Lumbopelvic

Question 1

Lumbopelvic Spine

X-Ray Series

Answer 1

Normal Series

• AP
• Lateral

Optional Views

• Oblique - Pars interarticularis
• Flexion/Extension - stablity
• Lateral Lumbosacral- L5-S1 spot view

Question 2

AP Lumbopelvic

Answer 2

• Cassette - 35x43 vertical
• Pt Positioning - stand against bucky, hips internally rotated. Can also do PA to reduce radiation
• Immobilisation - comfortable and suspended expiration
• Safety - no shielding if first image of series otherwise gondal shieldiong if not obsuring anatomy
• Marker - lateral
• SID - 100 but may need to increase lumbo pelvic
• CR - midline and level of ASIS
• Tube Tilt - 0
• Collimation -M-L - less than width if image plate. S-I less height of plate and include T12 - ischial truberosity
• kV - children 70 and adults 80

Question 3

Lateral Lumbopelvic

Answer 3

• Cassette - 35x43 vertical
• Pt Positioning - stands left side towards bucky, genie pose arms folded, supported if possbile and comfortable. suspended expiration
• Safety - gonad shielding if not obscuring
• Marker - anterior
• SID - 100 but may need to increase lumbo pelvic
• CR - midpoint between ASIS and PSIS level of ilac crest
• Tube Tilt - 0
• Collimation -M-L - less than width if image plate, accomodate for lordosis and sacrum. S-I less height of plate and include T12 - greater trochanter
• kV - children 70 and adults 90

Question 4

Oblique Lumbar

Answer 4

• Cassette -24x30cm vertical
• Pt Positioning - PA obliques(LAO/RAO), face bucky and rotate 45 towards one side, repeat on other side. AP oblique (LPO/RPO), face the xray tube and rotate 45 to one side and repeat on the other side
• Immobilisation - comfortable and suspended expiration
• Safety - gonad
• Marker - lateral
• SID - 100
• CR - lower costal margin, 3cm lateral to L3 SP towards sude away from bucky
• Tube Tilt - 0
• Collimation -M-L , width of spine 15cm, S-I less then image plate and including T12 AND s1
• kV - children 75 and adults 90

Question 5

Flexion Lumbar

Answer 5

• Cassette - 35x43 vertical
• Pt Positioning - standing perpendicular to bucky with hands on shoulders, bend forward at lumbars and not at the hips
• Immobilisation - comfortable stance, suspended expiration
• Safety - gonad if not obsuring anatomy
• Marker - anterior
• SID - 100
• CR - midpoint between ASIS and PSIS at L3-L4 level
• Tube Tilt - 0
• Collimation -M-L, less than width if image plate, lumbar SP and sacrum. S-I height include T12 and S1
• kV - children 75 and adults 90

Question 6

Extension Lumbar

Answer 6

Cassette - 35x43 vertical

Pt Positioning - standing perpendicular to bucky with hands on shoulders, bend backwards at lumbars and not at the hips

Immobilisation - comfortable stance, suspended expiration

Safety - gonad if not obsuring anatomy

Marker - anterior

SID - 100

CR - midpoint between ASIS and PSIS at L3-L4 level of crest

Tube Tilt - 0

Collimation -M-L, less than width if image plate, lumbar SP and sacrum. S-I height include T12 and S1

kV - children 75 and adults 90

Question 7

Lateral Lumbosacral Junction

Answer 7

• Cassette - 18x24 vertical
• Pt Positioning - pt stands perpendicular
• Immobilisation - comfortable and suspended expiration
• Safety - gonad
• Marker -anterior
• SID - 100
• CR - 3cm below iliac crest in the mid axillery line
• Tube Tilt - 0
• Collimation -A-P - 3cm inferior and posterior to midline. S-I iliac crest to greater trochanter
• kV - children 75 and adults 95