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X-RAY THE LEG

 

X-Ray Images the Leg


You have a request for a radiologic examination of the leg. You have the assistance of additional personnel if required. You will need a properly equipped X-ray exposure room with cassettes of various sizes, sandbags, lead shielding, letter markers, and various sized positioning sponges.

1.  Select the required view(s) based on the request.

2.  Gather the necessary materials and supplies.

a.  Appropriate cassettes.

b.  Sandbags.

c.  Lead shielding.

d.  Letter markers.

e.  Positioning sponges.

f.  Bed sheet.

3.  Prepare the patient.

a.  Bring the patient into the X-ray room.

b.  Ensure the patient is dressed properly.

(1)  Provide the patient a gown.

(2)  Ensure all foreign objects are removed from the patient as necessary.

(3)  Ensure the patient's clothing is removed as required.

(4)  Use a sheet to cover the patient as needed.

c.  Explain the procedure.

d.  Assist the patient onto the X-ray table.

4.  Measure the body part through the entry-exit site of the central ray.

5.  Set the control panel.

a.  Consult the technique chart.

b.  Set the appropriate mAs and kVp on the control panel.

6.  Select the proper film size.

NOTE: Use 1/2 of a 14" x 17" for the AP and LAT view. NOTE: For taller patients use a 14" x 17" for each view. Place the cassette diagonally (corner to corner) to include the knee and ankle joint.

7.  Place the cassette on the table lengthwise.

8.  Position the overhead tube.

a.  Set the tube angle perpendicular to the film.

b.  Set the source to image receptor distance (SID) to a minimum 40 inches (101 cm).

c.  Center the tube to the cassette.

d.  Adjust the conefield to both sides of the skin.

9.  Position the leg.

a.  AP view.

(1)  Patient supine, with no rotation of the pelvis.

(2)  Fully extend the affected leg.

(3)  Adjust pelvis, knee, and leg into a true AP position.

(4)  Place sandbags against ball of foot for stabilization.

(5)  Center and align midline of cassette (1/2 of 14" x 17") to long axis of the leg.

(6)  Insure that both knee and ankle joints are equal distance from the ends of each respective film border.

(7)  Central ray perpendicular to the film, directed to mid point of the film.

(8)  Collimate on both sides of the skin margins, with full collimation at ends of film borders to include maximum knee and ankle joints.

b.  Lateral view.

(1)  Patient in lateral recumbent position, injured side down.

NOTE: Generally the opposite leg may be placed behind the affected leg.

(2)  Flex knee about 45 degrees and insure leg is in true lateral position.

NOTE: Epicondyles should be perpendicular.

(3)  Center and align the cassette to the long axis of the leg.

(4)  Insure both knee and ankles joints are equal distance from their respective film borders.

(5)  Central ray perpendicular to film, directed to mid-point of film.

(6)  Collimate to both sides of the skin margins.

NOTE: A small film may be taken of the joint nearest the injury site, if needed.

10.  Place the appropriate identification marker on the cassette.

11.  Place the lead shielding across the patient's lap.

12.  Tell the patient, "DO NOT MOVE."

13.  Make the exposure.

14.  Tell the patient, "RELAX," and remove immobilization.

15.  Develop the exposed cassette(s) with patient identification.

X-RAY THE KNEE

 

X-Ray Images the Knee


You have a request for a radiologic examination of the knee. You have the assistance of additional personnel if required. You will need a properly equipped X-ray exposure room with cassettes of various sizes, sandbags, lead shielding, letter markers, and various positioning sponges.

1.  Select the required view(s) based on the request.

2.  Gather the necessary materials and supplies.

a.  Appropriate cassettes.

b.  Lead shielding.

c.  Letter markers.

d.  Positioning sponges.

e.  Sheet.

3.  Prepare the patient.

a.  Bring the patient into the X-ray room.

b.  Ensure the patient is properly dressed.

(1)  Ensure foreign objects are removed from the patient as necessary.

(2)  Ensure the patient's clothing is removed as required.

(3)  Use a sheet to cover the patient as needed.

c.  Explain the procedure to the patient.

d.  Assist the patient onto the X-ray table.

4.  Measure the body part through the entry-exit site of the central ray.

5.  Set the control panel.

a.  Consult the technique chart.

b.  Set the appropriate mAs and kVp on the control panel.

6.  Select the proper size cassette.

NOTE: Use an 8" x 10" cassette for each view.

7.  Place the cassette in the bucky lengthwise for the AP and lateral views.

8.  Position the overhead tube.

a.  Set the tube angle perpendicular to the film.

NOTE: Angle the tube 5-10 degrees cephalic for the lateral view.

b.  Set the source to image receptor distance (SID) to 40 inches (101 cm).

c.  Center the central ray to the cassette.

d.  Adjust the conefield to full film coverage.

9.  Position the knee.

a.  AP view.

(1)  Place the patient supine with both legs fully extended on the table.

NOTE: There should be no rotation of the pelvis.

(2)  Align and center the long axis of the leg and knee to the midline of the cassette.

(3)  Rotate the leg internally about 5 degrees for a true AP.

NOTE: Generally the patella will be slightly medial to the center of the dismal femur. NOTE: Place sandbags by the foot and ankle to stabilize and maintain this position.

(4)  Direct the central ray to a point 3/4 in or 1 cm distal to the apex of the patella.

b.  Lateral view.

(1)  Place the patient in a lateral recumbent position, affected side down.

NOTE: Place the opposite limb behind the knee being examined.

(2)  Adjust rotation of the body until the knee is in a true lateral position.

NOTE: Femoral epicondyles directly superimposed and the plane of patella perpendicular to the plane of the film.

(3)  Flex the knee 15-20 degrees.

(4)  Align and center long axis of leg and knee to the midline of cassette.

NOTE: True lateral - femoral condyles should be directly superimposed. The 5-10 degree cephalad angle of the central ray should result in direct superimposition of the distal borders of the condyles.

(5)  Direct the central ray to a point 3/4 in or 1 cm to the medial epicondyles.

10.  Place the appropriate letter marker on the cassette.

11.  Place the lead shielding across the patient's lap.

12.  Tell the patient, "DO NOT MOVE."

13.  Make the exposure.

14.  Tell the patient, "RELAX," and remove the immobilization.

15.  Develop the exposed cassettes with the patient identification.

 

David L. Heiserman, Editor

Copyright   SweetHaven Publishing Services
All Rights Reserved

Revised: June 06, 2015