Radiography - NOT Routine : Radiography - NOT Routine Connie Lyon, R.T.(R) (QM) 2
Slide 2 : AP Hip ID L AP Hip ID R
Slide 3 : Lateral Hip
Slide 4 : Hip- Axiolateral (Danelius-Miller method) for probable fracture Correct alignment of film - CR - and neck of femur; camera at same angle as CR Head Neck
Slide 5 : Hip This error also impacts density by increasing part thickness Camera positioned more parallel to femur causing viewer to see neck as shortened
Slide 6 : Camera positioned more perpendicular to femur causing viewer to see neck superimposed on the greater trochanter Lesser trochanter Ischial tuberosity Unaffected leg Edge of radiation field Greater trochanter Lesser trochanter Hip
Slide 7 : What is your response when things don’t go as expected?
Spine - : Spine -
Spine - cervical : Spine - cervical AP/odontoid - supine or upright
upright does NOT require 72” SID = about 3 times the mAS compared to 40”
even if grid is focused to 72” since using center of grid only
Obl/lat requires 72”
SID offsets magnification caused by OID
Spine - cervical odontoid : Spine - cervical odontoid align bottom of teeth with mastoid process with occipital protuberance
instruct patient to “lower jaw” or “drop jaw” in order to maintain position
3-5 degree caudal angle can aid in demonstrating C1-C2 joint space
Slide 11 :
Spine - cervical odontoid : Spine - cervical odontoid Courtesy of Kenneth Bontrager, “Pocket Atlas” 3rd edition
Spine - cervical odontoid : Spine - cervical odontoid with caudal tube tilt
Spine - cervical odontoid : Spine - cervical odontoid Alternatives after fracture has been ruled out
CR parallel to mentomeatal line Courtesy of Kenneth Bontrager, “Pocket Atlas” 3rd edition
Slide 15 : “Waters” for odontoid process
Spine - cervical oblique : Spine - cervical oblique VIP - have patient sit (or stand) very erect with shoulders relaxed down as much as possible
entire spine and skull in same plane
AP or PA
Slide 17 :
Spine - cervical oblique : Spine - cervical oblique Courtesy of Kenneth Bontrager, “Pocket Atlas” 3rd edition
Slide 19 : This or this?
Slide 20 : this
should
look
like
this
Slide 21 : Seeing C-7 Weights and/or relaxation
Slide 22 : Instabilities and dislocations
Slide 23 : Hangman’s fracture
Spine - cervical thoracic area - aka “Swimmers” view : Spine - cervical thoracic area - aka “Swimmers” view purpose is to see lower cervical and upper thoracic in as near lateral projection as possible - NOT a “joint” view
tight collimation and use of water bag under cervical can help equalize density