Chapter 7
What are the joints of the pelvic girdle?
Sacroiliac Joints (2), Hips (2), Symphysis Pubis, and Union of the Acetabulum
What are the four bone shapes?
Flat, irregular, long, and short
What should be visible on a KUB image?
Symphysis pubic, psoas muscles, kidneys, lower bladder margin
What is visible in profile of the proximal humerus in each of the following: external rotation, internal rotation, and neutral rotation.
External rotation: Greater tubercle
Internal rotation: Lesser tubercle
Neutral rotation: neither tubercle is in profile
How much rotation (and which way) is needed for a true AP position of the proximal femur?
15-20* internal rotation
How much of an angle is on the anterior aspect of the femur?
What are the divisions in body habitus?
Sthenic (50%), Asthenic (10%), Hyposthenic (35%), and Hypersthenic (5%)
What are the clinical indications of an abdominal exam?
Bowel obstruction, kidney stones, abdominal pain, or foreign body
What is the angle range for the AP Axial Clavicle projection?
0-15* for hypersthenic individuals, and 15-30* for hyposthenic individuals
Describe the Danelius-Miller Method (Axiolateral Inferosuperior).
Patient has to raise their unaffected leg over the tube head for this projection. The projection is shot mediolaterally.
What is the correct positioning for a Unilateral Frog-leg projection of the hip?
Patient is supine on table, with knee bent around 90* and femur abducted 45* from vertical
What are the two positioning rules?
1. Obtain at least two images 90* from each other
2. Obtain at least three projections if a joint is involved
What considerations do we need to keep in mind for different cast types?
Large plaster: + 8-10 kVp
Fiberglass:+3-4 kVp
What are the technical factors for the bottom half of the lower extremity?
65-75 kVp, short exposure time, small focal spot
What is the correct positioning of a patient of an AP Pelvis exam?
Patient is supine on table with no rotation of body, legs internally rotated ~15-20*. CR to midway between level of ASIS and pubic symphysis.
What are clinical indications for any pelvis, femur or hip exams?
Fractures, dislocations, degeneration, or bony lesions
What is a short cut to measuring where to place the CR on a PA chest exam?
Locate C7 and spread your thumb and pinky finger apart to simulate the gap needed
What are the three imaging principles?
1. Keep the part parallel to the IR
2. CR is perpendicular to the part and IR
3. Correctly center the CR
What is the correct positioning for a lateral mediolateral knee projection?
Patient is recumbent on table and lying up on affected hip. Knee is flexed ~20-30* with enough room for two fingers between the patella and the table. CR is angled 5-7* cephalic
When is the Clement-Nakayama Method (Modified Axiolateral) used?
When the patient has limited movement of both lower limbs.
What is the tube angle for males and for females in the AP Axial Outlet projection?
20-30* cephalic for males and 30-45* cephalic for females
Why is almost every lateral chest exam performed as a left lateral?
What do you do if your patient cannot straighten their arm for an AP elbow exam?
Take two separate images, one with the CR perpendicular to humerus, and one with the CR perpendicular to the forearm
When using the Beclere Method, how should the patient be positioned?
Patient it supine on table with the affected knee flexed 40-45*. The CR is centered 1/2" distal to the apex of the patella, perpendicular to the lower leg.
How can we shield patients in pelvic, femoral, or hip exams?
For females, an ovarian shield can be used for bilateral hips and proximal femora. For males, a small contact shield can be placed at the top border of the inferior margin of the pubis symphysis.