Babeh Edi

Spine Lumbar Spine AP

Indications for imaging Congenital abnormalities, trauma, pain, metastasis's. Anatomy  Demonstrated Lumbar vertebra, sacro iliac joints, sacrum and coccyx. Lumbar Spine AP Anatomy Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London Basic Patient Position The patient lies supine on the table midline aligned to the midline of the table, the hips and knees flexed 45 degrees to reduce the lumbar curve, the ASISs are equidistant from the table ensuring the midsaggital plane is at 90 degrees to the table. Lumbar Spine 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, in females positioning rules will determine protection in females. Anode heal effect and Dose in Lumbar Spine Examinations Link (BJR) Central Ray The vertical central ray is centered in the midline at the level of L3 at the lower costal margin, if the sacrum and SI joints are required on the film using a 30 x 40 cm cassette the vertical central ray may be centered in the midline at the level of the iliac crests. Exposure is made on suspended expiration. Exposure Factors Kv mAS FFD (cm) Grid Focus AEC Cassette 80 30 100 Yes Broad Yes 30 x 40 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 body of T12, inferiorly the SI joints, laterally the renal outlines. The intervertebral spaces should be visualised, the spinous processes should be projected over the centers of the vertebral bodies.  Lumbar Spine AP Radiograph (note spina bifida at L5) Related Projections Lumbar spine lateral Lumbar spine obliques. Additional modalities CT MRI