Radiographic drill

SAMPLE

QN; A patient comes to the radiology department with a suspected fracture of the pubic ramus.

• By using radiographic drill, explain how you will examine the patient.
• Guidelines (Exemplary radiographic drill)
• Anatomy/definition
• Basic views
• Equipment
• Patient preparation
• Positioning
• Centering
• Essential image characteristics
• Radiation protection
• Patient Aftercare
• NB; This is only an exemplary radiographic drill a universal one.
• The pubic ramus is a bone that forms the pubis (pubic bone) of the pelvis. The pelvis is
• made up of 3 innominate bones (ilium, ischium and pubis) and sacrum. The pelvis provides
• protective girdle for the pelvic organs and supports the lower limbs.
• ` In this scenario, I will perform the examination of the pelvis. The basic view for the
• pelvis is antero-posterior (AP).

Equipment employed can be a table Bucky direct digital radiography system (DDR) or a 35 x 43 cm computed radiography cassette or a 35 x 43 cm conventional radiography cassette.

• Also, accessories like foam pads and sand bags are employed.

In patient preparation, I will confirm the identity of the patient and the examination by cross checking the request form. I will explain the procedure to the patient and ask for verbal consent to begin the exam. I will then remove all radiopaque materials from the pelvis.

In patient positioning, the patient lies supine and symmetrical on the X-ray table with the median sagittal plane perpendicular to the tabletop. To avoid pelvic rotation, the anterior superior iliac spines must be equidistant from the tabletop. The limbs are slightly abducted and internally rotated to bring the femoral neck parallel to the image receptor. Sandbags and pads are placed against the ankle region to help maintain this position. For exposure factors, kVp and mAs will be according to body size and age but focal film distance (FFD) will be 100cm.

• In centering, the collimated vertical beam is centred over the midline midway between
• the upper boarder of symphysis pubis and anterior superior iliac spines.

In essential image characteristics, I will include both iliac crests and proximal femora including the lesser trochanters in the image. To prove there is no rotation, the iliac bones should be of equal dimensions and obturator foramina of equal size and shape.

In radiation protection, I will ensure close collimation and careful technique to avoid repeat examinations. Also, for first clinic visit I won’t apply gonad protection as it may obscure anatomy and result in missed information. However, for follow up visits, I will carefully position the gonad shield to avoid obscuring the area of interest.

In patient aftercare, I will ensure the patients takes back all their belongings and instruct him/her on where to see the doctor for results.