RDT 105 Positioning Situations Chest
45 degree RAO
A PA and lateral chest study reveals a suspicious mass located near the heart in the right lung. The radiologist would like a radiograph of the patient in an anterior oblique position to delineate the mass from the heart. Which position or projection should the technologist use to accomplish this objective.
Rotation into a left anterior oblique (LAO) position.
A PA chest radiograph reveals that the left sternoclavicular joint is superimposed over the spine (in comparison with the right joint). What specific positioning error is involved?
Left lateral decubitus chest
A patient enters the ER with an injury to the chest. The ER physician suspects a pneumothorax may be present in the right lung. The patient is unable to sit or stand erect. Which specific projection can be performed to confirm the presence of the pneumothorax?
Lateral decubitus with affected side up; or inspiration/expiration.
A patient has a possible small pneumothorax. Routine chest projections (PA and Lateral) fail to reveal the pneumothorax conclusively. Which additional projections could be taken to rule out this condition?
Right lateral decubitus chest
A patient with a history of pulmonary edema comes to the radiology department and is unable to stand. The physician suspects fluid in the lung. Which specific projection should be used to confirm this diagnosis?
The lungs are underinflated.
A radiograph of a PA projection of the chest shows only 7 posterior ribs above the diaphragm. What caused this problem?
Slight RAO position
A radiograph of a PA view of the chest reveals the sternoclavicular (SC) joints are not the same distance from the spine. The right SC joint is closer to the midline than is the left SC joint. What is the positioning error?
Look for the "gastric bubble" or the inferior heart shadow, these signify the patient's left side.
A radiograph of a lateral projection of the chest reveals the posterior ribs and costaphrenic angles are separated more than 1cm, indicating excessive rotation. Describe a possible method of determining the direction of the rotation.
Perform both lateral decubitus projections
A radiograph of an AP lordotic projection reveals the clavicles are projected within the apices. The clinical instructor informs the student technologist that the study is unacceptable, but during the repeat exposure the patient complains of being too unsteady to lean backward for another projection. What other options are available for the student to complete the study?
Yes. Decrease the exposure factors.
An ambulatory patient with a history of advanced emphysema enters the emergency room. The patient is having difficulty breathing and is receiving oxygen. Should the technologist alter the typical exposure factors for this patient?
LPO and RAO obliques
PA and left lateral projections demonstrate a suspicious region in the left lung. The radiologist orders an oblique projection that will best demonstrate or "elongate" the left lung. Which specific oblique projections will best elongate the left lung?
70-85 kV, short exposure time
What exposure factors are recommended for a chest study for a young pediatric patient?
RAO
Which anterior oblique projection would best demonstrate the left lung?
LPO
Which posterior oblique projection would best demonstrate the left lung?
