OSCE Views Flashcards
What is the CP and CR position for AP shoulder?
2.5cm medial and inferior to coracoid process. Horizontal ray, perpendicular to IR
What routine shoulder views are performed
AP, Lateral Scapula, Axial. Grasheys supplementary
What is the CP and CR position for Lat Scap
Medial border of scapula midpoint. Horizontal ray, perpendicular to IR
What is the CP and CR position for Axial shoulder
Midline In the glenohumeral joint space. Vertical ray, perpendicular to IR or 5 degree caudal tube and IR angle
What exposures are used for AP shoulder
60 kVP, 4 mAs. Broad focus, non grid
What exposures are used for lateral scapula
73 kVp, 12 mAs. Broad focus with grid
What exposures for Axial shoulder
60 kVp, 6.3 mAs. Fine focus, non-grid
What positioning considerations are there for shoulder
AP - 5-15 degrees turn to affected side. Arm abducted and palm forward.
Lat/Scap - PA position 45-60 degrees so HH and medial border align. Hand on tummy and arm abducted.
Axial - arm bent at elbow. Raise chair to lean over from waist
How to assess rotation and angulation in AP shoulder
R: HH superimposes 1/3 of Glenn’s cavity. Greater tubercle in profile.
A: clavicle at T3/T4 level
How to assess rotation and angulation in Lateral scapula
R: lateral and medial borders of scapula superimposed, HH in Y.
A: foreshortening of scapula
How to assess rotation and angulation in Axial shoulder
R: lesser tubercle in profile
A: GH joint open. No angulation of humerus
What are the routine positions for Cervical spine views
AP, Lateral, peg. Swimmers supplementary
What is the CP and CR position for Lateral C-spine
Thyroid cartilage at C4 level. Horizontal ray, perpendicular to IR
What is the CP and CR position for AP C-spine
Thyroid cartilage at C4 level. Tube angle of 15 degrees cephalic
What is the CP and CR position for Peg view
Body of C2, in line with crease of mouth. Horizontal ray, perpendicular to detector
What exposures are used for lateral c-spine?
77 kVP, 15 mAs. Broad focus with grid. 180cm SID
What exposures for AP c-spine?
70 kVp, 6.3 mAs. Fine focus with grid
What exposures for peg view c-spine
70 kVp, 8 mAs. Fine focus with grid
Positioning considerations for c-spine
Lateral - 180cm SID. L side to IR. Breathe out to relax shoulders. Chin forward.
AP - chin up slightly
Peg - occiput and incisor in line. Open bottom jaw
How is rotation and angulation assessed in lateral c-spine
R: double borders, facet joints open
A: open disc spaces, no cupping
Mandible can show A and R
How is rotation and angulation assessed in AP c-spine
R: spinous processes central
A: open joint spaces
How is rotation and angulation assessed in peg view
R: symmetry of joint spaces open. Lateral masses equidistant
A: occipital bone and incisors superimposed
What routine views for T-spine
AP and Lateral. Swimmers supplementary
What is the CP and CR position for AP T-spine
level of T7 midpoint between sternal notch and xiphysternum or inferior border of scapula. Horizontal ray, perpendicular to IR
What is the CP and CR of lateral T-spine
Level of T7. Inferior border of scapula. Horizontal ray, perpendicular to IR
What exposures for AP T-Spine
77 kVp, 16-20 mAs. Broad focus with grid
What exposures for Lateral T-Spine
73 kVp, 32-40 mAs. Broad focus with grid
What positioning considerations for T-Spine
Expose on arrested inspiration (breathe in)
Arms up for lateral
How to assess rotation and angulation in AP T-spine
R: spinous processes central
A: disc spaces open
How to assess angulation and rotation in lateral T-spine
R: ribs superimposed. Double borders. Facet joints open.
A: cupping of vertebrae, open joint spaces
What is the CP and CR position for AP L-spine
Lower Costal margin at midline, level of L3. Horizontal ray, perpendicular to IR
What are the CP and CR position for lateral L-spine
Level of L3 at lower costal margin. Horizontal ray, perpendicular to IR
What are the routine views for Lumbar Spine
AP/PA, Lateral. L5/S1 supplementary
CP and CR of L5/S1 view
L5/S1 joint space. Hand width below lower costal margin, midline between ASIS and PSIS. Horizontal ray, perpendicular to IR
What exposures for AP L-spine
77 kVp, 15 mAs. Broad focus with grid
What exposures for Lateral L- Spine
81 kVp, 40 mAs. Broad focus with grid
What exposures for L5-S1 view
90 kVp, 40 mAs. Broad focus with grid
What positioning considerations for lumbar spine
AP and lateral require arrested expiration (breathe out). Arms raised for lateral views
How to assess rotation and angulation for AP L-Spine
R: spinous processes central. SI joints equidistant.
A: disc spaces open.
How to assess rotation and angulation in lateral L-spine
R: double borders, ribs superimposed, facet joints open. Iliac crests superimposed
A: no cupping, disc spaces open
What are routine hip views
AP pelvis and rolled or cross table lateral of affected hip
What is the CP and CR position of AP pelvis
Midline at 5cm below ASIS. Top of light at top of crests. Vertical ray, perpendicular to IR
CP and CR position for rolled lateral hip
5cm medial and inferior to ASIS at crease (femoral neck). Vertical ray, perpendicular to IR. Rotate LBD to line of femur
What exposures for AP pelvis
73 kVp, 16 mAs. Broad focus with grid
What exposures for rolled lateral hip
70 kVp, 16 mAs. Broad focus with grid
Positioning considerations for Pelvis/hip
Pigeon toes for AP pelvis.
45 degrees sponge for rolled lateral. Knee flexed on affected leg
How to assess rotation and angulation on AP pelvis
R: crests symmetrical. OF open. Greater trochanter in profile and comparable in size and shape.
A: femoral necks demonstrated and not foreshortened. OF open and not elongated
How to assess rotation and angulation of rolled lateral hip
R: lesser trochanter in profile.
A: acetabulum open, no foreshortening of femur
What lines can help identify pathology on spinal imaging
Anterior vertebral, posterior vertebral, spinolaminar, spinous process
What lines can help identify pathology on pelvis
Sacral arcuate, ilio-ishial (inlet), anterior and posterior acetabular wall, Shenton’s line
