You have a request for an X-ray examination of the femur. You have the assistance of additional personnel if required. You will need a properly equipped X-ray exposure room with various sizes of film in cassettes, sandbags, lead apron, letter markers, and various sponges.
1. Select the required view(s) based on the request.
2. Gather the necessary materials and supplies.
a. Appropriate cassettes.
c. Lead apron.
d. Letter markers.
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 is dressed in a gown, if necessary.
(3) Use a drape sheet to cover patient as needed.
c. Explain the procedure if applicable.
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 a 14" X 17" cassette for the AP and lateral views (distal and proximal).
7. Place the cassette in the bucky 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 40 inches (101 cm).
c. Center the tube to the cassette.
d. Adjust the conefield to a 10" X 17" lengthwise coverage.
9. Position the femur.
NOTE: When demonstrating long bones, each view must include the joint nearest the site of injury.
a. AP view (distal and proximal).
(1) Place the patient supine on the table.
( a) Place the epicondyles parallel to the table for the distal view.
( b) Rotate the foot and leg of the affected side medially to form a 15 degrees with the table for the proximal view.
(2) Ensure the plane through the ASIS and midepicondyles is over the centerline of the table.
( a) Distal--apex of the patella 3'' below the lower edge of the cassette.
( b) Proximal--ASIS 3'' below the upper edge of the cassette.
b. Lateral view (distal and proximal).
(1) Place the patient laterally recumbent on the table.
(2) Place the epicondyles perpendicular to the table.
(3) Flex the knees.
(4) Ensure the plane through the greater trochanter and medial epicondyles of the knee is over the centerline of the table.
( a) Distal--draw the unaffected leg forward and buttress at hip level.
( b) Proximal--rotate the unaffected leg backward.
NOTE: Rotate the unaffected leg just enough to prevent superimposition of the greater trochanters.
(5) Central ray.
( a) Distal - apex of the patella 3'' above the lower edge of the cassette.
( b) Proximal - ASIS 3'' below the upper edge of the cassette
10. Immobilize the body part as required.
11. Place the appropriate identification marker on the cassette.
12. Place the lead apron across the patient's lap.
13. Tell the patient, "DO NOT MOVE."
14. Make the exposure.
15. Tell the patient, "RELAX," and remove immobilization.
16. Develop the exposed cassette(s) with patient identification for processing.