Road to Radiography

I have encountered a few points of ‘distress’ in studying for my spinal series tests that come up later this morning. I’m not sure why I can’t wrap my mind around these concepts, but I’m having one hell of a time sorting out oblique x-rays of the spine. Our text book doesn’t seem to clarify this very well, but when I’m looking at a radiograph of an oblique cervical spine, how can I tell if I’m viewing an LPO, RPO, LAO, or RAO position?

Shortly after I started this program, I decided that I wanted to get a copy of the Merrill’s Atlas of Radiographic Positioning as a supplementary text since we weren’t using it in my program. We use Bontrager’s Textbook of Radiographic Positioning and Related Anatomy. I decided to pull out the Merrill’s Atlas to see what it had to offer for my current problem. What I discovered is that the RAO and LPO views look very similar and the RPO and LAO views look similar as well. The differentiation between the two is which side of the spine you are viewing. The oblique view of the cervical spine shows the intervertebral foramina. The anterior obliques show the foramina closest to the image receptor while the posterior obliques show the foramina farthest away from the IR.

• RPO - shows patient’s left-side cervical spine intervertebral foramina
• LPO - shows patient’s right-side cervical spine intervertebral foramina
• RAO - shows patient’s right side cervical spine intervertebral foramina
• LAO - shows patient’s left side cervical spine intervertebral foramina

In the thoracic spine obliques, the same should hold true.  In the oblique views of the thoracic spine, we are looking for the zygapophyseal joints. 

• RPO - shows patient’s left side thoracic spine zygapophyseal joints
• LPO - shows patient’s right side thoracic spine zygapophyseal joints
• RAO - shows patient’s right side thoracic spine zygapophyseal joints
• LAO - shows patient’s left side thoracic spine zygapophyseal joints

This situation takes a twist when we get down to the lumbar spine.  The lumbar obliques also show zygapophyseal joints.

• RPO - shows patient’s right side lumbar spine zygapophyseal joints
• LPO - shows patient’s left side lumbar spine zygapophyseal joints
• RAO - shows patient’s left side lumbar spine zygapophyseal joints
• LAO - shows patient’s right side lumbar spine zygapophyseal joints

The Merrill’s Atlas has markers on the radiographs that demonstrate the patient position.  The Bontrager book seems to avoid that.  The Bontrager book just tags the image as ‘oblique’ rather than giving a right or left indicator for some reason.  I’m finding things l like and dislike about each of these books as we progress.  Having both sets is handy.  I still cant’ seem to identify a radiograph as one position or the other without an extra set of clues.  In our radiograph reviews, it will state ‘prone’ or ’supine’ which tells us if it’s a posterior or anterior oblique.  I guess I’ll try to sort it out in the morning before the test…

Powered by ScribeFire.

Tags: 2nd Semester, Important Concepts, RAD-112 by John Setzler
4 Comments »

Radiographic Positioning Videos for iPod:

I have reformatted my radiographic positioning videos for use on the iPod. You can find these video files by clicking on the POSITIONING VIDEOS link on the right side of this page under the PAGES heading. If you find any problems with these videos, please let me know. Check back in the future for additions.

These files are in .MP4 format for compatibility with Apple’s iPod line of products.  I can’t guarantee that they will run on other portable devices.  These videos will run on your PC with the help of Apple’s QuickTime (free software).

Powered by ScribeFire.

Tags: 2nd Semester, RAD-112, Video Clips by John Setzler
No Comments »

Here are some tidbits from my clinical adventures on Thursday and Friday of this week…

I learned that my pediatric comps don’t necessarily have to be six years old or younger as previously noted.  There are a couple exams where that is important, but others I can use older kids.  I was told that, in the case of upper or lower extremities, I can use a child of any age as long as their epiphyseal plates are distinct.  That’s gonna make comping my pediatric lower extremity a little easier.  I comped the pediatric upper extremity last week, and my precomps and master comp were both on six or under patients.

Thursday was my busiest day yet in clinical.  I logged 42 exams in one day.  I’m easily going to complete my 300 required exams for this semester before the half way point.  I only got one more comp this week, but that brings my total up to 10 out of the 22 I need for the maximum grade this semester. 

I saw some nasty fractures this week also.  I saw a third metatarsal transverse fracture, I saw several serious compression fractures in the lumbar spine, and I think I saw more rods, nuts, and bolts than you see in Home Depot. 

I ran into another new situation on Thursday.  I had two different exams on convicts from the jail who were escorted by armed guards.

We’re testing on spinal stuff on Monday, so I’ll get to start working on comps next week at clinical.  The only problem is that I’ll not likely get to comp my C-spine and L-Spine stuff in this orthopedic office.  They don’t do the obliques except for rare occasions, which I haven’t seen happen yet.  I may be able to comp the T-spine though, so we’ll see how that goes.  We’ll be diving into the ribs and sternum as soon as these tests are complete, so I’ll have some new positioning videos on that stuff in a week or so…

Powered by ScribeFire.

Tags: 2nd Semester, Clinical by John Setzler
No Comments »