The terms used to describe radiographic positioning can be confusing and depend on the area being imaged. They have flexible arms that allow for optimal positioning and keep exposure to a minimum. Similarly, the padding under the pelvis may need to be increased or decreased to superimpose the condyles. Non coated, coated, and closed cell foam products are not claw or teeth proof. To separate the phalanges, place some cotton between each toe (FIGURE 31). AST Standards of Practice for Ionizing Radiation Exposure in the Perioperative Setting. In her spare time, Jeannine enjoys reading, writing, cooking, and spending time with her husband, son, two dogs, and adopted blood donor cat. 4. Center the primary beam over the metacarpal bones and collimate to include the carpus and all of the phalanges (FIGURE 25). A V trough or other positioning device should be used to ensure the patient is as straight as possible (FIGURE 27). Understand the musculoskeletal, nervous and internal organ systems easily with these wall hangings in lamination or paper. Mechanical restraint is very helpful and, when paired with chemical restraint, eliminates the need for a technician, assistant, or trained associate to be in the room during a radiographic exposure. Accessed September 2016. nrc.gov/images/about-nrc/radiation/dose-limits.jpg. The maxilla should be centered on the plate or cassette, and the field of view should include the rostral maxilla to the pharynx region or to C2 (FIGURE 16). Providing the most information we can to obtain the best possible diagnosis or outcome for the patient is our primary goal! Center the primary beam in the middle of the tibia (FIGURE 13) and collimate to include the stifle and the tarsus. Using this marker allows the veterinary team to adjust for magnification by calibrating the radiograph with a known value: the size of the metal ball at the end of the flexible arm. Mediolateral view. Cardiovascular Disease in Small Animal Medicine, 3rd Ed. Illustrations of the teeth of the dog and cat. To separate the phalanges, take a 0.5-inch wide piece of tape, wrap it around P2, and pull the toe cranially. The nose should be parallel to the table, so padding also needs to be applied under the nose (FIGURE 1). Tape is applied behind the maxillary canine teeth to pull the nose 10 to 15 cranially (FIGURE 6). For example, if the left stifle is affected, position the patient in left lateral recumbency. The patient is positioned in lateral recumbency with the affected limb closest to the plate or cassette. The following tutorial includes positioning instructions to obtain two orthogonal views for the skull, shoulders, and elbows. The marker should be placed lateral to the joint indicating which leg is being imaged. Again, the fabellae may or may not appear symmetric; however, the diagnostic view should show fabellae that are bisected symmetrically by the epicondyles of the femur. The marker is placed on the dorsal aspect of the patient indicating recumbency. The VV50 Versa-View Ultra Stand portable x-ray unit positioning aid is versatile, convenient, stable, and has a compact design, providing quick and easy mobilization in the field. In some cases, I feel that this text may simply remind some readers of many useful, but less common (or forgotten) radiographic positioning techniques as well as tips for improving the common views. If needed, place some cotton padding under the tarsus to lift it and aid in superimposing the femoral condyles (FIGURE 3). Angle the affected tibia so that the femorotibial (stifle) joint and the tibiotarsal (tarsus) joints are at 90 angles (FIGURE 9). One of the standards we follow at Purdue is to perform a complete radiographic series, no matter what is being imaged. Association of Surgical Technologists. Our initiative is growing fast - be the first to know when new workshops, products, regulations and other updates come along! X-rays, like radio waves and microwaves, are part of the electromagnetic spectrum. Sedation is very helpful for this view, which can be painful and awkward for a nonsedated patient. The terms used to describe radiographic positioning can be confusing and depend on the area being imaged. I see a living being. The marker should indicate the patients recumbency. The patient is positioned in lateral recumbency. Part 1 of this article, published in the November/December 2016 issue of Todays Veterinary Nurse, described radiation safety policies, personal protective equipment, and guidelines for positioning orthopedic radiography patients to obtain diagnostic-quality images of the skull, shoulders, and elbows. One month after graduation, Jeannine accepted a position at Purdue University as a Versatech, a position created to fill gaps in various departments all over the hospital, including diagnostic imaging. Cotton padding may be needed under the carpus or foot to get the limb in a true lateral position. Center the beam on the top of the cranium and collimate to include only the entire cranium (FIGURE 13). This view of the pelvis is considered the most diagnostic view. To isolate the opposite arcade (the left maxilla), a VDRL view would be needed. When manual restraint is needed, the minimum number of people needed to position and restrain the patient without compromising the safety of patient and other personnel should be in the room. One of the standards we follow at Purdue is to perform a complete radiographic series, no matter what is being imaged. Abduct the nonaffected limb out of the view and tape it to the table (FIGURE 15). Male body cavity, reproductive organs, heart, liver and 24" X 36" (Laminated)
Pharm. Center the beam between the eyes just under the frontal sinus. This should separate the toes enough to visualize each toe. July 2009. Sedated patients should always be appropriately maintained with oxygen and monitoring. Browse animal CT, MRI and X-Ray equipment & training courses. This view helps to visualize the spine of the scapula and the proximal border. Small Animal Radiographic Techniques and Positioning is a practical, clinically applicable manual designed to aid veterinary technicians and nurses in correcting common artifacts in both film and digital radiography and in positioning the small animal patient for clear and consistent radiographs. The tube head is angled for this view but is aimed dorsoventrally. Written by a veterinary technician for practicing vet techs and students, this new edition offers a complete, practical guide to producing consistently superior radiographic images. They provide your animals excellent support for a wide variety of imaging needs. We entered into this profession with a passion for animals and have gained an immense knowledge of veterinary medicine, but it is our responsibility to learn more. Handbook of Radiographic Positioning for Veterinary Technicians, Margi Sirois, EdD, MS, RVT; Elaine Anthony, MA, CVT; Danielle Mauragis, CVT, * Appl. Designed to achieve a full mouth series in every patient in just 6 radiographs. Copyright 2016 Hands-Free X-Rays If the elbows are rotated, tape around them and pull in either direction to ensure that they point straight up. Center the primary beam over the tibia and collimate to include the stifle and the tarsus (FIGURE 17). Depending on the part of the body being imaged, this may include a mediolateral or lateromedial view, a caudocranial or craniocaudal view, a dorsoventral or ventrodorsal view, and even some oblique views. 13 year old Staffordshire Terrier 2 year old Thoroughbred The head is rotated ventrally at a 45 angle, using a radiolucent wedge or foam padding to lift the mandible off the table (FIGURE 17). Two markers are placed in this view, one indicating the recumbency of the patient and the other the beam direction. The book begins with a very good overview of the principles of radiographic positioning which includes patient preparation, directional terminology, positioning aids, as well as proper collimation, measurement, and labeling requirements. Dorsopalmar view (splay toe). The marker should be placed on the lateral aspect of the foot. Go under the hindlimbs, just above the stifles, with tape, then bring the tape up and crisscross it above the stifles to rotate the hindlimbs medially so that the femurs are parallel to each other. The view must include the entire head from the base of the skull to the tip of the nose (FIGURE 5). Position the opposite limb out of the way by taping around the carpus and pulling it across the body in a caudodorsal direction, and attach the tape to the edge of the table. To reduce the amount of equipment in the images, most of the photographs in this article feature cadavers or well-trained healthy dogs that could be taped and positioned without sedation. The patient is positioned in dorsal recumbency. The marker should be placed on the lateral aspect of the stifle. When describing the way the beam enters and exits the limb distal to the carpus and tarsus, it is appropriate to use the terms dorsopalmar and palmarodorsal for forelimbs or dorsoplantar and plantarodorsal for hindlimbs. Place another piece of tape around the metacarpus, above the first piece, distal to the carpus. Chemical restraint can increase efficiency in the workplace. Veterinary Radiology Modality Region Species 1 year old Labrador Retriever This 1-year-old dog has a history of chronic vomiting which worsened recently. The third trained associate should be focused on positioning the patient. Center the beam over the thoracic inlet (FIGURE 23) and collimate down to include the scapulohumeral joint, the distal scapula, and the proximal humerus (FIGURE 24). To get the forelimb in a straight craniocaudal position, the patients head and body may need to be rotated left to right (FIGURE 27). While working at a private practice, she was introduced to the role of veterinary technician. The marker should be placed on one side of the patient to indicate right or left. Tech. The mouth is propped open with a radiolucent object such as a syringe casing or a tongue depressor. The practice should always abide by the ALARA (as low as reasonably achievable) principle. Again, in some cases, if the condyles are not superimposed, the cotton from the tarsus can be removed and applied under the stifle. Center the beam over the elbow and collimate to include half of the humerus and half of the radius and ulna (FIGURE 41). Several important factors must be considered if an accurate reproduction is to be made: 1. The marker should be placed on the lateral aspect of the carpus. The patient is positioned as for the mediolateral elbow view, with the affected leg down and the opposite limb taped across the body. Lead aprons or wraps, whether front sided or two sided, should fit appropriately. Depending on the part of the body being imaged, this may include a mediolateral or lateromedial view, a caudocranial or craniocaudal view, a dorsoventral or ventrodorsal view, and even some oblique views. The positioning is identical to that for the mediolateral view, with one addition: a radiolucent material such as cotton or a foam wedge is placed under the elbow to elevate it and rotate the shoulder into a supinated position (FIGURE 25). If you click a merchant link and buy a product or service on their website, we may be paid a fee by the merchant. Markers should always be placed to indicate patient position and/or beam direction. This displaces the scapula dorsally above the dorsal spinous processes of the thoracic vertebrae. Clinical Laboratory Animal Medicine: An Introduction, 4th Ed (VSPN), Clinical Pathology & Laboratory Techniques for Veterinary Technicians (VSPN), Clinical Veterinary Advisor: Dogs and Cats, 2nd Ed, Dermatology for the Small Animal Practitioner (VSPN Review), Diagnostic Imaging of Exotic Pets: Birds, Small Mammals, Reptiles, Digital Radiography for the Veterinary Technician, 1st Ed. 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