Abdomen - Lateral DecubitusThis is a featured page

Radiographic Positioning


Adult
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Name of projection Abdomen - Lateral Decubitus
Area Covered The abdomen, from the diaphragm downwards
Pathology shown Air-fluid levels, pneumoperitoneum, bowel obstruction,
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 Yes, a decubitus filter can be used, except in slim patients. This will help to even out the soft tissue of the abdomen which gravity will move closer to the table bucky.
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 or PA, depending on the patient's position
Shielding Gonadal for males
(check your department's policy guidelines)
Respiration On suspended expiration- check your department's technique protocol
Positioning
  • If possible, the patient should be in the decubitus position for at least 10 minutes prior to the image being taken to best show any free gas
  • Patient lateral recumbent position (laying on their left side with their back to the wall bucky)
  • Make sure 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
  • Bring both hands above the head to remove the arms from the field of view
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
Collimation
  • Centre: L3 Lumbar vertebra, which is approximately 5cm 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
    • gas bubbles are sharply defined
    • skeletal structures such as the posterior ribs, vertebrae and pelvis
  • The contrast and density should be uniform over the abdomen
Special Notes Annotation
Annotate the image to indicate
  • either "L side up " or "R side up"
  • either "AP" or "PA"



AndyC
AndyC 		Latest page update: made by AndyC , Jun 19 2011, 2:59 PM EDT (about this update About This Update AndyC Edited by AndyC

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Keyword tags: abdomen abdomen acute abdomen lateral decubitus abdomen positioning AXR
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