Ribs - Oblique
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Radiographic Positioning
Adult | Other related pages of interest |
Name of projection | Ribs - Oblique (Posterior or Anterior Obliques) |
Area Covered | Upper Ribs view shows ribs 1 through to 10 Lower Ribs view shows rib 8 through to 12 |
Pathology shown | Fractures, benign and malignant tumours, rib notching, congenital abnormalities |
Radiographic Anatomy | Ribs Radiographic Anatomy |
IR Size & Orientation | 35 x 43 cm Portrait |
Film / Screen Combination | Regular (CR and DR as recommended by manufacturer) |
Bucky / Grid | Moving or Stationary Grid |
Filter | No |
Exposure | 66 kVp, 16 mAs for Upper Ribs 75 kVp, 30 mAs for Lower Ribs (to penetrate the abdomen) (can use long exposure time on table bucky) |
FFD / SID | 100 cm |
Central Ray | Posterior Obliques Directed to the centre of the IR, in line with the mid-clavicular line and so that the top of the IR is approximately 4 cm above the patient's shoulder Perpendicular to the IR Anterior Obliques Directed to the centre of the IR, to the point midway between the vertebral bodies and the lateral rib margins and so that the bottom of the IR is at the level of the Iliac Crest. Perpendicular to the IR |
Collimation | Upper Ribs Centre: Halfway between jugular notch and xiphoid sternum, approximately 1/4 of the way across from the midline towards the lateral rib margin Shutter A: Open to include from the vertebral bodies to the lateral rib margin Shutter B: Open to the film size superiorly and inferiorly Lower Ribs Centre: Place the lower margin of the IR at the level of the Iliac Crest, approximately 1/4 of the way across the patient from the midline to towards the lateral rib margin Shutter A: Open to include from the vertebral bodies to the lateral rib margin Shutter B: Open to the film size superiorly and inferiorly |
Markers | Posterior Obliques Superior and Lateral Indicate the side closest to the bucky (which is the affected side) Marker orientation is AP Anterior Obliques Superior and Lateral Indicate the side closest to the bucky (which is the affected side) Marker orientation is PA |
Shielding | Gonadal (check your department's policy guidelines) |
Respiration | Upper Ribs on suspended inspiration Lower Ribs on suspended expiration |
Positioning | Posterior Oblique view
Anterior Oblique view
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Critique | Positioning Assessment of correct patient obliquity
Centre: This will be approximately at the level of the 7th rib Shutter A: Open to include the vertebral bodies to the lateral rib margin Shutter B: Open to include the 1st rib at the top of the film Centre: This will be approximately at the level of the 10th rib Shutter A: Open to include the vertebral bodies to the lateral rib margin Shutter B: Open to include the 12th rib on the bottom of the film Exposure There should be adequate exposure so that
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Special Notes | Collimation Take care with collimation, especially while imaging upper ribs, as the rib cage expands on inspiration Determining how to fix incorrect obliquity If the person is not obliqued enough
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