Ribs - AP Lower (9-12)This is a featured page

Radiographic Positioning


Adult
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Name of projection Ribs - AP Lower (9-12)
(See "Special Notes" below).
Area Covered This view best shows the posterior ribs. It also shows the diaphragm.
Pathology shown Pathologies of the ribs, particularly, fractures of the lower posterior ribs.
Radiographic Anatomy Ribs radiographic anatomy
IR Size & Orientation 35 x 43 cm
Landscape usually, but may be portrait depending on body habitus
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 75 kVp
30 mAs
FFD / SID 100 cm
Central Ray Directed to the midsaggital plane at the level of the midpoint between the xiphoid process and the level of the lower costal margins.
Perpendicular to the IR
(Ensuring the level of the iliac crests is aligned with the inferior border of the IR will ensure the lower ribs will be included in the image).
Collimation Centre: At the midsaggital plane, at the level of the midpoint between the xiphoid process and the level of the lower costal margins
Shutter A: Open to include the iliac crests inferiorly
Shutter B: Open to include the lung fields and ribs laterally.
Markers Inferior and Lateral
Marker orientation AP
Shielding Gonadal (check your department's policy guidelines)
Respiration On suspended expiration
This ensures the diapragm is as high as possible, allowing as many lower ribs as possible to be seen
Positioning
  • This view can be performed with the patient either erect or supine
  • Position the patient so that their back is touching the bucky
  • Centre the midsaggital plane of the patient to the midline of the IR
  • Ensure the midsaggital plane is perpendicular to the IR, that is, the patient is not rotated
  • Arms relaxed and slightly abducted from the sides of the thorax
  • Adjust the lower border of the IR so that it is at the level of the iliac crests
  • Critique

    Positioning

    • No rotation of the thorax

    • The 8th though to 12th posterior ribs will be visualised below the diaphragm on expiration.
    Area Covered

    • Posterior ribs 8 through to 12, costophrenic angles, diaphragm

    Collimation
    • Centre: Approximately, the 10th rib
    • Shutter A: Open to show the iliac crests inferiorly
    • Shutter B: Open to show the lung fields and ribs laterally
    Exposure


    • There should be adequate exposure so that the ribs and thoracic vertebrae are seen faintly through the heart
    • There is minimal patient motion demonstrated by sharp, clear cortical margins and bony trabucular markings of the ribs being demonstrated.
    Special Notes PA vs AP Rib views
    There are several factors that will determine whether a PA or an AP rib view is indicated for the X-ray examination. The following information should be considered
    - the patient's clinical history
    - the mechanism of injury
    - the region of the rib cage which is painful
    The cortical margins and bony trabeculation of the ribs closest to the IR/bucky will be sharper and clearer. Therefore,
    Anterior ribs are best shown on a PA view
    &
    Posterior ribs are best shown on an AP view.



    AndyC
    AndyC
    Latest page update: made by AndyC , Jun 19 2011, 9:34 AM EDT (about this update About This Update AndyC Edited by AndyC

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