lower extremities, sternum, and ribs Flashcards
AP Great Toe
- 18x24cm
- flex knee
- CR angled 10* towards leg
- include a digit on either side
- marker on lateral side
- 40” SID
AP oblique Great Toe
- 18x24cm
- rotate medially 45*
- include distal half of metatarsals on either side
- move other toes out of way
- 40” SID
Lateral Great toe
- 18x24cm
- rotate medially
- marker face down
- move other toes out of way
- hang other leg off table, and bring knee down to touch table
- 40”SID
AP Axial Foot
- 18x24cm or 24x30cm
- Flex knee
- angle 10* towards heel
- use wedge filter
AP Oblique Foot
- 18x24cm or24x30cm
- flex knee
- rotate medially 45*
- use wedge filter
- angle cassette to keep foot at 90* with leg
Lateral Foot
- 18x24cm or 24x30cm
- roll onto affected side
- leg straight, don’t raise knee,
- mediolateral
- dorsiflex foot
- marker up towards toe
- 40” SID
Lateral Weight Bearing Foot
- 24x30cm
- use upright Bucky and footstool
- help patient up and down
- bring heel out
- have light on step
- markers RT, LT face down and arrow up
- 40”SID to cassette
AP axial weight bearing Feet (bilateral)
- 24x30cm or 35x43cm
- patient standing on cassette
- weight distributed
- 15* towards
- 40-48” SID
- makers RT, LT and arrow up
- use wedge filter
- don’t have lead hanging down
Axial Calcaneus
- 18x24cm
- off center anatomy
- extending leg, dorsiflex foot (use strap)
- 40* cephalad
- 40 SID
- marker up
- use wedge or boomerang filter
- slight internal rotation(lateral side parallel)
Lateral Calcaneus
- 18x24cm
- dorsiflex foot
- true lateral foot (mediolateral)
- include medial malleolus
- 40” SID
AP Ankle
- 18x24cm
- extend leg
- dorsiflex foot
- lateral malleolus is closer to IR
- 40” SID
Lateral Ankle
- 18x24cm
- true lateral foot (mediolateral)
- dorsiflex foot
- 40” SID
- show base of 5th
AP oblique Ankle-Mortise
- 18x24cm
- extend leg
- dorsiflex foot
- medially rotate until malleoli are parallel
- 40” SID
- include base of 5th
AP Tibia/Fibula
- 35x43cm
- extend leg
- dorsiflex foot
- must include both joints
- 40-48” SID
- don’t show whole patella
Lateral Tib/Fib
- 35x43cm
- turn onto affected side (mediolateral)
- flex knee
- dorsiflex foot
- must show both joints
- heel may be off IR
- 40-48” SID
AP Knee
- 18x24cm or 24x30cm
- table bucky
- extend leg
- line up epicondyles
- 40” SID
- match angle of tibia and then subtract 5*
Lateral Knee
- 18x24cm or 24x30cm
- mediolateral (roll onto affected side)
- table bucky
- flex knee 20-30
- put the other leg out in front
- angle tube 5-7*
- use wedge or boomerang filter
- raise heel
- check epicondyles
- marker up
AP oblique knee (external rotation)
- 18x24cm or24x30cm
- rotate entire leg externally 45*
- match angle of tube with the angle of the tibia and subtract 5*
- check epicondyles
- marker up
AP obilque knee (internal rotation)
- 18x24cm or 24x30cm
- rotate entire leg internal 45*
- match angle of tube with the angle of the tibia subtract 5*
- check epicondyles
- marker up
Trauma Lateral Knee
- 18x24cm or24x30cm
- use a gridded cassette
- sponge under knee
- check epicondyles
- bring feet together
- marker down, arrow up
- horizontal beam
AP weight-bearing Knee (bilateral)
- 35x43cm
- standing at wall bucky (AP)
- angle 5* caudad or perpendicular for large patients
- weight equally distributed, no shoes
- check epicondyles
- Lt, Rt, marker face up, and arrow up
PA weight-bearing knee (tunnel view) -bilateral
- 35x43cm
- standing at wall bucky (PA)
- flex knees 45*
- toes lined up bucky
- angle 10* caudad
- watch gonadal shielding
- Lt, Rt, marker face down and arrow up
PA Axial tunnel view (holmblad)
- 18x24cm
- patient kneeling on table
- bring unaffected knee forward, put sponge under
- lean forward until femur is out of the way
- tips of toes on table
- marker face down
PA Patella
- 18x24cm
- table bucky
- must be prone
- epicondyles parallel to IR
- rotate anterior knee 5* internally for true PA
- marker face down
Lateral Patella
- 18x24cm
- table bucky
- true lateral (mediolateral)
- flex knee slightly 5-10*
- collimate closely
Supine Skyline Patella
- 18x24cm
- tabletop
- bring patient to edge of table
- flex knee 30*
- angle 15* from tibia
- 40-48” SID
- use the wall to see the patella, so patient doesn’t have to stretch for a long time
- place IR at mid thigh so the patella is in the middle of the cassette
- tilt IR to be parallel with tube
- marker up
AP Pelvis
- 35x43cm
- no rotation of pelvis
- 40” SID
- must include symphysis
- center 2” below ASIS
- rotate legs internally but not if fractured or dislocated(move the heels apart and toes together)
- suspended respiration
- triangle shielding on follow up view
- lead apron to cover chest
AP Oblique Pelvis (Frog Legs) - bilateral
- 35x43cm
- supine, no rotation of pelvis
- knees flexed, feet together, abduct thighs 45*
- center 3”below ASIS
- 40” SID
- don’t need to show whole pelvis
- gonadal shielding
- suspended respiration
Unilateral (frog leg)
- 24x30cm
- affected leg abducted 45*
- foot against opposite knee
- center 3-4” distal to ASIS
- 40” SID
- turn collimator
- gonadal shielding
AP unilateral hip
- 24x30cm
- center 2” medial and 4” distal to ASIS
- 40” SID
- use apron for shielding
- rotate feet internally (heels out toes in)
- marker up
Lateral unilateral hip (Lauenstein)
- 24x30cm
- 40” SID
- put patient on sheet
- rotate onto affected side
- put leg that’s on sponge straight and put the other foot under that knee
- femur parallel to IR
- use sheet to turn patient to get femur parallel with table
- turn collimator head
- centering between ASIS and symphysis
- use apron for shielding
Axiolateral inferosuperior hip
- 24x30cm
- gridded cassette
- bring tube around
- 40” SID
- supine, leg extended
- unaffected leg on stool, move knee out to the side
- rotate affected foot internally (heel out toes in)
- use wedge filter
- make sure cassette isn’t tilted
- marker up
AP Femur
-35x43cm
-align femur with cassette
Distal:
-place IR 2” below knee
-make epicondyles parallel
-marker at top
Proximal:
-place IR top at ASIS
-internally rotate leg 15-20* (heel out toes in)
-marker at bottom
Lateral Femur
-34x43cm
-turn onto affected side (mediolateral)
-flex knee about 45*
-marker up
Distal:
-IR 2” below knee
-other leg forward
Proximal:
-top of IR at ASIS
-other leg back
AP Axial Pelvis (Outlet)
- 24x30cm
- supine
- angle males:20-35* cephalad females 30-45* cephalad
- center 2” below Greater troch or 6” below ASIS
- marker taped on
AP Axial Pelvis (Inlet)
- 35x43cm
- supine
- angle 40* caudad
- center at level of ASIS
- tape marker on
PA Oblique Sternum (RAO)
- 24x30cm or 35x43cm
- up right bucky
- 40” SID
- have patient AP and center in between jugular notch and xiphoid (get patient to show you) and then turn patient around
- facing bucky
- RAO 15-20* away from bucky (move sternum off spine)
- shallow breathing
- marker face down
Lateral Sternum
- 24x30cm or 35x43cm
- left lateral
- roll shoulders and arms back
- SID 60-72”
- center midway between jugular notch and xiphoid
- angle collimator
- suspend on 2nd deep inspiration
- marker up
Upper bilateral ribs AP/PA
ribs 1-10
- 35x43cm
- orientation depending on body habitus
- 72”SID (40” SID if unilateral)
- perpendicular ray
- include C7
- suspended 2nd inspiration
- roll shoulders forward
- don’t have hands in light
AP (posterior ribs)
- standing with back against bucky
- centering 3-4” below jugular notch (include C7)
- marker up
PA (anterior ribs)
- standing facing bucky
- centering at apex of scapula
- marker down
Lower bilateral ribs AP
ribs 8-12
- 35x43cm
- crosswise
- supine
- perpendicular ray
- centering between xiphoid and lower rib cage (include iliac crest)
- 40”SID
- suspended 2nd expiration
Axillary lower unilateral ribs (AP oblique ribs)
-10x12cm
-lengthwise
-supine
-rotate patient towards affected side
-45* oblique
-arms out of way
-perpendicular ray
-centering between xiphoid and lower rib cage(include iliac crest)
-40” SID
-marker up
-suspended 2nd expiration
RPO demo Rt. side
LPO demo Lt. side
Axillary upper unilateral ribs (AP oblique ribs)
- 35x43cm
- lengthwise
- oblique patient 45* (injury side towards IR)
- raise the arm off the ribs by getting an IV pole for them to hold
- centering 3-4” below jugular notch
- feel patients spine and make sure the light will go over their shoulder and include the spine
- suspended 2nd inspiration
- marker up