1. Spokane Community College Radiology Film Critique
Bony Thorax
Spokane Community College
Radiology Film Critique

2. 1
Manubrium 2 3 4
Body 5
Xiphoid 6 7 8 9 10 11 12

3. RIBS Routine views : AP above AP below RPO of the affected side
LPO of the affected side

4. Structures shown:
AP projection shows the posterior ribs, above or below the diaphragm

7. Good film
For AP upper ribs: Posterior ribs 1-10 above the diaphragm, both sides should be seen above the diaphragm and include in their entirety
For AP lower ribs: Posterior ribs 8-12 below the diaphragm, both sides should be seen below the diaphragm and include in their entirety
Ribs should be seen clearly through the lungs or abdomen according to the region examined. The AP views are done to see the bodies of the ribs.

8. Structures Shown:
RPO/LPO in this projection the axillary portion of the ribs are projected free of self-superimposition. The posterior ribs are also well demonstrated.
LPO
Left side down

9. Grashey
Scap “Y”
RPO
Upper
Ribs
Right side down

10. RPO
Lower
Ribs
Is the
Respiration
Phase correct?

11. LPO lower ribs

12. LPO lower ribs LT

13. Good film:
There should be approximately twice as much distance between the vertebral column and the outer border of the ribs on the affected side as there is on the unaffected side
Axillary portion of the ribs should be demonstrated free of superimposition

14. Sternum
Routine views:
RAO
Lateral

15. What is shown:
RAO method shows a slightly oblique PA projection of the sternum. The breathing motion obliterates the pulmonary markings
Structure shown: The entire sternum from jugular notch to tip of xiphoid

17. RAO

19. Good Film:
Entire manubrium to the tip of the xiphoid should be included
Visibility of the sternum through the thorax should be reasonably good
Sternum should be projected just free of superimposition from vertebral column
Sternum should be projected into the cardiac shadow
**Breathing technique: to blur pulmonary markings

20. Structure shown: Lateral projection of the entire length
of the sternum is demonstrated showing the superimposed sternoclavicular joints and medial ends of the clavicles

22. Sternoclavicular Articulations:
RAO
LAO
Axiolateral-Kurzbauer method of the affected side (not in book)

23. Structures shown:
This method presents a slightly oblique projection of the sternoclavicular joints. Shows the joint closer to the film with less distortion.
**LAO: Left side down: The joint closest to the IR is shown (left)

24. LEFT
LAO

25. Good film:
SC jnts of interest should be in the center of the film (down side)
Manubrium and medial ends of clavicles should be included
SC jnts space should be open
SC jnts of interest should be directly in front of the vertebral column with minimal obliquity
Visibility of the SC jnt through the superimposing rib and lung fields should be reasonably good

26. Adjust the position of the cassette so that its midpoint will coincide with the CR.
Respiration is suspended at the end of full inhalation.
Direct the CR through the lowermost sternoclavicular articulation at an angle of 15 degrees caudal.

27. Structures shown: This method presents an unobstructed lateral projection of the sternoclavicular articulation adjacent to the film

29. Good film: SC jnt of interest should be demonstrated
Shoulders should not superimpose the SC articulations.