Sign in or 
Location: Questions about rib positioning.
Discussion: Can you use a landscape IR for ribs if the person is too large?
Category:
Discussion Forum /
General Discussion
Share this
Showing 3 posts
|
Posted Anonymously |
Can you use a landscape IR for ribs if the person is too large?
Jul 17 2008, 9:38 PM EDT
I am having a tough time not clipping the sides of the ribs of large people. Any suggestions? I'm doing them at 40' SID like the book says and centering the MSP to the center of IR.Do you find this valuable?
Keyword tags:
rib
rib position
ribs
|
|
Posted Anonymously |
1. RE: Can you use a landscape IR for ribs if the person is too large?
Sep 3 2008, 6:58 AM EDT
The obvious answer is yes. I believe that 95% of patients will fit on an IR portrait and approx 95% will fit landscape. There will be a few that are too big to fit either way and will probably need 2 overlapping images.Do you find this valuable? |
|
Rodgonzbea |
2. RE: Can you use a landscape IR for ribs if the person is too large?
May 22 2009, 6:31 PM EDT
As a PDY I was once shown to do ribs supine, oblique (similarly as you position for a non-NOF # hip, injured side down, arm in down side above head) with 10-25 deg ang cephalic.. straightens trhe ribs beautifully, you use an abdomen type exposure (60-80 kv on 30-50mas). Very helpful in ED/Trauma, After you've done your PA/AP CXR you can your pat in the X-ray table, and it becomes a lot easier for the patient to position. Typically your pat will come hunching over, breathing in spurts, and if you need them to stand and raise the arm you get that look that you get when you tell them they have to try to extend their sore elbow... by lying them downmakes it easier to also "open" the area.. Also ribs are not of a uniform shape, and by looking "up" at them you can imagine you get a more clear view. Ah!! of course, you also need to place an aluminium filter (like a smaller decubitus, or even a foot for people of a slighter build), thinner side in line with sternum(vertically). Either way, I have also tried thies in Erect pats.. and if they are too large for confort, you can even use the automat in your table or erect bucky. By using a man exposure though, with the automats off, your bucky serves as a type of grid...Honestly it works nicely.. most patients wil fit in 1 film portrait. Plus, as Mr. Fuller said in one of his lectures.. you must firstly work out where the injury is, which area.. side, how it happenned, you look at them and their anatomy. that way you include that area in the one cassette, ensuring you include either end of the thoraccic cage for location of the injury in relation to the spine.I have met radiologists who will look forever in the wrong side, or miss them altogether, especially on busy hospitals, and when the the trad. hori ray tends to widen the ribs, and distort them.. also your usual rib exp can make vascular markings look a lot like cracks...
Do you find this valuable?
|
