Improved

ImagesJohn Harmon

• Soft tissue and bone of shoulder Superimposed over lower cervical vertebrae. Requires a swimmers.

• Patient should have been given instructions to relax shoulders and exposure taken on exhalation to keep shoulder muscle and tissue out of view of C-7 T-1.

SpinousProcess C-1

ZygapophysealJoints C-3 & 4

Posterior Arch

IntervertebralSpace

Lateral C-Spine

• No Marker Visible

Acceptable Lateral C-Spine

Vertebral bodies, intervertebraljoint spaces, articular pillars, Spinous processes, and Zyapophyseal joints all well Demonstrated. Joint space Between C-7 and T-1 visible.

Extension teardrop fracture

Spinousprocess

Posterior arch

Zygapophysealjoint Intervertebral space

Articularpillar

Joint space between C-7 and T1

Lateral C-spine

Swimmers

Odontoid

Dens, C-2Lateral Masses and Space between superiorarticlating surface of C-2

Waters for Sinuses

• Image is underexposed• Image was not properly collimated• There are artifacts in the image patient was not properly prepped• There is rotation and “tilt” due to poor positioning

Acceptable Waters

Properly collimated,No rotation of MSP orintepupilary baselinesProper Anatomical Marker in image

Frontal sinus

Bony nasal septum

Anterior nasal spineMaxillary sinus

Coronoid process

Maxilla

Mastoid process

Superior orbitalRim

Zygomatic bone

Zygomatic arch

Petrus ridge

Mandible

Odontoid process

On this Right Lateral Decubitus, portions of the ascending and descending colon Have been clipped making diagnosis difficult. Care should be taken to ensure entireAnatomy is within the image for diagnostic quality.

Left or splenic flexure

Right or hepaticFlexure, lower due to liver

Sigmoid Colon

DescendingColon

Transverse colon

Ascending colon

The pictured radiograph was made in the right lateral decubitus position. It is part of a series of radiographs made during an air-contrast (double-contrast) BE examination. A double-contrast examination of the large bowel is performed to see through the bowel to its posterior wall and to visualize any intraluminal (eg, polypoid) lesions or masses. Various body positions are used to redistribute the barium and air. To demonstrate the medial and lateral walls of the bowel, decubitus positions are performed. The radiograph presents a right lateral decubitus position, because the barium has gravitated to the right side (the side of the hepatic flexure). The air rises and delineates the medial side of the ascending colon and the lateral side of the descending colon. The posterior wall of the rectum could be visualized using the ventral decubitus position and a horizontal beam lateral of the rectum.

Right colic flexure

Left colicflexure

Ascending colon

Transversecolon

Descendingcolon

Sigmoid colon

Barium/Air levels

The End ?

The 70’s called…And they want their Puka shells back!

References

Bontrager, Kenneth L and Lampignano. 2014. Textbook of radiographic positioning and related anatomy. Mosby Inc. St. Louis, MO. Print.

Saia, Dorothy A .MA, RT(R), (M). 2008 . Lange’s Q&A., 9th ed. Mcgraw-Hill United States of America. Print

www.learningradiology.com