Radiographs

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Radiographs

• Film identification
• Radiograph markers
• Film storage

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Film Identification

• Some times leaded tape can be used on the
  cassette
• Most cassettes have corner shielded from x-rays

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Film Identification
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Film Identification

• Allows for exposure of label in dark room

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Film Identification
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Film Identification

• Label is permanently imprinted onto radiograph

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Film Identification
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Film Identification

• Film label requirements
• Must be permanent
• Name location of hospital
• Name of veterinarian
• Name of patient and client
• Case number
• Date

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Film Identification

• Film label requirements
• All of these requirements are extremely important
  especially when viewing films taken during past
  visits
• Allows assessment of changes
• Documents medical findings

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Film Identification

• Film labeling
• Prior to entering darkroom, fill out index card
  with appropriate information
• In dark room, place card into labeler
• Next, remove film from cassette
• Keep track of corner of film under shielded area
• Place this corner of the film into the labeler
  and expose

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Film Identification
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Film Identification

• Finally, develop film and label will appear on
  final radiograph

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Film Identification
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Film Identification

• Improperly labeled films
• Defective labeler
• Bulb weak or blown
• Weak or dead batteries
• Not plugged in

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Film Identification

• Improperly labeled films
• Label on exposed portion of film
• May be visible but difficult to read

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Film Identification

• Improperly labeled films
• Diagnostic area of film cut off by label

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Film Identification
Label obscures part of liver/stomach
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Film Identification

• Improperly labeled films
• Wrong patient
• Avoid by labeling film after exposure
• Do not pre-label films
• Wrong date
• Can complicate assessment of changes in disease,
  healing, age

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Radiograph markers

• Usually placed on top of cassette or table during
  exposure
• Must be sure to place in proper location
• Some markers need to be taped to the cassette

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Radiograph markers
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Radiograph markers

• Other markers are designed to be clipped to edge
  of cassette

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Radiograph markers

• Markers should be placed where they will not
  interfere with the subject or disappear behind
  the label

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Radiograph markers
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Radiograph markers

• Use to indicate position
• R vs. L
• Medial vs. Lateral
• More important in large animal extremities
• Mercury bubble markers
• Indicate direction

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Radiograph markers
Mercury directional marker
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Radiograph markers

• Use to indicate time
• Important in motility studies, myelograms
• Specially made markers have time stamps or
  indicators

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Radiograph markers

• Use to indicate view
• V-D vs D-V etc

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Radiograph markers

• If a marker was inadvertently not used then
  notations should be made on the film using a
  Sharpie or film pencil
• Anatomy can some times help with orientation
• Ex. left kidney is usually caudal to right
• Poor markers are far better than none

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Film Storage

• Each patient should have its own folder
• Allows for easy retrieval of old films for
  comparison if needed
• Avoids confusion with another similar sized
  patient owned by same client (if films were filed
  by client name)

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Film Storage

• Each patient should have a unique, sequential
  identification number
• A number is assigned only at the time of the
  first radiographic study
• This number should be recorded in the patients
  record
• Every radiograph for this patients whole life
  will be given the same identification number

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Film Storage

• Radiology log - each study should be recorded
  in a log book
• Purpose
• Serves as record of exposure / machine use
• Allows reference to proper technique for a
  specific patient whenever views are repeated
• Keeps account of who took the films

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Film Storage

• Log entries should include
• the information on the film label
• Name
• Veterinarian
• I.D. number
• Date
• Technician taking the films
• views taken
• Ex. chest V-D and Lateral

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Film Storage

• Log entries should include
• Technique
• kVp and mAs settings
• Film type used
• Grid system used
• Number of actual films exposed
• Include repeat films

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Film Storage

• Radiographs are considered part of the permanent
  medical record
• Ideally they should not leave the hospital
• Referrals should be either copied with an
  appropriate machine or scanned and transmitted
  electronically

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Film Storage

• Radiographs are considered part of the permanent
  medical record
• If original films need to be sent with client
  then they have to be signed out
• Original films should be placed in different
  folders for travel
• The original number folder should always remain
  in the hospital
• A notice should be placed in the folder
  indicating that some of the films are on loan

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Patient Positioning

• Proper positioning is critical to radiographic
  quality
• Poor positioning yields films of little or no
  diagnostic value
• Must be repeated
• Increases radiation exposure

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Patient Positioning

• Terminology
• Cranial toward the head
• Caudal toward the tail
• Dorsal toward the back
• Ventral toward the front (sternum)
• Lateral away from midline
• Right lateral right side down on table
• Medial towards midline

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Patient Positioning
Dorsal
Caudal
Cranial
Ventral
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Patient Positioning

• Terminology
• Rostral toward the nose
• Palmar toward palm
• Plantar toward the bottom of the foot

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Patient Positioning
Rostral
Palmar
Plantar
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Patient Positioning

• Terminology
• Anterior front (dorsal)
• Posterior back (palmar/plantar)
• Both derived from human anatomy and used often
  when discussing extremities

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Patient Positioning
Dorsal (Anterior)
Palmar (Posterior)
Plantar (Posterior)
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Patient Positioning

• Terminology
• Views are described in relation to direction of
  x-ray beam
• Example
• A ventrodorsal abdominal view indicates that the
  x-ray beam passes through the ventral side first
  and exits the dorsal side last

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Patient Positioning
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Patient Positioning

• A lateral view is akin to a side view

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Patient Positioning
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Patient Positioning

• Abbreviations
• V-D ventrodorsal
• A-P anteriopalmar/plantar
• Cr-Cd craniocaudal
• D-P dorsopalmar/plantar
• The first term always indicates the side the
  x-ray beam penetrates first

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Patient Positioning

• Is there a difference between a V-D chest film
  and a D-V chest film?

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Patient Positioning

• Yes
• Other than direction of beam, the image produced
  also varies
• The heart can look very different depending on
  the view (prefer D-V view for evaluating the
  heart)
• Also a D-V may be preferred in an animal that is
  should not be placed on its back (trouble
  breathing, wounds, pain)

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Patient Positioning

• Routine thoracic views
• V-D
• Right lateral
• D-V (cardiac)

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Patient Positioning
Beam centered over heart Patient must be straight
and level
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Patient Positioning
Beam centered over heart Patient must be straight
and level
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Patient Positioning
Beam centered over heart Patient must be straight
and level
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Patient Positioning
Center beam behind scapula
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Patient Positioning
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Patient Positioning

• Routine Abdominal views
• V-D
• Right lateral

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Patient Positioning
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Patient Positioning
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Patient Positioning
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Patient Positioning

• OFA (Orthopedic Foundation for Animals) Hip views
  
• V-D (evaluated by OFA)
• Lateral
• Animals must be at least two years of age to be
  certified but can be examined at any age

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Patient Positioning

• OFA Hips
• Proper positioning is essential
• Use sedation/anesthesia if needed
• V-D position
• Fully extend rear legs
• Rotate stifles internally
• Patellae must be centered
• Film should include entire pelvis and stifles

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Patient Positioning
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