Abdomen - ErectThis is a featured page

Radiographic Positioning


Adult
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Name of projection Abdomen - Erect
Area Covered From the diaphragm downwards
Pathology shown Air-fluid levels, air under the diaphragm
Radiographic Anatomy Abdomen Radiographic Anatomy
IR Size & Orientation 35 x 43 cm
Portrait
D.R. may cover 43 x 43 cm
Film / Screen Combination Regular
(CR and DR as recommended by manufacturer)
Bucky / Grid Moving or Stationary Grid
Filter No
Exposure 80 kVp
40 mAs
FFD / SID 100 cm
Central Ray Directed to the midsaggital plane, 5cm superior to the level of the iliac crests
Perpendicular to the IR
Collimation Centre: To the midsaggital plane, 5cm superior to the level of the iliac crests
Shutter A: Open to IR size inferiorly and superiorly to include the diaphragm and as much of the abdomen as possible
Shutter B: Open to include the lateral skin margins if possible
Markers Inferior and Lateral
Marker orientation AP
Shielding Gonadal on males, if possible
(check your department's policy guidelines)
Respiration On suspended expiration or inspiration - check your department's technique protocol
Positioning
  • If possible, the patient should be in the AP erect position for at least 10 minutes prior to the image being taken so that any intraperitoneal free air can be demonstrated under the diaphragm. (AP/PA chest radiography is more sensitive for pneumoperitoneum)
  • Patient is erect with their back to the wall bucky
  • There is no rotation of the torso
  • Ensure there are no artefacts, such as zips or buttons over the area being imaged
  • Centre the midsaggital plane of the patient to the midline of the IR
  • Arms slightly abducted from the torso
Critique

 Positioning
  • No rotation as evidenced by
    • symmetrical iliac wings
    • the sacrum is centred in the pelvic inlet
    • the pedicles of the vertebrae are the same distance from the spinous processes on each side
Area Covered
  • The diaphragm, abdomen, flanks
Collimation
  • Centre: L3 Lumbar vertebra, which is approximately 5cm (2 inches) superior to the level of the iliac crests
  • Shutter A: Open to include the entire diaphragm superiorly
  • Shutter B: Open to include the lateral skin margins if possible
Exposure
  • There should be adequate exposure and no patient motion so that the following anatomy is shown
    • the outline of the psoas muscles
    • the outline of the kidneys
    • skeletal structures such as the posterior ribs, vertebrae and pelvis
Special Notes Can be performed PA, especially applicable in the case of unsteady patients.



AndyC
AndyC 		Latest page update: made by AndyC , Jun 9 2011, 5:22 AM EDT (about this update About This Update AndyC Edited by AndyC


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Keyword tags: abdomen abdomen acute abdomen erect abdomen fluid gas levels abdomen positioning AXR
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