Justification, Positioning Descriptors and Image Critique

Question 1

What do you do if the information is incorrect on the request form

Answer 1

Check with referrer or with the ward the request came from

Question 2

What alternatives are there to CT

Answer 2

Ultrasound, MRI, or do an x-ray rather than CT if you can

Question 3

When can you do MRI in pregnancy

Answer 3

Early stages, avoid x-rays throughout pregnancy

Question 4

Insignificant dose to the foetus

Answer 4

Usually, all ‘plain film’ x-rays not below the diaphragm or above the knee.​

Upper limb radiography, knee down exams, neck and sometimes CXR are in this category.​

Question 5

Low dose to the foetus

Answer 5

28 Day rule’ pregnancy check to be performed​
where the primary beam is over the area of the uterus, and normally some of the high dose exams (like CT and angio) where other parts of the body are being imaged.​

X-ray Examinations such as Pelvis / hip /femur, abdomen and lower spine. ​

Question 6

High dose to the foetus​

Answer 6

‘10 Day rule’ pregnancy check required

These exams include the high dose procedures over the female uterus area, such as fluoroscopy and CT of the torso, Interventional radiology and most Nuclear Medicine scans.​

Question 7

Positioning descriptions

Answer 7

Gross Position​

Fine Position​

SID​

Direction of Central Ray​

Centring Point​

Collimation​

Marker​

Patient Instructions​

Radiation Protection

Question 8

10 point check list

Answer 8

1. Patient Demographics correct?​
2. Markers & Legends correct?​
3. Area of interest & collimation appropriate?​
4. Projection & positioning? ​
5. Exposure, dose & processing algorithm ?
6. Radiographic brightness?​ B
7. Radiographic contrast?​ C
8. Unsharpness?​ U
9. Artefacts &/or anatomical variation (inc pathology)​
10. Need for actions?