Routine Projection
3 or 4
AP [AP lumbar, AP lumbopelvic, AP lumbosacral]
AP spot
Lateral
Lateral Spot
AP Lumbopelvic APLP structures
lumbar spine- L1-L5, entire pelvis- including ischial tub
APLP film
14x17
APLP kVp
80
APLP measure
L4 sagittal [belly button]
APLP shield
shield gonads-males
gonadal filter for females
APLP Central Ray
2' below iliac crest
APLP collimation
include trochanters
L1-L5
APLP FFD
40
APLP breathing
hold expiration
AP lumbosacral structures
all lumbar spine and sacrum including SI
AP lumbosacral Central Ray
1" above iliac crest [L3]
AP lumbosacral collimation
7x17-narrow
Most often AP used in hospitals for lumbar
AP lumbosacral
AP lumbosacral KvP
80
AP lumbosacral measure
L4/L5 sagittal
AP lumbosacral FFD
40
AP lumbosacral film
14x17
Pt info AP lumbosacral
have knees/hips slightly flexed if recumbent
HOLD on exhalation
AP lumbar spine common?
no, not commonly used
AP lumbar FFD
40
AP lumbar kVp
80-85
AP lumbar tilt
none
AP lumbar film size
10x12
AP lumbar Central Ray
mid lumbar- about 2-3" above crest
AP lumbar structures
L1 through top of sacrum - SI not necessary
AP lumbar pt instructions
hold expiration
Lateral Lumbar structures
lumbar bodies and intevertebral foramen
Lateral lumbar film
14x17
lateral lumbar FFD
40
lateral lumbar kVp
90
lateral lumbar measure
iliac crest coronal
lateral lumbar central ray
perpendicular 1-2" above iliac crest
lateral lumbar collimation
area of interest- include sacrum
Latteral breathing
hold expiration, patient crosses arms in front
lateral lumbosacral FFD
40
lateral lumbosacral kVp
90
lateral lumbosacral film
14x17
lateral lumbosacral central ray
1-2" above iliac crest
lateral lumbosacral pt instructions
deep expiration and hold
lateral lumbosacral shield
use filters at diaphragm and over gonadal area
lateral lumbosacral collimation
narrow to body 7x17
lateral lumbosacral measure
iliac crest coronal
AP lumbosacral spot structures
lumbosacral joint and both SI joints
AP lumbosacral spot kVp
80
AP lumbosacral spot FFD
40 [33 or 34]
AP lumbosacral spot film
10x12
AP lumbosacral spot tilt
Males- 30
females- 35
cephaled
AP lumbosacral spot central ray
2" below ASIS (between ASIS and pubic symphysis)
AP lumbosacral spot collimation
including SI
AP lumbosacral spot measure
iliac crest sagittal
AP lumbosacral spot pt instructions
hold expiration, hips slightly flexed if supine
lateral spot structures
open lumbosacral junction
lateral spot film
10x12
lateral spot FFD
40
lateral spot kVp
90
lateral spot measure
coronal plane at ASIS
lateral spot collimation
L4-S1
lateral spot breathing
hold expiration
lateral spot shield
no shield needed
lateral spot central ray
2" below iliac crest level and vert axis mid way between ASIS and PSIS
Anterior Oblique structures
pars interarticularis and zygapophyseal joints
anterior oblique film
10x12 for lumbar
14x17 for lumbosacral
anterior oblique FFD
40
anterior oblique kVp
85
anterior oblique measure
iliac crest sagittal
anterior oblique central ray
Lumbar: 1-2" above iliac crest and 1-2" away from spinous toward elevated side
lumbosacral: At iliac crest and 1-2" away from spinous towards elevated side
anterior oblique collimation
to area of interest
anterior oblique breathing
suspend on expiration
posterior oblique FFD
40
posterior oblique kVP
80-85
posterior oblique film size
10x12
14x17
posterior oblique central ray
1-2" above iliac crest and about 2' from elevated ASIS towards midline
posterior oblique pt instructions
suspended expiration
posterior oblique collimation
to area of interest
posterior oblique breathing instructions
suspend on expiration