bony thorax spokane community college radiology film critique

Bony Thorax

Spokane Community College

Radiology Film Critique

Manubrium

Body

Xiphoid

1

2

34

5

6

7

8

9

10

11

12

RIBS

• Routine views :• AP above• AP below• RPO of the affected side• LPO of the affected side

Structures shown:

• AP projection shows the posterior ribs, above or below the diaphragm

Good film

• For AP upper ribs: Posterior ribs 1-10 above the diaphragm, both sides should be seen above the diaphragm and include in their entirety

• For AP lower ribs: Posterior ribs 8-12 below the diaphragm, both sides should be seen below the diaphragm and include in their entirety

• Ribs should be seen clearly through the lungs or abdomen according to the region examined. The AP views are done to see the bodies of the ribs.

Structures Shown:

• RPO/LPO in this projection the axillary portion of the ribs are projected free of self-superimposition. The posterior ribs are also well demonstrated.

LPOLeft side down

RPOUpper Ribs

Right side down

Grashey

Scap “Y”

RPOLowerRibs

Is theRespirationPhase correct?

LPO lower ribs

LT

LPO lower ribs

Good film:

• There should be approximately twice as much distance between the vertebral column and the outer border of the ribs on the affected side as there is on the unaffected side

• Axillary portion of the ribs should be demonstrated free of superimposition

Sternum

• Routine views:

• RAO

• Lateral

What is shown:

• RAO method shows a slightly oblique PA projection of the sternum. The breathing motion obliterates the pulmonary markings

Structure shown: The entire sternum from jugular notch to tip of xiphoid

RAO

Good Film:

• Entire manubrium to the tip of the xiphoid should be included

• Visibility of the sternum through the thorax should be reasonably good

• Sternum should be projected just free of superimposition from vertebral column

• Sternum should be projected into the cardiac shadow

• **Breathing technique: to blur pulmonary markings

Structure shown:

• Lateral projection of the entire length

of the sternum is demonstrated showing the superimposed sternoclavicular joints and medial ends of the clavicles

Sternoclavicular Articulations:

• RAO

• LAO

• Axiolateral-Kurzbauer method of the affected side (not in book)

Structures shown:

• This method presents a slightly oblique projection of the sternoclavicular joints. Shows the joint closer to the film with less distortion.

**LAO: Left side down: The joint closest to the IR is shown (left)

LAO

LEFT

Good film:

• SC jnts of interest should be in the center of the film (down side)

• Manubrium and medial ends of clavicles should be included

• SC jnts space should be open• SC jnts of interest should be directly in front of

the vertebral column with minimal obliquity• Visibility of the SC jnt through the superimposing

rib and lung fields should be reasonably good

Adjust the position of the cassette so that its midpoint will coincide with the CR.Respiration is suspended at the end of full inhalation. Direct the CR through the lowermost sternoclavicular articulation at an angle of 15 degrees caudal.

Structures shown: This method presents an unobstructed lateral projection of the sternoclavicular articulation adjacent to the film

Good film:

• SC jnt of interest should be demonstrated• Shoulders should not superimpose the SC

articulations.