Babeh Edi

Spine Sacrum & Coccyx Lateral

Indications for imaging Trauma, congenital deformities, metastases. Anatomy  Demonstrated Sacrum, coccyx, lumbar sacral articulation. Sacrum & Coccyx Lateral Anatomy Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London Basic Patient Position The patient lies on the table with the mid saggital plane parallel to the table, support under the waist may be required. The long axis of the patient should be in line with the long axis of the table, the hips and knees flexed to aid comfort and stability. Sacrum & Coccyx Lateral 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 Central Ray The vertical central ray is directed to a point midway between the greater trochanter of the femur and the ASIS. Exposure is made on suspended respiration. Exposure Factors Kv mAS FFD (cm) Grid Focus AEC Cassette 90 100 100 Yes Broad 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, inferiorly the distal coccygeal segment, posteriorly the skin surface anteriorly the anterior border of the first sacral segment The sacrum and coccyx should be seen in lateral profile with the intersegmental joint spaces visible where not fused.   Sacrum & Coccyx Lateral Radiograph Related Projections Sacrum AP Coccyx AP Additional modalities CT MRI