Babeh Edi

Spine Sacrum AP

Indications for imaging Trauma, congenital abnormalities. Anatomy  Demonstrated Sacrum, sacro iliac joints and lumbar sacral junction. Sacrum AP Anatomy Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London Basic Patient Position The patient lies supine on the table with the long axis of the body in line with the center of the table, legs and knees extended. The anterior superior iliac spines should be equidistant from the table ensuring there is no rotation of the mid saggital plane. Sacrum AP Patient Position Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London Radiation protection There are many local rules for gonad protection however the following should be taken into account. The 28 day rule should be applied for female patients. In males direct lead rubber gonad protection can be applied at all times On small patients the omission of a grid will reduced the exposure. Central Ray The vertical central ray is angles 20 ( the optimum angle may be evaluated from the lateral) degrees cephalad and centered in the midline to a point in the midline midway between the symphysis pubis and a line joining the anterior superior iliac spines. Exposure is made on suspended respiration. Exposure Factors Kv mAS FFD (cm) Grid Focus AEC Cassette 80 40 100 Yes Broad/Fine Yes 24 x 30 cm Evaluation of the Image ID and markers must be present and correct in the appropriate area of the film Evidence of collimation on four sides equally around the centering point. Optimal exposure should penetrate all the bone structures and contrast should be low enough to visualise fully the bone and soft tissue structures. Limits of the examination, superiorly the lumbar sacral articulation, laterally the sacro iliac joints and inferiorly the coccyx. The sacrum should not be foreshortened and should appear symmetrical about the midline Sacrum AP Radiograph Related Projections Coccyx AP Sacrum Lateral SI joints Lumbar spine AP Additional modalities RNI CT MRI