RS222 sim

axiolateral: danelius miller (hip)

modified axiolateral: Clements nakayma

best demonstrates superimposition of anterior/posterior aspect of pelvic ring

pelvic inlet: lilenfeld method

best demonstrates opened and elongates obturators and inferior pubic rami

pelvic outlet: Taylor method

best demonstrates malgaigne and bucket fxs

pelvic outlet: Taylor method

best demonstrates anterior rim of acetabulum and iliopubic column

iliac oblique acetabulum

best demonstrates posterior rim of acetabulum and iliopubic column

obturator oblique acetabulum

best demonstrates superoposterior wall of acetabulum and fovea capitis in profile

PA axial oblique: teufel method (acetabulum)

best demonstrates lumbosacral junction and sacrum

PA and AP axial SI joints

best demonstrates open intervertebral disk space between L5 and S1

PA and AP axial SI joints

Best demonstrates both SI joints adequately penetrated

PA and AP axial SI joints

best demonstrates open SI joint with minimal overlapping of the ilium and sacrum and SI joint closest to IR (the downside either L or R)

PA oblique SI joints

best demonstrates the sacrum seen free of foreshortening with the sacral curvature straightened

AP/PA axial sacrum

best demonstrates the pubic bones not overlapping the sacrum

AP/PA axial sacrum

best demonstrates no rotation of the sacrum, as demonstrated by symmetric alae

AP/PA axial sacrum

best demonstrates coccygeal segments not superimposed by pubic bones

AP/PA axial coccyx

best demonstrates no rotation of the coccyx, as demonstrated by distal segment in line with pubic symphysis

AP/PA axial coccyx

best demonstrates closely superimposed posterior margins of the ischia and ilia, showing no rotation

lateral sacrum/coccyx

best demonstrates no rotation and open intervertebral disk spaces

AP lumber spine

best demonstrates symmetric vertebrae with spinous processes centered to the bodies

AP lumber spine

best demonstrates SI joints equidistant from the vertebral column

AP lumber spine

best demonstrates SI joints and transverse process equal, along with spinus process centered making the spine appear straight

AP lumber spine

best demonstrates open intervertebral foramina AND disks

lateral lumbar spine

best demonstrates Spondylolisthesis seen and spinous processes in profile

lateral lumbar spine

best demonstrates open lumbosacral intervertebral disk space

lateral L5-S1

best demonstrates Zygapophyseal joints closes to IR (open and uniformly visible through the vertebral bodies)

AP oblique Lumbar spine

best demonstrates open intervertebral space between L5 and S1 with both SI joints adequately penetrated

AP axial: Ferguson

best demonstrates vertebral column aligned to middle of radiograph

AP thoracic spine

best demonstrates tspine intervertebral foramina and open intervertebral disk spaces

lateral thoracic spine

• affected limb (hip) rotated 15-20° medially

• IR parallel to femoral neck

• IR vertical with upper border in crease above iliac crest

• CR perpendicular to long axis of femoral neck

• pt supine with knee/hip of unaffected side bent up

• trauma projection

axiolateral: danelius miller

• IR 15° posterior tilt on Bucky tray

• CR horizontal with 15° posterior angle (towards table and gluteus Maximus)

• pt supine unable to lift either leg

modified axiolateral: Clements nakayama

• CR 40° caudal

• centered to ASIS

• feet and lower limbs medially rotated 15-20°

• pt supine

Pelvic inlet / superioinferior axial

• CR 40° cephalic

• centered 1-2” inferior to pubic symphysis

• feet and lower limbs medially rotated 15-20°

• pt supine

pelvic outlet

• CR centered 2” medial and inferior to down ASIS

• pt position: external oblique

  • supine with affected side down

iliac oblique (acetabulum)

• CR centered 2” inferior to ASIS to affected side

• pt position: internal oblique

  • supine with affected side up

obturator oblique (acetabulum)

• CR 12° cephalic

• centered 1” superior to the level of the greater trochanter and 2” lateral to MSP

• 35-40° anterior oblique for downside

• pt prone

PA axial oblique (acetabulum)

• CR caudal 30-35°

• pt prone with no pelvic rotations

• centered pubic symphysis

PA axial SI joints

• CR cephalic 30-35°

• pt supine with no pelvic rotations

• centered pubic symphysis

AP axial SI joints

• pt PA

• pelvis oblique 20-30° towards affected side

• exhibiting SI joint nearest IR

• CR 1” medial to affected ASIS

LAO/RAO SI joints

• pt AP

• pelvis oblique 20-30° away from table

• exhibiting SI joint farthest from IR

• CR 1” medial to affected ASIS

LPO/RPO SI joints

• pt prone

• centered to ASIS

• hips 25-30° anterior oblique position

PA oblique SI joint

• pt supine

• centered 2” superior to public symphysis

• CR 15° cephalic

AP axial sacrum AND coccyx

• pt prone

• centered at level of sacral curve

• CR 15° caudal

PA axial sacrum AND coccyx

• pt in recumbent lateral

• top of iliac perpendicular to IR

• centered at ASIS and 3.5” posterior (sacrum)

• centered 3.5” posterior and 2” inferior to ASIS (coccyx)

• led placed behind to absorb scatter

lateral sacrum AND coccyx

• pt supine or upright

• centered 1.5” above iliac crests

• shoulders and hips in same horizontal plane

AP L spine

• pt recumbent or upright

• true lateral with MCP vertical

• centered to iliac crests

lateral L spine

• pt recumbent or upright

• 45° posterior oblique position

• Centered 2 inches medial to elevated ASIS at L3 and 1.5 inches above iliac crests

ap oblique L spine

• Pt supine

• Centered 1.5 inches above pubic symphysis

• CR cephalic 30-35°

***May also be performed with pt prone (PA axial) with CR caudal 35°

AP axial: Ferguson

• pt supine or upright

• IR placed 1.5-2” above shoulders to place T7 in the center

• CR centered halfway between jugular notch and xiphoid process

• Breathing: full exhalation OR automography

AP T spine

• pt in left lateral

• Centered 2 inches posterior to MCP at T7

• Breathing: full exhalation OR automography

• Should be light behind pt

lateral T spine