Clark's Pocket Handbook for Radiographers (Clark's Companion Essential Guides)

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Where there is a possibility of injury to the base of the first metacarpal, the carpo-metacarpal joint must be included on the image. The image should include the fingertip and the distal third of the metacarpal bone.

Centre to the middle of the image receptor, with the vertical central ray parallel to the imaginary line joining the femoral condyles. The intervertebral foramina should be demonstrated clearly. C1–T1 should be included within the image. The mandible and the occipital bone should be clear of the vertebrae. Abdomen – Antero-posterior 40 Supine Abdomen – Prone 42 Abdomen – Left Lateral 44 Decubitus Acromioclavicular Joint 46 Ankle – Antero-posterior/ 48 Mortice Joint Ankle – Lateral 50 Calcaneum – Axial 52 Cervical Spine – Antero54 posterior C3–C7 Cervical Spine – Lateral Erect 56 Cervical Spine – Antero58 posterior C1–C2 ‘Open Mouth’ Cervical Spine – Lateral 60 ‘Swimmer’s’ Cervical Spine – Lateral Supine 62 Cervical Spine – Posterior 64 Oblique Cervical Spine – Flexion and 66 Extension Chest – Postero-anterior 68 Chest – Antero-posterior 70 (Erect) Chest – Lateral 72 Chest – Supine 74 (Antero-posterior)

Skull – Occipito-frontal 30 Degrees↑ (Reverse Towne’s) Skull – Lateral Erect Skull – Fronto-occipital 20 Degrees↑ (Supine/ Trolley) Skull – Modified Half Axial (Supine/Trolley) Skull – Lateral (Supine/ Trolley) Sternum – Lateral Thoracic Spine – Anteroposterior SHOULDER JOINT – LATERAL OBLIQUE ‘Y’ PROJECTION If the arm is immobilized and no abduction of the arm is possible, then a lateral oblique ‘Y’ projection is taken.

Exposure) Regulations (IR(ME)R) 2000. This legislation is designed to protect patients by keeping doses as low as reasonably practicable. (ALARP). The regulations set out responsibilities for those who refer patients for an examination (referrers); those who justify the exposure to take place (practitioners); and those who undertake the exposure (operators). Radiographers frequently act as practitioners and as such must be aware of the legislation along with the risks and benefits of the examination to be able to justify it. Is there an alternative imaging modality? The use of an alternative imaging modality that may provide more relevant information or the information required at a lower dose should be considered. The use of non-ionizing imaging modalities, such as ultrasound and magnetic resonance (MRI), should also be considered where appropriate. Denton BK (1998) Improving plain radiography of the skull: the half axial projection re-described. Synergy August: 9–11. The image should include the distal end of the radius and ulna and the proximal end of the metacarpals. The pisiform should be seen clearly in profile situated anterior to the triquetral. The long axis of the scaphoid should be seen perpendicular to the image receptor. Chest – Mobile/Trolley (Antero-posterior) Clavicle – Postero-anterior Clavicle – Infero-superior Coccyx – Lateral Elbow – Antero-posterior Elbow – Antero-posterior Alternate Projections for Trauma Elbow – Lateral Facial Bones – Occipitomental Facial Bones – Occipitomental 30º↓ Femur – Antero-posterior Femur – Lateral Fingers – Dorsi-palmar Fingers – Lateral Index and Middle Fingers Fingers – Lateral Ring and Little Fingers Foot – Dorsi-plantar Foot – Dorsi-plantar Oblique Foot – Lateral Erect Forearm – Antero-posterior Forearm – Lateral Hand – Dorsi-palmar Hand – Dorsi-palmar Oblique RADiographers Charles Sloane MSc DCR DRI Cert CI Principal Lecturer and Radiography Course Leader, University of Cumbria, Lancaster, UK Ken Holmes MSc TDCR DRI Cert CI Senior Lecturer, School of Medical Imaging Sciences, University of Cumbria, Lancaster, UK Craig Anderson MSc BSc Clinical Tutor, X-ray Department, Furness General Hospital, Cumbria, UK A Stewart Whitley FCR TDCR HDCR FETC Radiology Advisor, UK Radiology Advisory Services Ltd, Preston, UKCare should be taken when a supracondylar fracture of the humerus is suspected. In such cases, no attempt should be made to extend the elbow joint, and a modified technique must be employed. The patient is seated alongside the table with the affected side nearest the table. The arm is extended across the table with the elbow flexed and the forearm pronated. If possible, the shoulder, elbow and wrist should be at the level of the tabletop. The wrist is positioned over the centre of the image receptor and the hand is adducted (ulnar deviation). Ensure that the radial and ulnar styloid processes are equidistant from the image receptor. The hand and lower forearm are immobilized using sandbags. The central ray is directed perpendicular to the image receptor and centred in the midline at the levels of the angles of the mandible.