W5 - Bladder, Decub ABD, Scoliosis, Leg Length

Indications of Dorsal Decub ABD

• pt is unable to stand or lay on their side

• to demonstrate air-fluid levels

• to demonstrate pre-vertebral space

• umbilical hernia, aortic aneurysms, mass/abscess

Marker - Dorsal Decub ABD

• side marker in contact with IR

• arrow or decub marker 

Positioning - AP AXIAL Bladder

• CR

• CP

• PT Position

• 10-15 caud

• 2” sup PS

• pt supine with legs extended

Structures Included - AP AXIAL Bladder

• pelvic inlet to visualize entire bladder

• proximal portion of urethra for males 

Collimation - AP AXIAL Bladder

• med to both ASISs

• ASIS → below PS 

Positioning - AP OBL Ureters

• CR

• CP

• OBL

• PT Position

• perp

• 2” sup to PS and med to raised ASIS

• 40-60 internal rot’n (dependent side raised)

• keep raised leg straight so it doesn’t SI over bladder

Structures Included - AP OBL Ureters

• distal ureters

• entire bladder

• entire urethra for females

• ½ proximal urethra for males 

Positioning - AP OBL Urethra

• CR

• CP

• OBL

• PT Position

• perp

• mid ASISs and level of raised GT

• 35-40 ext rot’n

• place ST of penis on dependent thigh, and retract raised thigh 

Positioning - LAT Bladder

• CR

• CP

• PT Position

• perp

• MCP, 2” sup to GT

• recumbent or erect, flex knee and elbows, place sponge between knees

Respiration for all Bladder Exams

expiration

Leg Length Typical Exam

done bilaterally

Leg Length Indications 

pre or post-op for hip/knee replacements to assess joints and determine angles 

Structures Included - Leg Length

IC → medial malleoli

Respiration - Leg Length

suspended 

PT Positioning - Leg Length

• remove shoes

• bear weight evenly

• sep the feet 13-15cm

• knee in AP

Structures Included - Scoliosis

TEA → 2” below IC (3410) or GT (3211)

PA/LAT Scoliosis Exams Demonstrate

• extent of curvature with gravity

• evaluation of spinal fixation devices

• excessive kyphosis, lordosis, spondylolisthesis 

PA Lateral Bending Demonstrates

• upright = curvature under gravity

• to identify primary vs. sec curvatures

Minimum SID for Scoliosis

150cm

Which Scoliosis Projection is preferrred

PA

Positioning - PA Scoliosis

• remove shoes

• weight evenly distributed

• no supports to hold on 

• arms hang by side

Positioning - LAT Scoliosis

• no shoes

• left lateral

• arms moved slightly forward but not too high