Contributors: Patsy Whelehan

 Species: Feline   |   Classification: Techniques

Introduction Requirements Preparation Procedure Aftercare Outcomes Further Reading

Introduction

  • A high definition film-screen combination is required.
  • A grid is not required.
  • kV should not exceed about 50.
  • Soft tissues should be included.
  • General anesthesia or heavy sedation is required.
  • The film should be correctly exposed and developed, and free from movement blur and artifact.
  • The anatomical marker must be clearly visible, along with the patient's identification, the date, and the name of the hospital or practice.

Uses

  • Fracture Fracture: overview  Antebrachium: fracture 02 - radiograph CrCd .
  • Neoplasia (distal radius).
  • Premature distal ulna growth plate closure (angular limb deformity).

Advantages

  • Non-invasive.
  • Straightforward.

Time Required

Preparation

  • Dependent upon the method of chemical restraint (GA or sedation).

Procedure

  • 10 to 15 minutes, or longer, dependent upon skill of radiographer.

Decision Taking

Criteria for choosing test

Is the examination appropriate?

  • Can you make the diagnosis without it?
  • Can it tell you what you need to know?
  • Will your management be affected by the radiological findings?

Choosing the right projections

Lateral
  • Standard projection.

Craniocaudal

  • Standard projection.
  • Two views always necessary.

Requirements

Personnel

Other involvement

  • Radiographer, or Technician carrying out radiography.

Materials Required

Minimum equipment

  • X-ray machine.
  • Cassettes with high definition screens.
  • Processing facilities.
  • Immobilization and positioning aids: sandbags, foam wedges, tying tapes.
  • Protective clothing (lead-rubber aprons).

Ideal equipment

  • High output X-ray machine.
  • Rare earth high definition screens.
  • Automatic processing facilities.

Minimum consumables

  • X-ray film.
  • Pharmaceuticals for chemical restraint.

Preparation

Restraint

  • One to two competent people.
  • Sandbags.
  • Foam wedges.
  • Tying tapes.

Procedure

Core Procedure

Step 1 - Lateral

  • Position the patient in lateral recumbency on the side to be examined and immobilize.
  • Use padding under the shoulder and carpus as necessary to ensure that the radius and ulna are parallel to the film and in a lateral position .
  • Check that both the elbow and the carpus are in the true lateral position.
  • Secure the limb at the carpus.
  • Center with a vertical beam at mid-shaft level.
  • Collimate to include both the antebrachio-carpal joint and the elbow, and the skin surfaces on the cranial and caudal aspects .

Step 2 - Craniocaudal

  • Place the patient in sternal recumbency.
  • Extend the affected limb as far cranially as possible and secure .
    If the elbow and shoulder are not in full extension it will be very difficult to maintain an unrotated craniocaudal position of the radius and ulna.
  • Place the thin end of a 15 degree foam wedge between the elbow and the film. This will facilitate achieving the true craniocaudal position.
  • Rotate the limb until the point of the elbow is palpable beneath the middle of the cranial aspect ie until the elbow is in a true craniocaudal position.
    To prevent the elbow from slipping laterally, place padding at the lateral aspect, with a heavy sandbag lateral to that.
  • Secure the limb at the carpus if necessary.
  • Center mid-shaft.
  • Collimate to include both joints (and as far as the metacarpals in the case of angular limb deformity) and the skin surfaces laterally and medially .

Aftercare

Outcomes

Reasons for Treatment Failure

  • Inadequate sedation.
  • Poor technique: inaccurate positioning or centering, wrong exposure factors.
    The most common positioning problem is rotation in the craniocaudal position.
  • Follow the tips to ensure that this does not happen.
  • Poor processing.
  • Equipment failure.

Further Reading

Publications

Refereed papers