Common Specialised Projections - Broden's, Valgus/Varus Stress Test, Scoliosis Imaging Flashcards
Patient Position for Broden’s View
Key: To demonstrate the subtalar joints & visualized the calcaneum
Affected side ankle joint is dorsiflexed
Affected leg is rotated 45 degrees medially
Exposure Parameters for Broden’s View
Fine focus
No grid
52 - 60kVp
2.5 - 6mAs
Central Ray Position for Broden’s View
Centred 2.5cm distal to Lateral Malleolus
Cranial angulation to demonstrate various parts of the Posterior Articulation
10 degrees cranial angulation = Posterior part
20 - 30 degrees = Middle Part and Middle Articulation
40 degrees = Anterior part
Collimation Area for Broden’s View
Superiorly: Distal fourth of tiblia/fibula
Inferiorly: Inferior soft tissue of calcaneum
Lateral Soft tissue margins
Base of metatarsals medially
Patient Positioning for PA Scoliosis
Errect
Patient stands upright with MSP parallel to long axis of IR
Fingertips placed over superior aspect of shoulders (most neutral)
Ensure that orthopaedic ruler is included, either left or right side of patient
Things to note on Scoliosis Imaging
For measurement purpose only, not diagnostic
Cobb’s angle is measured from End vertebrae to End Vertebrae (Form a open angle triangle)
Routine views are done standing
Pre-operative planning - Supine, side bending.
Central Ray Position for PA Scoliosis
Centred perpendicular towards midline, at a point midway between C3 to hip joint
Patient Position for Lateral Scoliosis
Erect
Patient stand barefooted with either left or right side against bucky
Request patient to raise arms with his/her fingers placed on clavicle
Ensure pt stands upright with MSP parallel to long axis of IR
MCP perpendicular to IR
Central Ray Position for Lateral Scoliosis
Perpendicularly towards long axis of thoracic vertebra at the midpoint between upper ear lobe C1 to hip joint
Patient Position for Side Bending Scoliosis
Structural curve do not change when patient bend, only non-structural curves
Patient lay supine on table (if DR)
Bend sideways towards the left and then to right
Central Ray Position for Side Bending Scoliosis
Structural curve do not change when patient bend, only non-structural curves
Patient lay supine on table (if DR)
Bend sideways towards the left and then to right
Direct beam perpendicularly towards the patient’s midline at a level midway between C3 to ASIS.
Type of Grid required for Scoliosis Imaging?
Long length imaging
SID: 180 - 230cm
Collimation Area for PA Scoliosis Imaging (Errect)
Superiorly: EAM
Inferiorly: Hip Joint
Laterally: Lateral soft tissue margins
Collimation Area for Lateral Scoliosis Imaging (Errect)
Superiorly: Upper Ear Lobe
Inferiorly: Hip Joint
Laterally: Posterior skin margin and anterior skin margin of cervical spine
Exposure Parameters for PA Scoliosis Imaging (Errect)
Long Film Imaging
Broad Focus, Grid/Wall Bucky
SID 180 - 230cm
77 to 81 kVp
18 to 28 mAs/Centre AEC
