radiography

Question 1

3 things that make a good radiographic study

Answer 1

-good algorithm
-good radiography
-good radiology

Question 2

good algorithm

Answer 2

-digital x-ray system
-ask supplier to improve it or buy a new one
-poor quality algorithm could not be fixed by post processing

Question 3

good radiography

Answer 3

-taking the radiographs
-2 factors - sedation/GA and positioning aids

Question 4

good radiology

Answer 4

-interpreting radiographs
-4 factors - good quality radiographs, 2 large monitors (not x-ray system monitor), know normal anatomy, systematic approach

Question 5

thorax and abdomen views

Answer 5

-L lateral - L side down
-R lateral - R side down
-DV - dorsoventral, lying on belly (ventral recumbency)
-VD - ventrodorsal, lying on back (dorsal recumbency)

Question 6

thoracic limb views

Answer 6

-craniocaudal - proximal to antebrachiocarpal joint
-dorsopalmar - distal to antebrachiocarpal joint

Question 7

pelvic limb views

Answer 7

-craniocaudal - proximal to tarsocrural joint
-dorsoplantar - distal to tarsocrural joint

Question 8

steps to take radiograph

Answer 8

1) patient prep for abdomen - fast and empty bladder
2) plan procedure
3) sedate / anaesthetise
4) position patient
5) check FFD, collimate beam
6) place left/right beam
7) measure thickness w caliper
8) set exposure factors - chart
9) check for safety - everyone out of room
10) take exposure (press button)
11) finalise radiographs on digital x-ray system
12) interpret radiographic study - radiology
13) enter conclusions in record

Question 9

patient prep for abdomen

Answer 9

-empty bladder just before
-fast for at least 12h

Question 10

plan procedure

Answer 10

-write list of order of radiographs that’ll be taken
-eg For taking both the thorax and abdomen - do L laterals for thorax & abdomen, roll up into dorsal recumbency and do VD for thorax & abdomen, roll over to other side to do R laterals
-or DV if the patient is too
dyspnoeic to do a VD

Question 11

sedate / anaesthetise

Answer 11

-lack of adequate sedation leads to holding patient (exposing personnel to radiation) or poor quality radiographs (risks misdiagnosis)
-holding only done for medical reasons (patient is too sick)
-not for economic/social reasons
-inadequate excuses for lack of sedation - O doesn’t want it or can’t afford it, “it’ll be quick”, not expecting to find something, young patient, boss’s dog, no time, wasn’t quoted for it, has to go home soon etc

Question 12

position patient - aids

Answer 12

-pieces of foam (radiolucent)
-sandbags
-cotton wool (radiolucent) - for when foam size not available
-tape - lots of it is used

Question 13

check film focal distance (FFD)

Answer 13

-distance bw x-ray machine and detector plate
-affects exposure (greater if closer) and image detail (reduced if closer)
-each machine has a recommended FFD - usually 100cm for sophisticated and 80-90cm for smaller/portable ones
-sophisticated ones have ruler on stand, smaller ones often have a tape measure > pull down to table/detector plate

Question 14

collimate the beam

Answer 14

-collimators - lead shutters that
reduce volume of tissue exposed, so less scatter is made
-light indicates the area that is
being radiographed
-anatomic landmarks estimate collimation - centre, cranial, caudal

Question 15

centre the collimation

Answer 15

-at umbilicus
-measure thickness here

Question 16

cranial collimation

Answer 16

2 fingers cranial to xiphoid (caudal part of sternum)

Question 17

caudal collimation

Answer 17

greater trochanter

Question 18

place L/R marker

Answer 18

-markers of metal
-eg R side down (right lateral recumbency), L/R side of patient, L/R limb

Question 19

take exposure (press button)

Answer 19

-thorax - just before peak inspiration (if you wait till the absolute peak, you will miss it)
-abdomen - just after expiration, there is a pause, so there will be no movement blur
-musculoskeletal - any time

Question 20

finalise radiographs on digital x-ray system

Answer 20

-quality check - need retaken?
-orientation, displayed correctly?
-marker - check all have one
-patient info - is this correct?

Question 21

correct way to view radiographs

Answer 21

-thorax, abdominal, and MS viewed in a standard way
-helps reduce variation and helps us recognise pathology
-can be ‘flipped’ on the monitor, regardless of how taken
-cranial and rostral are L of monitor
-L side patient on R
side of monitor
-lateral aspect of limb is on R
side of monitor - marker too