Week 2 - Terminology Flashcards
Radiolucent
X-ray see through (black on the image)
Radio-opaque
X-ray blocked
Latent image
Image on the receptor yet to be processed to visualise
Anechoic
Black - anything fluid filled
Hypechoic
Dark
Timor, lymph node
Hyperechoic
Bright
Fat tissue, stone
Projection
The path the X-ray travel from the tube through the subject to the image receptor
Positioning
The part of the body closes to the image receptor usually used for obliques
View
Refers to the image only, not the patient position or path of the beam which resulted in the image
Lateromedial lateral
Position? Projection? View?
Position - medial
Projection - medial to lateral
View - lateral
Mediolateral lateral
Projection? Position? View?
Projection - medial to lateral
Position - lateral
View - lateral
Ap
Anterio-posterior
PA
Posterior-anterior
DP
Dorsi-plantar
#
fracture
OBL
Oblique
MY
Metatarsal
What must imaging referrals contain
Patient details:
- Name
- DOB
- Adress
- Clinical request - region
- Hidtory
Referrer Details
- provider number
- practice address
- signature
- date of referral
Angle of gait
The angle formed between the feet and the line of progression while walking
Approx: 10 to 15 degrees in an average individual
Base of gait
Distance between both medial malleoli while walking
What does weight bearing show
Positional relationships of anatomy while subjected to the stress of body weight
What stance is base of gait performed in
Midtsnace
When shouldn’t weight bearing and base of gait be chosen
- Trauma cases
- non-ambulatory patients
- patient with acute pain or recent surgery
- unsteady patients
What are Routine projections
Form the departments general protocol for normal circumstances
Complementary projections
Extra views which may be utilised when specific anatomy needs to be demonstrated
Alternative projections
Done instead of routine as they show much the same thing, but in a specific way
Routine projections
DP
OBI
+/- lateral
Alternative
PD
LATERAL (LATEROMEDIAL)
DP
LATERAL
MEDIAL OBI
DP
LATERAL
Complementary
Lateral obi
Lateral obi - WB
Clinical history Qs
- What is the problem -acute or chronic
- Has there been any trauma
- if so - when?, - mechanism of injury - Has the patient had any significant medical history that might impact what images are taken
- possible pregnancy
- current ulcer/wound/known pathogen
- dementia
- inability to weightbear or instability on weight bearing - What is your initial diagnosis
5 what projections will best confirm or rule out the condition? - Is there any previous imagine
- if there is - is it relevant?
Projections and anatomy demonstrated for toes - routine
DP
Medial oblique
Lateral (on request)
Lateral toe (additional) - imaging options
WB
MEDIOLATERAL LATERAL
LATEROMEDIAL LATERAL
Toes (complementary) - sesamoids
Supine (Holly method)
Prone (Lewis method)
Routine foot X-rays
DP - shows outlines of phalanges, metatarsals and tarsals
DP MEDIAL OBLIQUE - rolled in - medial side closest to receptor - creates less overlapping of tarsal bones
Foot +/- lateral
May be excluded from routine series (only performed if truama or foreign body are detected)
- may include all the ankle joint
- shows subtler and proximal tarsal joints
Foot COMPLEMENTARY X-ray
Lateral oblique - improved separation of the 1st and 2nd MY
- shows medial cuneiform ! Navicular and seasmoids
Foot (alternative)
Plantar Doris
- patient prone
- no angular ion used
- good for lisfranc
Foot (alternative)
DP WB
WB compared to non-WB
WB - see compression of foot and the Mets lay flatter in WB
Calcaneus - projections and anatomy demonstrated
Lateral - Mediolateral, Bilateral for spurs: shows anterior articulations and sinus tarsi, position as for lateral foot
Axial - plantodorsal, Patient supine, toes pulled back: shows trochlear and lateral process, sustenaculum tali, calcaneocuboid joint and tuberosity, good fr visualising # displacement and shape abnormalities
Calcaneus (Complementary)
Harris Beath - for assessment of talocalcaneal facet joints, sometimes known as the ski-jump position
Allows visualisation of the posterior facet of the subtalar joint and the varus/valgus rotation
Subtalar joints (Routine)
Medial oblique ankle - shows posterior subtalar joint and sinus tarsi
Lateral oblique ankle - posterior subtalar joint and tibiofibular syndesmosis
Sub-talar joints (alternative)
Broden method - demonstrates posterior subtalar joints
Subtalar joints (complimentary)
Modified Anthonsens (Subinferior Oblique)
- over-rotated lateral position
- 20 degrees caudal tube angulation
- middle and posterior facets
- sinus tarsi
Ankle - routine projections
AP ankle - entire ankle joint and both malleoli in profile
Medial Oblique - toes rotated from oblique, show distal tib/fib joint, talar dome and inferior fibulotalar joint
Lateral - shows AP dimensions od tibiotalar joint, pre-Achilles fat pad, talar dome
Ankle joint (alternative - specifically requested)
AP and lateral (lateromedial WB)
- difficult to assess if intrinsic foot problems, metatarsal adductus supinated or pronated stance positions
Ankle joint - complementary
AP forced inversion and eversion - may be done for comparison (joint stability or instability)
- if ligaments are ruptured or stretch there will be an increase in the space when inv and ever stress is applied
tibia/fibular - projection
AP
Lateral
Knee projection routine
AP
Lateral
Knee - complimentary
Weightbearing bilateral knees to compare
