Bony Thorax

1. BonyThorax Spokane Community College Radiology Film Critique

2. 1 Manubrium 2 3 4 Body 5 Xiphoid 6 7 8 9 10 11 12

3. RIBS • Routine views : • AP above • AP below • RPO of the affected side • LPO of the affected side

4. Structures shown: • AP projection shows the posterior ribs, above or below the diaphragm

7. Good film • For ribs above the diaphragm, posterior ribs 1-10 from both sides should be seen above the diaphragm and include in their entirety • For ribs below the diaphragm, posterior ribs 8-12 from both sides should be seen below the diaphragm and include in their entirety • Ribs should be seen clearly through the lungs or abdomen according to the region examined

8. Structures Shown: • RPO/LPO in this projection the axillary portion of the ribs are projected free of self-superimposition LPO Left side down

9. Grashey Scap “Y” RPO Upper Ribs Right side down

10. RPO Lower Ribs

11. LPO lower ribs

12. LPO lower ribs LT

13. Good film: • There should be approximately twice as much distance between the vertebral column and the outer border of the ribs on the affected side as there is on the unaffected side • Axillary portion of the ribs should be demonstrated free of superimposition

14. Sternum • Routine views: • RAO • Lateral

15. What is shown: • This method shows a slightly oblique PA projection of the sternum. The breathing motion obliterates the pulmonary markings • Structure shown: The entire sternum from jugular notch to tip of xiphoid

17. RAO

19. Good Film: • Entire manubrium to the tip of the xiphoid should be included • Visibility of the sternum through the thorax should be reasonably good • Sternum should be projected just free of superimposition from vertebral column • Sternum should be projected into the cardiac shadow • **Breathing technique: to blur pulmonary markings

20. Structureshown: • Lateral projection of the entire length of the sternum is demonstrated showing the superimposed sternoclavicular joints and medial ends of the clavicles

22. Sternoclavicular Articulations: • RAO • LAO • Axiolateral-Kurzbauer method of the affected side (not in book)

23. Structures shown: • This method presents a slightly oblique projection of the sternoclavicular joints. Shows the joint closer to the film with less distortion. **LAO: Left side down: The joint closest to the IR is shown (left)

24. LEFT LAO

25. Good film: • SC jnts of interest should be in the center of the film (down side) • Manubrium and medial ends of clavicles should be included • SC jnts space should be open • SC jnts of interest should be directly in front of the vertebral column with minimal obliquity • Visibility of the SC jnt through the superimposing rib and lung fields should be reasonably good

26. Adjust the position of the cassette so that its midpoint will coincide with the CR. Respiration is suspended at the end of full inhalation. Direct the CR through the lowermost sternoclavicular articulation at an angle of 15 degrees caudal.

27. Structures shown: This method presents an unobstructed lateral projection of the sternoclavicular articulation adjacent to the film

29. Good film: • SC jnt of interest should be demonstrated • Shoulders should not superimpose the SC articulations.