Sternum - RAOThis is a featured page

Radiographic Positioning


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Name of projection Sternum - RAO
Area Covered Entire sternum including sterno-clavicular joints
Pathology shown Pathologies of the sternum, for example, fractures,
Radiographic Anatomy Sternum Radiographic Anatomy
IR Size & Orientation 24 x 30 cm
Portrait
Film / Screen Combination Regular
(CR and DR as recommended by manufacturer)
Bucky / Grid Moving or Stationary Grid
Filter No
Exposure Breathing technique used
70 kVp
25 mA
3 seconds
FFD / SID 100 cm
Central Ray Directed to the level of the mid sternum and slightly left of the midline
Perpendicular to the IR
Collimation Centre: Mid sternum (mid way between the jugular notch and the xiphoid process)
Shutter A: Open to collimate to film size lengthwise, ensuring the jugular notch is included superiorly
Shutter B: Open laterally to approximately 13 cm
Markers Superior and Laterally
Marker orientation PA (unless patient is supine, then marker is AP)
Shielding Gonadal (check your department's policy guidelines)
Respiration No suspension of breath - use the Breathing Technique to blur the lung markings. The exposure is taken while the patient is taking shallow breaths.
Positioning The patient's presentation may dictate the method for positioning, for example
Upright Patient (preferred method)
  • Patient is erect with chest touching the bucky
  • From this PA position, oblique the patient 15° in an Right Anterior Oblique (RAO) position, right shoulder touching the bucky
  • Centre the sternum to the IR
Supine Patient
  • Patient supine on the table bucky
  • Angle the central ray 15° from right to left across the patient
Patient (effectively) prone
  • this projection has the patient bending from the waist so that their sternum/chest is touching the table bucky. However, first.....
  • place the film in the table bucky
  • angle the X-ray tube 15 degrees so that is will be going from left to right across the patient
  • collimate light field to the film size
  • have the patient bend from the waist so that their sternum is flat resting on the table (adjust the table height so this is comfortable)
  • align the long axis of the sternum to the long axis of the film, with the jugular notch at the top

Critique

 Positioning
  • Correct obliquity is demonstrated by
    • the sternum is seen along side the spine without superimposition of the vertebrae
    • the sternum is seen through the heart shadow
Area Covered
  • Entire sternum from the jugular notch superiorly to the xiphoid process inferiorly, and the sternoclavicular joints are seen
Collimation
  • Centre: Mid sternum
  • Shutter A: Jugular notch and xiphoid sternum are included
  • Shutter B: The lateral borders of the sternum and sterno-clavicular joints are included
Exposure
  • Correct breathing technique is used as evidenced by
    • Lung markings are blurred
    • Cortical outlines of the sternum are seen overlying the heart shadow
Special Notes



AndyC
AndyC 		Latest page update: made by AndyC , Jun 19 2011, 2:38 PM EDT (about this update About This Update AndyC Edited by AndyC

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Keyword tags: sternum sternum positioning sternum RAO sternum technique
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BIJUSS My experience 1 Jan 18 2012, 6:05 PM EST by metal-fan-666
Thread started: Nov 27 2009, 2:13 AM EST  Watch
YES ,both oblique can use for sternum;but from my experience LAO is more better since the heart shadow wont disturbe the image quality.Thre things are vry impotant -1.degree of obliquity of patient (20-25),2.CR such a way to penitrate throuh the mid sternum 3.breathing and KV(KV must be just sufficient)
Thanks
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chris.rodgers "Moore" method 4 Oct 28 2009, 1:20 AM EDT by vitharana
Thread started: Oct 25 2009, 9:05 PM EDT  Watch
In my studies there has been a LAO method mentioned, prone bent over the table, with varying angulation based on patent thickness. it's referenced as being in the Merrill book, can anyone confirm this for me? (p474 and 502 maybe)
Thanks
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