chapter 18 foot radiography fractures are characterized by involvement of the subtalar joint (75%)...
TRANSCRIPT
![Page 1: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/1.jpg)
Chapter 18 Foot Radiography
• Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint.
• Stress fractures are common in runners but typically not seen on radiographs.
• Stress fractures , plantar fascitis or heel spurs are common repetitive use conditions.
![Page 2: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/2.jpg)
Foot or Heel Radiography
• Views of the foot and calcaneus are totally different.
• If a heel injury is suspected, take heel views and not foot views.
• A 30 degree medial oblique view can be useful. The oblique and lateral will demonstrate the subtalar joint.
![Page 3: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/3.jpg)
Foot Radiography
• Foot view must include the tarsal bones, metatarsals and phalanges.
• A tube angle is used to open the tarsal bone articulations on the A-P view.
• If the patient is flat footed, no tube angle would be needed.
![Page 4: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/4.jpg)
Foot Radiography
• The medial oblique view is particularly useful. It provides:
• A clear view of the tarsal bone including the calcaneus.
• The 4th & 5th metatarsals
• Intertarsal joints
• Detail of the 5th metatarsal
![Page 5: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/5.jpg)
Foot Radiography
• The “basketball foot” is a traumatic medial subtalar dislocation resulting from landing on an inverted foot.
• The “Jones fracture is an avulsion fracture off the base of the 5th metatarsal.
• Stress fractures of the metatarsals are generally transverse resulting from marching or jumping.
![Page 6: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/6.jpg)
Toe Radiography
• Toe radiography can be particularly challenging.
• The natural curve of the toes toward the plantar surface of the foot results in foreshortening and closure of the interphalangeal joint spaces.
• Besides the A-P, an angled axial view is used to open the joint spaces.
![Page 7: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/7.jpg)
18.4 Foot A-P
• Measure: A-P at base of third metatarsal
• Protection: Apron• SID: 40” Table Top• Tube Angle: 10°
cephalad• Film: 1/2 of 10” x 12
Extremity Cassette I.D. up
![Page 8: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/8.jpg)
Foot A-P• Patient seated or lying on
table with the long axis of the affected foot centered to table.
• Place cassette on table.• Have patient place foot
flat on cassette.• Horizontal CR: base of
third metatarsal
![Page 9: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/9.jpg)
Foot A-P• Vertical CR: long axis of
foot.• Collimation Top to
Bottom: distal tibia to tips of toes.
• Collimation Side to Side: soft tissue of foot
• Instructions: Remain still• Make exposure and let
patient relax
![Page 10: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/10.jpg)
Foot A-P Film
• Should demonstrate toes , metatarsals and most of the tarsal bones. The talus and calcaneus will not be seen.
• The tube angle will help open the tarsal joint spaces.
![Page 11: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/11.jpg)
18.5Foot Oblique
• Measure: A-P at base of third metatarsal
• Protection: Apron• SID: 40” Table Top• No Tube Angle• Film: 1/2 of 10” x 12
Extremity Cassette I.D. up
![Page 12: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/12.jpg)
Foot Oblique• Patient seated or lying
on table with the long axis of the affected foot centered to table.
• Place cassette on table.• Have patient place foot
flat on cassette.• The foot is medially
rotated 30 to 40°• A sponge may be used
under the plantar surface of the foot.
![Page 13: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/13.jpg)
Foot Oblique• Horizontal CR: base of
third metatarsal• Vertical CR: long axis
of foot.• Collimation Top to
Bottom: distal tibia to tips of toes.
• Collimation Side to Side: soft tissue of foot
• Instructions: Remain still
• Make exposure and let patient relax
![Page 14: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/14.jpg)
Foot Oblique Film
• Should demonstrate toes , metatarsals and most of the tarsal bones. The talus and calcaneus will not be seen.
• The calcaneus will be well visualized
• Tarsal joint spaces should be open.
![Page 15: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/15.jpg)
18.6 Foot Lateral
• Measure: Lateral at base of first metatarsal
• Protection: Lead Apron• SID: 40” Table Top• No Tube Angle• Film: 8” x 10” or 10” x 12”
Extremity depending on foot size.
![Page 16: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/16.jpg)
Foot Lateral
• Patient lies on the affected side with lower leg in lateral position.
• The foot should be dorsiflexed until the plantar surface is perpendicular to ankle.
• The plantar surface of foot is perpendicular to film.
![Page 17: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/17.jpg)
Foot Lateral
• The film may be turned diagonally or the foot placed diagonally on film to fit the entire foot on the film.
• Horizontal CR: base of 1st metatarsal
• Vertical CR: base of first metatarsal
![Page 18: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/18.jpg)
Foot Lateral
• Collimation Top to Bottom: to include ankle to plantar surface soft tissue
• Collimation Side to Side: to include from heel to tips of toes.
• Instructions: Remain still• Make exposure and let
patient relax.
![Page 19: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/19.jpg)
Foot Lateral Film
• The foot and ankle should be in a lateral position.
• The metatarsals and toes will be superimposed.
• The distal fibula should overlie the distal tibia.
• The talotibial joint space should be open.
![Page 20: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/20.jpg)
18.7 Toes A-P & Axial A-P
• Measure: A-P at 3rd metatarsal phalangeal joint or affected toe
• Protection: Lead Apron• SID: 40” Table Top• Tube Angle A-P: none• Tube Angle Axial A-P:
15° cephalad• Film: 1/4 of 10 x 12
Extremity
![Page 21: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/21.jpg)
Toes A-P & Axial A-P
• A-P : patient places foot flat on film.
• Horizontal & Vertical CR: 3rd M-P joint for all toes or M-P joint of the affected toe for individual toe series.
• A-P Axial tube angle: same as above but with 15° cephalad angle.
![Page 22: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/22.jpg)
Toes A-P & Axial A-P
• A-P Axial with Sponge: a 15° sponge is placed under toes instead of angling the tube. Or
• The Sponge is placed under the cassette
• Horizontal & Vertical CR: 3rd M-P joint for all toes or M-P joint of affected toe.
![Page 23: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/23.jpg)
Toes A-P & Axial A-P
• Collimation top to bottom: to include all M-P joints to tips of toes or M-P joint to tip of affected toe.
• Collimation Side to Side: soft tissue of foot or individual toe.
• Instructions: Remain Still
• Expose and let patient relax
![Page 24: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/24.jpg)
Toes A-P & Axial A-P Film
• A-P is upper right image.
• A-P Axial is upper left image. The phalangeal joints will be open on the axial view.
• Views must include all of the affected toe or toes.
• Note that collimation was too tight top to bottom.
![Page 25: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/25.jpg)
18.8 Toes Medial Oblique
• Measure: A-P at metatarsal-phalangeal joints
• Protection: Apron• SID: 40” Table Top• No tube angle• Film: 1/4 of 10” x 12”
or 8” x 10” Extremity Cassette
![Page 26: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/26.jpg)
Toes Medial Oblique
• Patient places distal foot on unexposed portion of cassette.
• Patient medially rotates lower leg until the plantar surface forms a 30 to 45° angle.
• Horizontal CR: 3rd MTP joint or the affected toe.
![Page 27: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/27.jpg)
Toes Medial Oblique
• Vertical CR: centered to long axis of foot or the affected toe
• Collimation top to bottom: Distal metatarsal to tips of toes or affected toe
• Collimation side to side: soft tissue of foot or affected toe.
![Page 28: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/28.jpg)
Toes Medial Oblique
• Patient instructions: Remain Still
• Make exposure and let patient relax.
• Note that a sponge may be placed under plantar surface of foot to control angle of view . It will also make it more comfortable for the patient.
![Page 29: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/29.jpg)
Toes Medial Oblique
• The joint spaces should be open.
• The distal metatarsal and tips of the toes should be visualized.
![Page 30: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/30.jpg)
18.8 Toes Lateral
• Measure: Lateral across the metatarsal-phalangeal joints For individual toe use A-P measurement.
• Protection: Apron• SID: 40” Table Top• No tube angle• Film: 1/4 of 10” x 12” or
8” x 10” Extremity Cassette
![Page 31: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/31.jpg)
1st Toe Lateral • Patient places distal foot
on unexposed portion of cassette.
• For 1st through 3rd toes
• Patient medially rotates lower leg until the plantar surface forms a 90° angle.
• For 4th and 5th toes
• Patient laterally rotates foot until the plantar surface is perpendicular to film.
![Page 32: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/32.jpg)
2nd Toe Lateral
• For individual toes, tape and tongue depressors are used to clear the other toes out of the view.
• Without the use of tape and tongue depressors, there will be too much superimposition
![Page 33: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/33.jpg)
3rd Toe Lateral• Horizontal CR: 3rd MTP joint or the affected toe.
• Vertical CR: centered to long axis of foot or the affected toe
• Collimation top to bottom: Distal metatarsal to tips of toes or affected toe
• Collimation side to side: soft tissue of foot or affected toe.
![Page 34: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/34.jpg)
4th Toe Lateral
• Patient instructions: Remain Still
• Make exposure and let patient relax.
• Note that the lateral surface of the foot is next to the film.
![Page 35: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/35.jpg)
5th Toe Lateral
• Note that the lateral surface of the foot is next to the film.
• The toe need to remain parallel to the film.
• The 5th toe is the most challenging lateral toe view.
![Page 36: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/36.jpg)
Toes Lateral Film
• The joint spaces should be open.
• The distal metatarsal and tips of the toes should be visualized.
• The affected toe should be free of superimposition.
![Page 37: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/37.jpg)
Accessory Testing
• Accessories include the cassettes, grids outside the Bucky, Lead Aprons and gonadal protection.
• The cassettes and screens are the primary concern.
• Screens should be cleaned monthly with screen cleaner. Keeping the darkroom clean is also important for screen cleanliness.
![Page 38: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/38.jpg)
23.4 Screen Contact Testing
• Procedure:• Clean screens and let
them dry. Use screen cleaner design for the screen used.
• With a felt tip pen, write an identification number on the screen next to the I.D. and on the back of the cassette.
• Load cassettes.
![Page 39: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/39.jpg)
Screen Contact Testing
• Procedure:• Set SID to 40” Table Top• Place cassette on table.• Place wire mesh tool on
cassette.• Set collimation to film
size.• Make exposure and
process film.
![Page 40: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/40.jpg)
Screen Contact Testing
• Procedure:• Hang film on view box.• Step back 72” from view
box and view film.• Areas of increased
density or loss of resolution indicates poor contact or stained screens.
![Page 41: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/41.jpg)
Screen Contact Testing
• Procedure:• The I.D. # will help you
find a cassette that needs to be cleaned or taken from service.
• Frequency of tests: semiannual
![Page 42: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/42.jpg)
Poor Screen Contact
• There is a loss of detail in the thoracic and lumbar spine due to poor screen contact.
• This was a new cassette.
![Page 43: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/43.jpg)
Poor Screen Contact
• Note the blurry image in the spine but sharp image of the ribs.
• The screens were not in proper contact in the middle of the cassette due to a bow in the cassette back.
![Page 44: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/44.jpg)
Screen Cleaning
• Materials needed:• Screen Cleaner
designed for type of screens used.
• 4 x 4 gauze or cotton balls
• Tape & Pen
![Page 45: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/45.jpg)
Screen Cleaning
• Procedure:• Unload cassette if
contact is not being tested.
• Apply cleaner with gauze.
• Wipe excess off with dry gauze.
![Page 46: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/46.jpg)
Screen Cleaning
• Leave open to air dry.• Make sure cassette #
is still legible.• After dry, reload
cassette.
![Page 47: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/47.jpg)
Screen Cleaning
• Record date on tape and place on back of cassette.
• By having each cassette identified, selected cassette can be cleaned as needed.
![Page 48: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/48.jpg)
Screen Cleaning
• California Department of Radiologic Health recommends cleaning screens monthly.
• Should definitely be done quarterly and sooner as needed when artifacts are identified on films.
• Never use alcohol or detergents not designed for cleaning screens.
![Page 49: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/49.jpg)
Cassette Care
• Methods to get the maximum life from cassettes:– Avoid dropping the cassettes– Open only far enough the change films– Keep outside of cassette clean and dry.– Keep screens clean– Store on end.
![Page 50: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/50.jpg)
Dirty or Damaged Screens
• Dirty or damaged screen will cause white spots on the image.
![Page 51: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/51.jpg)
Dirty & Damaged Screens
• The white spots on this film are the result of damaged or worn out screens.
• Never use alcohol or detergents to clean screens.
![Page 52: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/52.jpg)
Speed Matching
• After looking for screen contact problems:• Measure speed of cassettes by reading density
with the Densitometer. The density of the exposed area should not vary more than ± 0.05 OD.
• As screen age, they loose speed. • Always make sure the light spectrum of the
screens and film are matched.
![Page 53: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/53.jpg)
23.5 Apron and Gonad Shield Testing
• Lead aprons and shields should be tested semiannually for defects
• Aprons with defective lead provide little protection for the patient.
![Page 54: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/54.jpg)
Apron and Gonad Shield Testing
• Tools needed:– 14” x 17” cassette– View Box
• Coat Apron Procedure:• Drape apron over Bucky• Place cassette in Bucky
make exposures in upper and lower Bucky slots.
![Page 55: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/55.jpg)
Apron and Gonad Shield Testing
• Coat Apron Procedure:• Note that this is the same
test as used for grid alignment.
• Process films• View films on view box:
![Page 56: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/56.jpg)
Apron and Gonad Shield Testing
• Half Apron and Small Shield Procedure:
• Place cassette on table• Set SID at 40”• Place apron or shields
on cassette.• Make exposure and
process the film.
![Page 57: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/57.jpg)
Apron and Gonad Shield Testing
• Viewing the test films:– Note creases in the
lead.– Full holes will produce
a black area on the film.
– If cracks or defects are in the area that should cover the gonads, replace apron.
![Page 58: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/58.jpg)
Care of Aprons
• Never fold aprons
• Store flat or hung on apron rack
• Use only aprons with the lead equivalency of 0.5mm for patient and staff protection.
• Do not use as lead blockers for extremity films.
• Protect from heat and direct sun light.
![Page 59: Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Stress fractures](https://reader036.vdocument.in/reader036/viewer/2022062313/56649ccf5503460f9499a5b5/html5/thumbnails/59.jpg)
Grid Uniformity Testing
• Procedure is the same as testing the Bucky Grid.
• Place homogenous phantom or lead apron over grid that is taped to the top of the cassette.
• Make exposure and look for density changes and grid damage.