Improved
ImagesJohn Harmon
• Soft tissue and bone of shoulder Superimposed over lower cervical vertebrae. Requires a swimmers.
• Patient should have been given instructions to relax shoulders and exposure taken on exhalation to keep shoulder muscle and tissue out of view of C-7 T-1.
SpinousProcess C-1
ZygapophysealJoints C-3 & 4
Posterior Arch
IntervertebralSpace
Lateral C-Spine
• No Marker Visible
Acceptable Lateral C-Spine
Vertebral bodies, intervertebraljoint spaces, articular pillars, Spinous processes, and Zyapophyseal joints all well Demonstrated. Joint space Between C-7 and T-1 visible.
Extension teardrop fracture
Spinousprocess
Posterior arch
Zygapophysealjoint Intervertebral space
Articularpillar
Joint space between C-7 and T1
Lateral C-spine
Swimmers
Odontoid
Dens, C-2Lateral Masses and Space between superiorarticlating surface of C-2
Waters for Sinuses
• Image is underexposed• Image was not properly collimated• There are artifacts in the image patient was not properly prepped• There is rotation and “tilt” due to poor positioning
Acceptable Waters
Properly collimated,No rotation of MSP orintepupilary baselinesProper Anatomical Marker in image
Frontal sinus
Bony nasal septum
Anterior nasal spineMaxillary sinus
Coronoid process
Maxilla
Mastoid process
Superior orbitalRim
Zygomatic bone
Zygomatic arch
Petrus ridge
Mandible
Odontoid process
On this Right Lateral Decubitus, portions of the ascending and descending colon Have been clipped making diagnosis difficult. Care should be taken to ensure entireAnatomy is within the image for diagnostic quality.
Left or splenic flexure
Right or hepaticFlexure, lower due to liver
Sigmoid Colon
DescendingColon
Transverse colon
Ascending colon
The pictured radiograph was made in the right lateral decubitus position. It is part of a series of radiographs made during an air-contrast (double-contrast) BE examination. A double-contrast examination of the large bowel is performed to see through the bowel to its posterior wall and to visualize any intraluminal (eg, polypoid) lesions or masses. Various body positions are used to redistribute the barium and air. To demonstrate the medial and lateral walls of the bowel, decubitus positions are performed. The radiograph presents a right lateral decubitus position, because the barium has gravitated to the right side (the side of the hepatic flexure). The air rises and delineates the medial side of the ascending colon and the lateral side of the descending colon. The posterior wall of the rectum could be visualized using the ventral decubitus position and a horizontal beam lateral of the rectum.
Right colic flexure
Left colicflexure
Ascending colon
Transversecolon
Descendingcolon
Sigmoid colon
Barium/Air levels
The End ?
The 70’s called…And they want their Puka shells back!
References
Bontrager, Kenneth L and Lampignano. 2014. Textbook of radiographic positioning and related anatomy. Mosby Inc. St. Louis, MO. Print.
Saia, Dorothy A .MA, RT(R), (M). 2008 . Lange’s Q&A., 9th ed. Mcgraw-Hill United States of America. Print
www.learningradiology.com