Radiographic Techniques - Thoracic Bones

Radiographic examination of the ribs and sternum is crucial to identify trauma, especially in cases of chest wall injury.

Standard PA or AP views are essential for assessing chest wall injury, pleural changes, and potential lung damage.

Oblique rib views, typically used for minor trauma, offer a more detailed look at individual ribs.

Multiple rib fractures can cause the chest to collapse during inhalation, compromising lung function, known as flail chest.

A supine AP view may be necessary in severe trauma cases, but it may obscure a pneumothorax.

A lateral radiograph using a horizontal beam is needed for confirming a pneumothorax in a supine patient.

Fractures of the clavicle and 1st ribs may indicate vascular injury, requiring careful examination on frontal projections.

Lower rib injuries often require further investigation due to potential damage to organs like the liver, spleen, and kidneys.

The cassette is placed transversely in the Bucky tray with its lower edge positioned just below the lower costal margin, ensuring the area of interest is centered with the central beam.

The collimated vertical beam is angled cranially to coincide with the center of the image receptor. This helps visualize the maximum number of ribs below the diaphragm.

The patient is positioned supine or erect, with the mid-clavicular line of the side being examined aligned with the midline of the Bucky tray. The trunk is rotated 45° to the side being examined, ensuring the raised side is supported on non-opaque pads.

The cassette is positioned to include the area of interest, from the middle of the sternum to the lower costal margin, ensuring all relevant ribs are captured.

The collimated vertical beam is centered on the anterior surface of the patient at the level of the lower costal margin. The beam is then angled cranially to coincide with the center of the image receptor.

Exposure is made on full expiration to ensure the ribs are spread out and easier to visualize.

Right and left posterior oblique positioning allows for individual rib visualization by angling the patient to separate the ribs for better clarity.

Oblique rib views provide a more detailed look at specific ribs, ideal for detecting fractures or other anomalies, especially in minor trauma cases.

The first and second ribs are best visualized using an antero-posterior (AP) projection. This technique requires a larger cassette (18x24cm or 24x30cm) and ensures proper positioning of the patient and image receptor.

The collimated x-ray beam should be directed perpendicular to the image receptor and centered to the middle of the clavicle. This ensures the entire upper rib area is captured and the image is well-defined.

Cervical ribs are most evident when visualizing the cervical vertebrae or using a PA chest projection. This typically requires a 24x30cm cassette placed transversely on the Bucky tray.

The patient should be positioned so their median sagittal plane is perpendicular to the cassette and aligned with the midline of the Bucky table. This ensures proper alignment for a clear image.

The x-ray beam should be angled 10° cranially from the perpendicular, aimed towards the sternal notch, for optimal visualization of the cervical ribs.

Antero-posterior (AP) projections of the lower ribs utilize a larger cassette (35x43cm) to capture the entire rib cage from the sternum to the lower costal margin.

The patient should be positioned supine on the imaging table with their spine aligned with the center of the table. The anterior superior iliac spines should be equidistant from the table top to ensure proper positioning.

Radiographic techniques are used to diagnose and treat patients by capturing images of internal structures. These techniques help identify diseases, foreign objects, and structural damage or abnormalities.