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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