Bucky Markers

Introduction

The successful use of side markers in radiography can easily be overlooked as a quality assurance issue. This page looks at a type of side marker that is attached to the bucky tray.

Why use Side Markers?

There are two primary uses for side markers. Firstly, they allow the observer to distinguish left from right anatomy. This can be critical in terms of any treatment or intervention that the patient is subject to. Secondly, side markers can include the radiographers initials. This is important in establishing which radiographer has taken a radiograph. If the image is of poor quality, the radiographer can be counselled/tutored. Equally, the radiographer can take pride in a good quality image that is identified as belonging to them. This is the artist's equivalent of the signature in the corner of the oil painting.

Bucky Markers

If you were to analyse why radiographers fail to use side markers, the following would feature prominently

• Lost my Markers
• Forgot to use them

Because they are attached to the bucky, they tend not to become misplaced- they have a home. Secondly, it is very difficult to forget to use a bucky marker- when you place the cassette in the bucky tray- the bucky marker is highly visible.

This bucky marker has the word "ERECT" engraved into it. Given that this bucky markers stay on the wall bucky, images are almost always erect.	This is a bucky marker shown up-side-down. The rare-earth magnet which hold the bucky marker to the cassette tray is visible

Bucky marker as it appears on supine abdominal image

Advantages of Bucky Markers

Bucky markers are quick and easy to use because they sit in place on the bucky tray. The major advantage of using bucky markers is the high level of compliance. You should achieve a side marker success rate of nearly 100% for bucky radiography with bucky markers. The addition of the words 'ERECT' or 'SUPINE' are also a considerable bonus.

Disadvantages of Bucky Markers

Bucky markers can only be used on buckys. Moreover, they can only be used on buckys made of a ferrous metal or ferrous metal alloy. Check your bucky tray with a magnet before pursuing bucky markers for your department. Bucky markers will not display the radiographer's initials. This is less of a problem with digital systems because the radiographer's initials can be included on the image electronically.

Making Bucky Markers

These markers are largely home made. The components are as follows

• Engraving brass
• 3mm stainless steel countersunk bolt
• 3mm stainless steel nut
• HDPE 20 mm rod
• Rare earth magnet
• Contact cement

The lettering is engraved by a professional engraver. The engraver also sited the 3mm hole for the stainless steel bolt.

The HDPE Block

The white mounting block is made of high density polyethylene. Other plastics may be equally suitable. The HDPE is purchased as a 20mm rod. It is cut into 15mm segments. The block has several holes drilled in it to accommodate the 3mm bolt, the 3mm nut, and the rare earth magnet. The 3mm nut and the magnet are push fitted into the HDPE.

The Rare earth Magnet

Rare earth magnets, also known as Neodymium Iron Boron (or NdFeb), are remarkably powerful for their size. I have used the same bucky markers for7 years and the magnets do not appear to have lost any of their power. The bucky markers always stay attached to the bucky which probably acts as a "cap" and helps to keep their magnetic strength.

The Engraving

The lettered brass is cut from a special brass known as engraving brass. This is cut by en engraver using a machine called a pantograph.

Construction.

The brass marker is glued and bolted to the HDPE mounting block. The nut will not turn if the hole to accommodate it is a tight push fit. Similarly, the rare earth magnet will stay in place if it is a tight push fit.

Engineering Drawings

Plan View Side Elevation

Conclusion

Bucky markers have been in use in my department for approximately seven years. They initially cost more, but it should be considered that we haven't lost one yet. Side marker compliance for bucky radiography noticeably improved with the introduction of bucky markers.

Bucky markers could easily be fabricated by an engineer or handyman.

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