Positioning

Question 1

Describe the positioning of a DP and Oblique Hand

Answer 1

DP
Room Set Up = Table/Horizontal Bucky, patients legs parallel
Positioning = Hand Flat, palm to IR, fingers extended & separated
Centring Point = 3rd Metacarpal
SID = 100cm
Collimation = Distal phalanges, wrist joint, soft tissue borders
Exposure Factors = 60kv, 2.5 mAs

Oblique
Positioning = 45* rotation externally

Question 2

Describe the positioning of an AP and Lateral Wrist

Answer 2

AP
Room Set Up = Table/Horizontal Bucky, patients legs parallel
Positioning = Hand Flat, palm to IR, fingers extended & separated
Centring Point = Between ulnar and radial styloid processes
SID = 100cm
Collimation = Proximal metacarpals, distal radius & ulna, soft tissue
Exposure Factors = 62kV, 3.2 mAs

Lateral
Positioning = Rotated 90*, styloid processes superimposed
Centring Point = Over radial styloid process

Question 3

Describe the positioning of an AP and lateral Forearm

Answer 3

AP
Room Set Up = Table/Horizontal Bucky, patients legs parallel
Positioning = Arm stretched, posterior contact with IR, arm on one plane, styloid processes and epicondyle equidistant
Centring Point = Midway between wrist and elbow
SID = 100cm
Collimation = Wrist joint, elbow joint, soft tissue
Exposure Factors = 64kV, 4mAs

Lateral
Positioning = Elbow flexed 90, medial aspect contact, epicondyles and styloid processes superimposed, hand lateral

Question 4

Describe the positioning of an AP and Lateral Elbow

Answer 4

AP
Room Set Up = Table/Horizontal Bucky, patients legs parallel
Positioning = Arm extended, arm on one plane, epicondyles equidistant
Centring Point = 2.5cm below epicondyle midline
SID = 100cm
Collimation = distal 1/3 humerus, proximal 1/3 forearm, soft tissue
Exposure Factors = 63kV, 4mAs

Lateral
Positioning = Elbow flexed 90*, wrist lateral, epicondyles superimposed
Centring Point = Over lateral epicondyle

Question 5

Describe the positioning of an AP and Lateral Humerus

Answer 5

AP
Room Set Up = Vertical bucky, top of IR 5cm from top of shoulder
Positioning = Patient standing, posterior in contact, palm forward
Centring Point = Midway between shoulder and elbow
SID = 100cm
Collimation = Shoulder joint, elbow joint
Exposure Factors = 66kV, 5mAs

Lateral
Positioning = Patient facing IR, elbow flexed 90*, lateral in contact

Question 6

Describe the positioning of an AP Shoulder

Answer 6

AP
Room Set Up = Upright bucky, patient standing, facing tube
Positioning = Posterior in contact, rotate 5-20*, palm forwards
Centring Point = Coracoid process
SID = 100cm
Collimation = C7, bottom of scapula, proximal humerus, sternoclavicular joint, soft tissue
Exposure Factors = 66kV, 6mAs

Question 7

Describe the positioning of a DP and Oblique Foot

Answer 7

DP
Room Set Up = Table
Positioning = Sitting or supine, foot flat to IR
Centring Point = base of 2nd metatarsal
SID = 100cm
Collimation = Distal phalanges, inferior tarsal bones, soft tissue
Exposure Factors = 64kV, 1.25mAs

Oblique
Positioning = Foot internally rotated 30-45*
Centring Point = over base of 3rd metatarsal

Question 8

Describe the positioning of an AP and Lateral Ankle

Answer 8

AP
Room Set Up = Table
Positioning = Leg extended, foot flexed, malleoli equidistant
Centring Point = Between malleoli
SID = 100cm
Collimation = distal 1/3 tib/fib, talus, soft tissue
Exposure Factors = 65kV, 4mAs

Lateral
Positioning = Leg externally rotated, malleoli superimposed, foot flexed
Centring Point = Over medial malleoli
Collimation = distal 1/3 tib/fib, calcaneum, base of 5th metatarsal

Question 9

Describe the positioning of an AP and Lateral Tib/Fib

Answer 9

AP
Room Set Up = Table
Positioning = leg extended, malleoli equidistant
Centring Point = Midway between knee and ankle
SID = 100cm
Collimation = knee joint, ankle joint, soft tissue
Exposure Factors = 65kV, 4.5-5 mAs

Lateral
Positioning = Patient on hip, lateral in contact, foot flexed, malleoli superimposed

Question 10

Describe the positioning of an AP and Lateral Knee

Answer 10

AP
Room Set Up = Table
Positioning = Sitting or supine, posterior in contact, internally rotated-epicondyles equidistant
Centring Point = Apex of patella
SID = 100cm
Collimation = distal femur, proximal tib/fib, soft tissue
Exposure Factors = 64kV, 6mAs

Lateral
Positioning =Sitting on hip, knee flexed 90*, lateral in contact, leg on one plane
Centring Point = over medial condyle

Question 11

Describe the positioning of an AP Femur

Answer 11

Distal
Room Set Up = Table (check pregnancy)
Positioning = Supine, leg extended, leg internally rotated-epicondyles equidistant
Centring Point = midshaft of femur
SID = 100cm
Collimation = Knee, as much of femur as possible, soft tissue
Exposure Factors = 64kV, 8mAs

Proximal
Ensure grid is used, move to include hip joint

Question 12

Describe the positioning of a PA Chest

Answer 12

Room Set Up = Vertical bucky, grid needed, patient standing
Positioning = Facing IR, ~5cm above shoulders, patient straight, scapulae removed, shoulders down, taken on arrested inspiration
Centring Point = T7/8
SID = 180cm
Collimation = Apices, diaphragm, lateral chest walls
Exposure Factors = 90kV, 5mAs

Question 13

Describe the positioning of an AP abdomen

Answer 13

Room Set Up = Grid needed, table, check pregnancy, patient supine
Positioning = arms removed, no rotation, patient straight, spinous processes in midline.
Centring Point = midline of iliac crest
SID = 100cm
Collimation = Pubic symphysis, as much of superior abdomen, soft tissue
Exposure = 75kVp