LATERAL POSITON PATIENT ERECT | SCOLIOSIS SERIES

Sunday, October 19, 2014

Scoliotic Deformity X-ray - Lateral View

Structure Shown in erct lateral scoliosis series:

  • Spondylolisthesis degree of kyphosis, or lordosis.

Technical Factors:

  • Cassette size 35 x 43 cm (14 x 17 inches), lenghtwise or 35 x 90 cm (14 x 36 inches film if patient is taller.
  • Stationary or moving grid.
  • Erect marker
  • Use of compensating filters to help obtain a more uniform density along the vertebral column.
  • 90 to 100 kV range
  • Technique and dose at 60 inches
  • mAs 50

lateral scoliosis
Lateral projection using 35 x 90 cm or 14 x 36 inch IR

Shielding:

  • Place contact shield or shadow shield over gonads without obscuring area of interest, Use breast shield for younger female patients.

Patient Position:

  • Position patient in erect lateral position with arms elevated, or if unsteady, grasping a support in front. The convex side of the curve is positioned against the cassette.

Part Position:

  • Place pelvis and torso in as true a lateral position as possible.
  • Ensure midcoronal plane is align to body and center of cassette.
  • Lower margin of cassette should be 1 to 2 inches below the iliac crest. Determine by cassette size used and patient size.

Central Ray:

  • Central ray perpendicular, directed to midpoint of cassette.
  • Source to image distance of 40 to 60 inches or 100 to 150 cm; longer SID required in larger image receptor to obtain required collimation.

Collimation:

  • Four side of cassette must be collimated to avoid cut-off of area of interest. Use lateral collimation cautiously to prevent vertebral column cutoff.

Respiration:

  • Suspend respiration on expiration.

Radiographic Criteria in lateral Scoliosis series:

Lateral Using 35 x 90 cm or 14 x 36 inch IR

Structure Shown:

  • Thoracic and lumbar vertebrae are demonstrated in a lateral position.

Position:

  • Thoracic and lumbar vertebrae are in as true a lateral position as possible.
  • Rotation of pelvis and torso are seen because scoliosis generally is accompanied by twisting or rotation of involved vertebrae.

Collimation and CR:

  • Vertebrae column should be in center of collimation field of cassette.
  • A minimum of 1 inch or 2.5 cm of the iliac crest should be included.

Exposure Criteria:

  • Optimal density and contrast demonstrated lumbar vertebrae and thracic verterbrae.
  • A compensation filter is useful for ensuring and even density if a 35 x 90 cm or 14 x 36 inch IR is used.
  • Sharp bony margins indicate no motion.

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