Positioning and routine
projections
, https://cdn.britannica.com/51/54751-050-E65F3C33/Front-views-human-skeleton.jpg
Anatomy
https://radiopaedia.org/articles/lumbar-spine-lateral-view-2?lang=gb
Centering
, Preparation?
•Prepare room
•Call patient
•Introduce yourself and gain consent
•Identification – 3 forms (Name, DOB, Address)
•Check why patient is attending
•Confirm body part to be imaged and why
•Remove artefacts
Request Card
Must include?
•Clinicians signature
•Date
•Patients identifiable
information (3 forms of
ID)
•Clinical information/
question
, lumber spine
Anatomy to include:
Pt preparation
• name, date of birth, address or hospital number
• cheek clinical details + area of interest, justification
• explanation
• remove artefacts eg coats jewelry
• last menstrual period (lmp) 10 or 28 day rule? Pt over 55 don't
need to sign form
Clinical indications?
• trauma - fall, sport injury, RTA? Fracture/
Subluxation.
•post # follow up Referral from orthopaedic
(fracture) clinic. Ap
•Chronic conditions -Osteoarthritis (OA) AKA
spondylosis, osteoporotic collar spondylolysis,
spondylolisthesis
•Hereditary conditions - Scoliosis, spina bifida Lateral
Equipment?
•Anti scatter grid -
•Anatomical marker
•AED chamber
L5-S1 view
•IR Lateral?
•From supine, turn the patient onto
Ap? their side - MSP parallel to the
•pt lies supine, arms by their sides cassette
•MSP perpendicular to tabletop (90) •Arms raised; elbows clasped (under
•MSP aligned along long axis of table head like they’re sleeping
•Anterior superior iliac spines (ASISs) •Knees flexed and pad placed between
equidistant from tabletop them
•Shoulders, hips and ankles
Oblique (orthopedic
Centring? superimposed respectively requests)
•SID 115/110 •Ensure lateral position by checking
•centering - over midline, at the level of the vertical superimposition of shoulders
lower costal margin (L3) and hips
AOI? Centring?
•collimate to include T12 superior & SIJs •SID – 110/115
laterally and l5-s1 inferior •Centre – vertical ray centred at the
·
Is the anatomical marker in the
•Pedicles equidistant from spinous processes level of the lower costal margin; 7.5
•No rotation - spinous processes central and cm anterior to the spinous process
correct orientation??
transverse processes equal in length
AOI?
•Exposure made on arrested expiration •Collimate to include From T12 down,
to include the lumbosacral junction.
Entirety of vertebral bodies, Spinous
processes (not foreshortened),
Intervertebral disc spaces, Pedicles
superimposed, Posterior vertebral
bodies superimposed
•Place anatomical marker in primary
beam
•Exposure made on arrested
expiration.
projections
, https://cdn.britannica.com/51/54751-050-E65F3C33/Front-views-human-skeleton.jpg
Anatomy
https://radiopaedia.org/articles/lumbar-spine-lateral-view-2?lang=gb
Centering
, Preparation?
•Prepare room
•Call patient
•Introduce yourself and gain consent
•Identification – 3 forms (Name, DOB, Address)
•Check why patient is attending
•Confirm body part to be imaged and why
•Remove artefacts
Request Card
Must include?
•Clinicians signature
•Date
•Patients identifiable
information (3 forms of
ID)
•Clinical information/
question
, lumber spine
Anatomy to include:
Pt preparation
• name, date of birth, address or hospital number
• cheek clinical details + area of interest, justification
• explanation
• remove artefacts eg coats jewelry
• last menstrual period (lmp) 10 or 28 day rule? Pt over 55 don't
need to sign form
Clinical indications?
• trauma - fall, sport injury, RTA? Fracture/
Subluxation.
•post # follow up Referral from orthopaedic
(fracture) clinic. Ap
•Chronic conditions -Osteoarthritis (OA) AKA
spondylosis, osteoporotic collar spondylolysis,
spondylolisthesis
•Hereditary conditions - Scoliosis, spina bifida Lateral
Equipment?
•Anti scatter grid -
•Anatomical marker
•AED chamber
L5-S1 view
•IR Lateral?
•From supine, turn the patient onto
Ap? their side - MSP parallel to the
•pt lies supine, arms by their sides cassette
•MSP perpendicular to tabletop (90) •Arms raised; elbows clasped (under
•MSP aligned along long axis of table head like they’re sleeping
•Anterior superior iliac spines (ASISs) •Knees flexed and pad placed between
equidistant from tabletop them
•Shoulders, hips and ankles
Oblique (orthopedic
Centring? superimposed respectively requests)
•SID 115/110 •Ensure lateral position by checking
•centering - over midline, at the level of the vertical superimposition of shoulders
lower costal margin (L3) and hips
AOI? Centring?
•collimate to include T12 superior & SIJs •SID – 110/115
laterally and l5-s1 inferior •Centre – vertical ray centred at the
·
Is the anatomical marker in the
•Pedicles equidistant from spinous processes level of the lower costal margin; 7.5
•No rotation - spinous processes central and cm anterior to the spinous process
correct orientation??
transverse processes equal in length
AOI?
•Exposure made on arrested expiration •Collimate to include From T12 down,
to include the lumbosacral junction.
Entirety of vertebral bodies, Spinous
processes (not foreshortened),
Intervertebral disc spaces, Pedicles
superimposed, Posterior vertebral
bodies superimposed
•Place anatomical marker in primary
beam
•Exposure made on arrested
expiration.
