

Question 38

How would you position your patient for a radiograph of the mediolateral tarsus and paw?

Answer 38

1. Place your patient in lateral recumbency (side of interest down) 2. Move the unaffected limb craniodorsally along the body using ties and sandbags 3. Leave the affected limb in a neutral position

Question 39

What are the anatomical landmarks used to radiograph the mediolateral tarsus and paw?

Answer 39

Centre: Medial malleolus Cranial: Distal third of the tibia Caudal: Length of the paw Lateral: Skin surfaces