Download Pelvic Positioning Course Handout

Radiographic Positioning for Dogs
Pelvis Radiographs: Lateral View
A routine pelvis exam consists of a lateral and ventrodorsal view. When performing pelvic
radiographs, a quality control check system is performed. The guidelines for this check are
listed here for review. If your answer is yes to all of questions below, have your doctor review
the images and then send them to AIS for evaluation. If you answer is no, review the material to
help you obtain a diagnostic quality radiograph.
1.
Check the anatomical boundaries
Lateral
Anatomy Boundaries Needed
The cranial edge of the wing of the ilium, the
caudal edge of the ischium and the dorsal
edge of wing of the ilium.
If dorsal margin is ok and beam is centered on
the greater trochanter, ventral margin should
be fine.
The area just cranial to the ilium, just caudal
to the ischium and proximal femurs should be
included.
2. Is the patient straight? Is the positioning appropriate?
Checklist
 Patient right side (affected side) down
 Keep patient in lateral position
 Keep limbs together if desired by
doctor; otherwise stagger top limb
caudally and down limb cranially
 Use appropriate positioning devices
 Collimate to include landmarks
 Verify positioning
3. Is the technique appropriate? Is the background black? Can you see the needed
anatomy including soft tissues?
Lateral
Anatomy Needed
 the ilium
 the ischium
 the femur


Verify that the femoral heads are superimposed
You should be able to see through the disc spaces
4. Is there a positioning marker present? Is it on the correct side of the patient, not
obscuring anatomy and legible? Is the patient ID information correct on the image or
file?
5. Do you have all of the necessary views? Lateral and ventrodorsal
Quick Tips
1. If the patient is sedated/anesthetized, note type of sedation on the radiology form
2. Use of patient positioning devices is recommended to keep patient in the proper
position. Some examples include foam wedges, sandbags and ties
3. Patient must be flat on table with pelvis square on all views
4. Discuss limb placement (LAT view: parallel or separated) with doctor prior to positioning
patient
5. It is not necessary to include the fat dorsal to the spine in the image. However, you want
to include the entire spine including the spinous processes
6. If calipers are used, measure at the level of the greater trochanters
7. If you are having difficulty centering the x-ray beam on greater trochanter you can
gently flex and extend the pelvic limbs while palpating to locate
8. Wear your personal protective equipment appropriately and distance yourself from the
primary beam
9. Once reviewed, submit the study to AIS immediately to expedite interpretation and
communication of results
10. Appreciate your patient
Page 2 of 6
Pelvis Radiograph – Ventrodorsal View
When performing pelvic radiographs, a quality control check system is performed. The
guidelines for this check are listed here for review. If your answer is yes to all of questions
below, have your doctor review the images and then send them to AIS for evaluation. If you
answer is no, review the material to help you obtain a diagnostic quality radiograph.
1. Check the anatomical boundaries
Ventrodorsal
Anatomy Boundaries Needed
Center the x-ray beam on the pubis
Open collimator enough to include the cranial
edge of wing of the ilium to the stifle. May
move center as needed (depending on the
conformation of the patient – if patient is
large, it is better to cut off part of stifle than
the ilium of pelvis
The area just cranial to the ilium to the level of
the stifles must be included.
2. Is the patient straight? Is the positioning appropriate?
Checklist
 Sedation needed for this view
 Patient on back
 Reasonable but not extreme traction
on pelvic limbs
 Femurs must be straight
 Pelvis must be straight
 Internal rotation of the femurs
 Traction on thoracic limbs to keep in
place
 Utilize appropriate positioning devices
 Collimate to include landmarks
 Verify positioning
Page 3 of 6
3. Is the technique appropriate? Is the background black? Can you see the needed
anatomy including soft tissues?
Ventrodorsal
Anatomy Needed
 the ilium
 the ischium
 the femur
 the stifles


The wings of the ilium and obturator foramen should be symmetrical
The femurs should be parallel to the x-ray table
4. Is there a positioning marker present? Is it on the correct side of the patient, not
obscuring anatomy and legible? Is the patient ID information correct on the image or
file?
5. Do you have all of the necessary views? Lateral and ventrodorsal
Quick Tips
1. Note the type of sedation used on the radiology form
2. Use of patient positioning devices is recommended to keep patient in the proper
position. Some examples include foam wedges, sandbags and ties
3. Patient must be flat on table with pelvis square
4. If calipers are used, measure at the level of the greater trochanters
5. Verify pelvis is not rotated (obturator foramen should be equal in size and shape) and
the long axis of the femurs parallel to each other
6. Taping of the hindlimbs can help to maintain parallel femurs
7. If you are having difficulty centering the x-ray beam on greater trochanter you can
gently flex and extend the pelvic limbs while palpating to locate
8. Wear your personal protective equipment appropriately and distance yourself from the
primary beam
9. Once reviewed, submit the study to AIS immediately to expedite interpretation and
communication of results
10. Appreciate your patient
Page 4 of 6
Pelvis Radiograph – Frog- Leg Ventrodorsal View
When performing pelvic radiographs, a quality control check system is performed. The
guidelines for this check are listed here for review. If your answer is yes to all of questions
below, have your doctor review the images and then send them to AIS for evaluation. If you
answer is no, review the material to help you obtain a diagnostic quality radiograph.
1. Check the anatomical boundaries
Frog-Leg Ventrodorsal
Anatomy Boundaries Needed
Center the x-ray beam on the pubis
Open collimator just enough to include
cranial edge of wing of the ilium and proximal
1/3 of the femurs
2. Is the patient straight? Is the positioning appropriate?
Checklist
 Sedation needed for this view
 Patient on back
 Pelvis must be straight
 Allow hindlimbs to fall naturally
 Femurs will be approximately 45
degree angles
 Utilize appropriate positioning
devices
 Collimate to landmarks
 Verify positioning
Page 5 of 6
3. Is the technique appropriate? Is the background black? Can you see the needed
anatomy including soft tissues?
Frog-Leg Ventrodorsal
Anatomy Needed
 the ilium
 the ischium
 the proximal 1/3 of the femurs

The wings of the ilium and obturator foramen should be symmetrical
4. Is there a marker present? Is it on the correct side of the patient, not obscuring
anatomy and legible? Is the patient ID information correct on the image or file?
5. Do you have all of the necessary views?
Quick Tips
1. If the patient is sedated/anesthetized, note type of sedation on the radiology form
2. Use of patient positioning devices is recommended to keep patient in the proper
position. Some examples include foam wedges, sandbags and ties
3. Patient must be flat on table with pelvis square
4. If calipers are used, measure at the thickest point of the pelvis
5. Verify pelvis is not rotated (obturator foramen should be equal in size and shape).
6. Allow legs to rest at approximately 45 degrees
7. If you are having difficulty centering the x-ray beam on greater trochanter you can
gently flex and extend the pelvic limbs while palpating to locate
8. Wear your personal protective equipment appropriately and distance yourself from the
primary beam
9. Once reviewed, submit the study to AIS immediately to expedite interpretation and
communication of results
10. Appreciate your patient
Page 6 of 6