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Jun 9 2011, 5:07 AM EDT AndyC 9 words added, 8 words deleted

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Radiographic Positioning


Adult
Other related pages of interest

Name of projection Abdomen - Supine
Area Covered The diaphragm, abdomen, pubic symphysis
Pathology shown Bowel obstruction, inflammatory bowel disease, volvulus, organomegaly, pneumoperitoneum, tumour and ascities
Radiographic Anatomy Abdomen Radiographic Anatomy
IR Size & Orientation 35 x 43 cm
Portrait
D.R. may cover 43 x 43 cm
Some obese patients will require two 35 x 43 cm landscape to cover the abdominal area. (sometimes 4 films required)
Film / Screen Combination Regular
(CR and DR as recommended by manufacturer)
Bucky / Grid Moving or Stationary Grid
Filter No
Exposure 75 kVp
35 mAs
FFD / SID 100 cm
Central Ray Directed to the midsaggital plane at the level of the iliac crests
Perpendicular to the IR
Collimation Centre: To the midsaggital plane at the level of the iliac crests
Shutter A: Open to include the pubic symphysis inferiorly
Shutter B: Open to include the lateral skin margins
Markers Inferior and Lateral
Marker orientation AP
Shielding Gonadal for males (check your department's policy guidelines)
Respiration Suspended on expiration - this lifts the diaphragm and presents the abdominal contents in a more relaxed state. (check your departmental technique protocol)
Positioning
  • Patient is supine on the table
  • Cushion for head
  • Patient's arms slightly abducted from the torso
  • Positioned without rotation of the pelvis and 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
  • CR directed to the midsaggital plane at the level of the iliac crests
Critique

 Positioning
No rotation as evidenced by
  • symmetrical iliac wings
  • the obturator foramina are both open and symmetrical
  • 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 to pubic symphysis
Collimation
  • Centre: L4 Lumbar vertebra, which is at the level of the iliac crests
  • Shutter A: Open to include the pubic symphysis inferiorly and 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 demonstrated
    • the outline of the psoas muscles
    • the outline of the kidneys
    • skeletal structures such as the posterior ribs, vertebrae and pelvic anatomy
Special Notes This technique is modified to demonstrate particular pathologies. e.g. inguinal hernia, renal stone follow up, cholycystitis etc.