scoliosis and sacrum/coccyx

what is the blue part of this spine called

apex

when doing scoliosis imaging it’s important to watch

weight even on both feet and pelvis alignment

PA scoli SID

start at 60 move to 72 of needed

collimation for scoli imaging

eam to ASIS

Lateral scoli SID

72

How do you know which side to place on IR for lateral scoli

place the side with the apex of the curve on IR

where to place arms for lat scoli

prayer or above head

which image do we preform first for sacrum/coccyx

lateral 

why do we take lateral sacrum/coccyx before AP

to assess the convex curvature of the sacrum 

Pt positioning for lateral sacrum and coccyx

true lateral on left side

for lat sacrum or lat sacrum/coccyx CR is

3-4 inches posterior to ASIS

for lateral coccyx CR is

3-4 inches posterior and inferior to ASIS

how to identify rotation for lat/sacrum coccyx

superimposition of femoral heads and pelvis

CR for AP sacrum

15 cephalic 

CR for AP coccyx

10 caudal 

AP Axial Sacrum positioning

supine, knees flexed up

AP Axial sacrum CR

15 cephalic 2 inferior to ASIS

collimation for AP axial sacrum

crest to symphysis and laterally to ASIS

how to check for rotation on ap sacrum

center of sacrum aligned with pubis symphysis, equal sacral foramina  

AP axial coccyx CR

CR 10 caudal and 2 superior to pubis

if a pt cant lay on back for ap coccyx

flip to stomach and switch angles

how to check for rotation on ap coccyx

5th lumbar vertebrae or obturator foramen

AP axial SI joints CR angle for men

30

ap axial SI CR angle for women

35

CR placement for ap axial SI 

30-35 cehalic and 2 inches below level of ASIS

collimation for AP SI

crest and ASIS included

how to evaluate ap SI joints

sacrum at equal distances from pelvis,

posterior oblique SI joints body rotation

shallow oblique 25-30 degrees 

posterior oblique SI joints CR

1 inch medial to UPSIDE ASIS

inlet of pelvis 

outlet of pelvis 

PA axial inlet CR

40 caudal at level of ASIS

AP axial outlet male angle

20-30 cephalic

ap axial outlet female angle 

30-45 

CR for ap axial outlet

at level of greater trochanter

evaluate inlet pelvis

ischial spines equal in size and shape, superimposed anterior and posterior structures

evaluate outlet pelvis 

obturator foramen ( wider is further from IR) 

Judet method views the

acetabulum

for judet we always do

LPO and RPO (45 degrees)

CR for judets side down image

2 inches distal and 2 inches medial to downside asis 

CR for judets upside images 

2 inches directly distal to upside ASIS

Upside Judets shows

anterior ring of acetabulum and iliac wings

downside judets shows

posterior ring of acetabulum and obturator foramen