Digital Radiography Positioning Tips and Tricks

Welcome to Digital Radiography: Positioning Tips and Tricks. I. Overview of Siemens systems with digital detectors   A. Aristos MX                  B. Multix M        C. Luminos mFD   D. Ysio   II. Positioning aids for digital detectors   A. Pigg-O-Stat™   B. Detector holders and protectors   III. Positioning with digital detectors   A. Positioning overview   B. Tips and tricks for certain positions   1. Shoulder   2. Knee   3. Elbow   4. Hip   5. Nasal bones Aristos MX Multix M Luminos TF with mFD Ysio System Flexibility System Flexibility Trauma Foot Positioning System Flexibility Detector Holders and Protectors     Siemens Systems with Digital Detectors     Positioning Overview     115-cm (45-in.) focus 2 Focused Grids 180 cm (72 inch) 115 cm (45 inch) Correctly Positioned Grid focal distance focus of grid central axis proper position off focus mFD 110-cm (43 in.) focus   wi-D 115-cm (45 in.) focus   central axis central axis proper position proper position center of grid off level off center Rules to help achieve the best image quality: Use the correct focal distance   Center to the grid   The grid and the central ray should be perpendicular   Positioning Tips and Tricks     Cropping Error Field Light within Detector Borders Part: Patient is supine with unaffected leg flexed and abducted out of the way of the central ray.   Central Ray: CR is perpendicular to the image receptor and the femoral neck and directed through the femoral neck.   Structures Shown: Femoral head, neck, and trochanters   Part: Patient is supine with arm abducted 90 degrees.   Central Ray: CR is directed horizontally through the axilla.   Structures Shown: Glenohumeral joint and other shoulder structures   Part: Patient is seated or supine with affected knee flexed so that patella is perpendicular to the IR.   Central Ray: CR is angled to enter the patellofemoral joint space.   Structures Shown: Open patellofemoral joint space   Part: Patient is prone with affected knee flexed 50 to 60 degrees.   Central Ray: CR is angled 45 degrees toward the patellofemoral joint.   Structures Shown: An open patellofemoral joint space   Part: Patient is prone with affected knee flexed as much as possible.   Central Ray: CR angulation depends on degree of flexion and is directed to the patellofemoral joint.   Structures Shown: An open patellofemoral joint space   Part: Patient is supine with knees flexed 30-90 degrees Central Ray: CR is angled approximately 15 degrees less than the angle of the legs toward the patellofemoral joint.   Structures Shown: Patellofemoral joints   Cassettes. Rochester Cassette Sales and Service website image. http://www.rochestercassette.com/products/digital/crCassettes.shtml   :2010. Accessed 4/24/2010.   Pigg-O-Stat. Pacific Northwest X-ray Inc. website image.  http://www.opraxmedical.com/Accessories/PatAsst/Restraints/ :2010. Accessed 4/24/2010. Decubitus block with film cassette holder. Electro-Medical Equipment Co. Limited website image. http://emeco-xray.ca/catalog/cfi-medical-solutions/decubitus-block-with-film-cassette-holder  :2010. Accessed 4/24/2010. 2-Step Platform. Clear Image Devices website image. http://www.clearimagedevices.com/platform.asp  :2010. Accessed 4/24/2010. DR Panel Protector. Clear Image Devices website image. http://www.clearimagedevices.com/cradle.asp  :2010. Accessed 4/24/2010. Merchant board. Pacific Northwest X-ray Inc. website image. http://www.pnwx.com/Accessories/PatAsst/MerchantBoards/?Sr=Go&gclid=CJXjwo3IpaECFR5rgwod3Ep4Ew :2010. Accessed 4/24/2010. Bushong, Stewart C. Radiologic Science for Technologists: Physics, Biology, and Protection, 6th ed. Houston, TX. Mosby-Year Book Inc;1997: 222-224. Ballinger, Philip W. Merrill’s Atlas of Radiographic Positions and Radiologic Procedures, Vol 1. 7th ed. Columbus, OH. Mosby-Year Book Inc. 1991.