Principles and Positioning Reader Flashcards
What is the sequence suggested for taking X-rays?
pg 4
What are some of the aspects that you can critique on an image?
pg 12, 13
PA Lumbosacral Spine/ AP lumbopelvic view Cassette size SID kVp Grid Central Ray Tube tilt: Breathing:
pg 23
Lateral Lumbar SID kVp Grid Central Ray Tube tilt: Breathing:
25
Anterior Oblique (lumbar) SID kVp Grid Central Ray Tube tilt: Breathing:
26
PA angulated lumbosacral Spot view SID kVp Grid Central Ray Tube tilt: Breathing:
27
Lateral lumbosacral spot view SID kVp Grid Central Ray Tube tilt: Breathing:
28
AP sacrum/ Coccyx SID kVp Grid Central Ray Tube tilt: Breathing:
29
Lateral Sacrum SID kVp Grid Central Ray Tube tilt: Breathing:
30
PA chest SID kVp Grid Central Ray Tube tilt: Breathing:
32
Lateral Chest SID kVp Grid Central Ray Tube tilt: Breathing:
34
Apical Lordotic Chest SID kVp Grid Central Ray Tube tilt: Breathing: 35
35
Rib Views SID kVp Grid Central Ray Tube tilt: Breathing: special considerations
37
AP Thoracic SID kVp Grid Central Ray Tube tilt: Breathing: special considerations: 38
38
Lateral Thoracic SID kVp Grid Central Ray Tube tilt: Breathing: special considerations: 39
39
Swimmers view SID kVp Grid Central Ray Tube tilt: Breathing: special considerations: 40
40
AP Open mouth SID kVp Grid Central Ray Tube tilt: Breathing: special considerations: 41
41
AP lower cervical SID kVp Grid Central Ray Tube tilt: Breathing: special considerations: 43
43
Lateral cervical SID kVp Grid Central Ray Tube tilt: Breathing: special considerations: 44
44
R and left Anterior obliques cervical SID kVp Grid Central Ray Tube tilt: Breathing: special considerations: pg 45
45
Flexion, extension, lateral Cervical SID kVp Grid Central Ray Tube tilt: Breathing: special considerations: 47
47
Standard Hip Views: AP Pelvis Cassette SID: 100cm kVp: 80 Grid: Yes Central Ray: Breathing: Special considerations: Shielding? 48
AP Pelvis Cassette: 35 x 43 SID: 100cm kVp: 80 Grid: Yes Central Ray: midline between ASIS and pubic symphysis Breathing: Suspended respiration Special considerations: Leg internally rotated 10 degrees Shielding? Yes
AP Spot Hip Cassette Size: SID: 100 kvP: 80 grid: Yes Central Ray: Tube tilt: Breathing: Special considerations: 49
Cassette: 24 x 30 SID: 100 KvP: 80 Grid: Yes Central Ray: 5-7cm below mid point between ASIS and pubis on that side Tube tilt: none Breathing: Suspended respiration Special considerations: Internal rotation of femurs 10deg Gonadal shielding
Frog leg Hip View: Cassette Size: SID kVp: Grid: Central Ray: Tube tilt: Breathing: Special Considerations 50
Cassette Size: 24 x 30 SID: 100 kVp: 80 Grid: Yes Central Ray: Same as AP spot Tube tilt: none Breathing: Suspended respiration Special Considerations: lower part of knee on same leg should be as close to table as possible, if cant touch have a padded support If pt cant get within 10c, of table top, elevate patients opposite side untill knee contacts table, elevate pts opposite side untill knee contacts table, and place foam pad under elevated hip.
AP Knee (pg 52) Cassette size: SID: kVp: Grid: Central Ray: Tube tilt: Breathing: Special considerations:
Cassette size: lil one portrait (18 x 24) SID: 100 kVp: 60 Grid: NO Central Ray: 1 cm below apex of patella Tube tilt: 10 deg cephalad Breathing: suspended Special considerations: Might need to internally rotate knee to ensure AP orientation. -knee should be fully extended SHILEDING USE ON ALL KNEES AND ANKLES
Lateral Knee: 53 Cassette Size: SID: kvP: Grid: Central Ray: Tube Tilt: Breathing: Special considerations
Cassette: Small one portrait SID: 100 kvP: 60 Grid; NO Central Ray: Joint space Tube tilt: 5deg cephalad Breathing: suspended Special considerations: knee bent at 45 deg Lateral side of knee contacting table
Intercondylar View (TUNNEL) View 54 Cassette Size: SID: kVP: Grid: None s Central Ray: Tube Tilt: breathing: Special considerations:
54
Intercondylar View (TUNNEL) View
Cassette Size: 18 x 24
SID: 100
kVP: 60
Grid: None (unles knee measures greater than 14cm- then use a grid and multiply mAs by 3 x
Central Ray: Popliteal fossa
Tube Tilt: 45deg Caudal
breathing: Suspended respiration
Special considerations: Patient prone, knee flexed to 45
-Increase mAs 50% from AP view (so measure AP)
-remember to account for a large tube tilt
-patella should contact upper half of cassette to allow for imageprojection into centre.
Tangential (Sunrise) View - 55 Cassette size: SID kVP Grid: Central ray: Tube tilt: breathing: Special considerations:
Tangential (Sunrise) View - 55 Cassette size: 18 x 24 SID: 100 kVP: 60 Grid: non (unless etc) Central ray: Patellofemoral joint Tube tilt: breathing: Special considerations: Knee should be fully flexed, may need assistance if cant reach -if they have patella trauma, rule out fx before performing this view. -Increase 1.5 x from AP (so measure AP) and collimate area of interest.
AP and Lateral Leg view 56 Cassette size: SID kVP Grid: Central ray: Tube tilt: breathing: Special considerations:
56
Cassette size: 35 x 43 oblique
SID: 100
kVP: 60
Grid: none
Central ray: mid shaft
Tube tilt: non
breathing: suspended
Special considerations:
-AP position without rotation
-lateral position without rotation, lateral side contacting cassette
-must attempt to include joints at each end of leg
-If leg too long, can plave leg diagonal and increase SID to 110cm
-can take both views on one large cassette if legs fit
-Use 1/3 mAs of AP knee (because fo switch from detail to regular speed cassette)
-Measure CR
AP Ankle 57 Cassette size: SID kVP Grid: Central ray: Tube tilt: breathing: Special considerations:
57 Cassette size: 24 x 30 SID: 100 kVP: 55 Grid: None Central ray: Between malleoli Tube tilt: none breathing: suspended Special considerations: -divide a cassette in half by placing lead strip over half not being used. -Foot facing straight up neutral, close to perpendicular to the cassette (relaxed but not plantar flexed)
Medial Oblique Ankle 58 Cassette size: SID kVP Grid: Central ray: Tube tilt: breathing: Special considerations:
58 Cassette size: 24 x 30cm (one half- landscape) SID: 100cm kVP: 55 Grid: None Central ray: Between malleoli Tube tilt: none breathing: suspended Special considerations: -leg and ankle medially rotated 45 deg -ankle dorsiflexed if possible
Lateral ankle 59 Cassette size: 24 x 30cm detail portrait or landscape SID: 100 kVP Grid: Central ray: Tube tilt: breathing: Special considerations:
Lateral ankle- 59 Cassette size: 24 x 30 SID: 100 kVP: 55 Grid: non Central ray: Medial Malleolus Tube tilt: None breathing: Suspended respiration Special considerations: -ankle is placed lateral side down -position ankle in 90deg dorsiflexion -collimate to the ankle/ hindfoot region- this is not a lateral foot view.
Mortise
60
Similar to AP, but medially rotate 15deg- best to evaluate mortise joint
FOOT VIEWS DP foot -61 Cassette size: SID: Grid: Central Ray: Tube tilt: Breathing: Special considerations:
61 Cassette size: 24 x 30 (1/2 cassette) SID: 100 kvP: 55 Grid: 55 Central Ray: base of 3rd metatarsal Tube tilt: 10degrees CEPHALAD!!! Breathing: suspended Special considerations: -foot must be flat against cassette -measure at mid foot and use compensatory filters to avoid burnt out toes MUST include toes on film- legal
Medial Oblique Foot: 62 Cassette size: SID: kVp: Grid: Central Ray: Tube tilt: Breathing: Special considerations:
Cassette size: 24 x 30 (half) SID: 100 kvp: 55 Grid: None Central Ray: Base of 3rd metatarsal Tube tilt: none Breathing: suspended Special considerations: -lateral side of foot is elevated (medial side down) -use foam wedge to help hold position (under foot or knee)
Lateral Foot: 63 Cassette size: SID: kVp: Grid: Central Ray: Tube tilt: Breathing: Special considerations:
Cassette size: 18x 24 (detail) SID: 100 kVp:55 Grid: non Central Ray: base of 3rd metatarsal Tube tilt: none Breathing: suspended Special considerations: -lateral side of foot against cassette for patient comfort -must include toes and calcaneus -make sure plantar surface is perpendicular to cassette and ANKLE IS DORSIFLEXED to 90 deg. -For larger feet, use a 24 x 30cm cassette
Axial calcaneus View: 64 Cassette size: SID: kVp: Grid: Central Ray: Tube tilt: Breathing: Special considerations:
Cassette size: 18 x 24 (detail) SID: 100 kVp: 55 Grid: non Central Ray: mid calcaneus Tube tilt: 40 deg cephalad Breathing: suspended Special considerations:
ALL AP shoulder Views 67 Cassette size: SID: kVp: Grid: Central Ray: Tube tilt: Breathing: Special considerations:
Cassette size: 24 x 30
SID: 100
kVp: 70
Grid: yes
Central Ray: 2.5cm below coracoid process (about 5cm below top of clavicle
Tube tilt: non
Breathing: suspended respiration
Special considerations:
-pt back flat against the grid holder
-head turned away from the x-ray (to protect eyes)
Collimation should be to just beyond the outer soft tissue edges.
-can place a filter over the ‘dead space’ above the shoulder to reduce back scatter and AC region over exposure.
AP external rotation
arm slightly abducted
AP internal rotation:
- arm slightly abducted and palms facing
- ENSURE pt doesnt hunch shoulder forward.
AP Shoulder- Weight Bearing All factors same as AP views humerus in neutral position -pt holds weighted object (3-10kgs) with relaxed shoulder to assess stability of AC and GH joints 68
a
SHoulder
posterior oblique (Grashey)
69
Cassette size: SID: kVp: Grid: Central Ray: Tube tilt: Breathing: Special considerations:
Cassette size: 24 x 30
SID: 100
kVp: 70
Grid: Yes
Central Ray: 2.5cm below coracoid process
Tube tilt: non
Breathing:suspended respiration
Special considerations:
-pts scapular body placed flat against the grid cabnet (about 30-40deg of body rotation)
-arm slightly abducted in neutral
Purpose: to see directly through glenohumeral joint.
Trans-scapular View: 70 Cassette size: SID: kVp: Grid: Central Ray: Tube tilt: Breathing: Special considerations:
Cassette size: 24 x 30 SID: 100cm kVp: 70 Grid: Yes Central Ray: plane of scapulocostal articulation, mid scap body (measure through central ray) Tube tilt: none Breathing: suspended respiration Special considerations: -stand pt in anterior oblique position -arm across body anteriorly -generally requires 45-60deg of obliquity, depending on humeral position.
