Sacro-Coccygeal Flashcards
What is the Dennis classification?
Looks at sacral #’s
With zone 3 the medial area of the sacrum having a >50% chance of a neurological defect.
Name the 2 pelvic lines of symmetry
(anterior) Iliopectineal line -> follows the pelvic brim
(posterior) Ilioischial line
Asymmetry here could be due to # of poor patient orientation.
Why si radioation protection needed for sacro-coccygeal imaging and what protection should be used?
High dose exams
Thyroid and abdomen sheiliding
Typical kvp and breathing for sacro-coccygeal projections
75
susp. respiration
How is the patient best orientated for an AP sacrum and AP coccyx?
Supine, legs extended.
Beam angulation for AP sacrum and AP coccyx
Sacrum = 15 caudad Coccyx = 15 cephalad
Due to curvature of the anatomy.
mAs for lateral sacral-coccygeal
50
Patient positioning for lateral sacro-coccygeal
Recumbent on side, facing away.
If a patient has broader hips what kind of angulation should be used?
Caudad
SI joint dislocations are serious and typically referred to CT or MRI. If they however are performed on xray, how should it be taken?
Bilaterally.
Lumbarisation of S1
Less common then sacralisation
6 lumbar vertebrae.
- Increased IV’s
- Increased facet joints.
- squaring of vertebral body.
INCREASED MOBILISATION
Sacralisation of L5
More common than lumbarisation
4 lumbar verte
natural ‘Ankylisation’
LESS MOBILITY
Name of X-ray examination to asses pelvis of pregenant female?
pelvimitry.
NAI
Non accidental injury.
What is important about direction of sacral #
Identify if they are horixontal or vertical and wether they are heading towards sacral foramena.
What direction do sacral # typically go in ?
anterior angulation.
What projection is best used to asses a sacral #
lateral
less SI
Best view to asses a acetabular #
Judet’s view (AP Int oblique pelvis)
Positioning for Judet’s view
45 obliquity, UNAFFLICTED side raised.
LPO/RPO
Meaning patient is resting on injured side … painful
Modified Judet’s positioning
Normal postiont with vertical beam and then
External AP oblique. Patient is rolled onto unaffected side. the afflicted side will be raised
IR out of bucky.
patient is never rolled onto afflicted side
What does an internal (illiac) Judet show?
Anterior aspect of iliopubic collumn and post acetabulum
Obturator view
WHat does an external (obturator) judets show?
Post ilioischial collumn and anterior acetabulum.
Illiac view
MOI for acetabular #
Sagital force smashes femur into pelvis
Possible damage to viscera and vascularisation (iliofemoral Aa.)
What does the collumn and wall indicate in a judet view?
Wall indicated # (acetabular) and collumn indicates displacement.
