You have followed 100 year old instructions which ended up including the ankle and lower leg. So that is 50% more radiation dose and scatter. To correct the AP, keep the tube in the same place but angle the tube less because in this situation tube angulation only changes collimation as shown in my xray beam geometry video ruclips.net/video/mZPD_gLs5Dw/видео.htmlsi=vLGXcjRdXvPB5aQ_ Likewise for the oblique. Never include the ankle and lower leg on a foot xray.
You say there is no shielding necessary, yet you use shielding on a chest xray and a humerus xray. If you want to be consistent, men have gonads that are not protected by inches of flesh and bone, so are more vulnerable to low energy scatter as you would get from the collimator and tube filtration.
The lateral should have the elbow lateral. This is best achieved PA. Is your xray machine so poorly designed that there is significant radiation outside the primary beam? Have you tested to see how much extra focal and scatter from the collimator and filtration there is? If you test for it more than 6 inches away from the edge of the primary beam, you will find nothing. I can understand that men need more protection as their gonads are not surrounded by flesh and bone, but the ovaries are in a very secure place, well protected from radiation damage
You can, depending on the complaint, injury and pain sensitivity portion of the patients. But remember this, the clavicle does not take part in the shoulder joint.
In the days of film and chemistry, I would put axial and lateral both collimated to fit on an 18x24cm. Centring points are useless. Just collimate to the region of interest to cut dose, complication and scatter. For speed and efficiency, I would do standing axial
Thanks for demonstrating how pointless centring points are. Just collimate to the cassette or less. For women like this in the old film and chemistry days we would use a cassette 30x35cm and for wider women 35x35cm. We would never collimate and use a 35x43cm cassette partly due to the dose, but partly due to the cost of film and chemistry
If it is well collimated, don't use centring points. All that is required is to get the symphysis pubis on the bottom of the image and the light from the LBD will allow you to do that.
Don't include the arms in the primary beam. Shrug the shoulders forward to keep scapula off the image, and to prevent geometry issues if the patient leans back as they take in a big breath.
The entire day I was only doing chest x-rays and right as I was about to clock out the doc ordered a shoulder AP and scap Y. The AP turned out great, the Y on the other hand was fail haha
@@getrealhood One thing that helps is to pay attention to how the condyles are on the AP view. Not everyone has the same anatomy. A cross-table with the IP between the knees is a quick and dirty way to get a high chance of nailing it on the first shot but then you are technically exposing both knees. It's hard to feel guilty though when these hospitals give us cheap rooms that have tubes with limited movement. I had an easier time doing lateral knees when I was a mobile tech. With most mobile tubes you have absolute freedom to angle the tube however you want.
Even experienced.. I'm 10 years in and all 10 I have worked alone. My first 3 I did mobile, almost everything was by eye. Every scapular Y was done in a reclining chair. And for some reason it was easy. Now I work in an urgent care. The tube has a more restricted motion. It became very difficult. Some people have very different anatomy, some older people have shoulders nearly in the Y position when they are facing you. Sometimes the patient is large and it is impossible to feel any boney landmark. So we need to brush up occasionally on great videos like this.
Should have also shown how to do the lateral
You have followed 100 year old instructions which ended up including the ankle and lower leg. So that is 50% more radiation dose and scatter. To correct the AP, keep the tube in the same place but angle the tube less because in this situation tube angulation only changes collimation as shown in my xray beam geometry video ruclips.net/video/mZPD_gLs5Dw/видео.htmlsi=vLGXcjRdXvPB5aQ_ Likewise for the oblique. Never include the ankle and lower leg on a foot xray.
Use high kV exposure similar to a chest xray as that will show air and flesh and reduce the contrast of bone.
You say there is no shielding necessary, yet you use shielding on a chest xray and a humerus xray. If you want to be consistent, men have gonads that are not protected by inches of flesh and bone, so are more vulnerable to low energy scatter as you would get from the collimator and tube filtration.
The lateral should have the elbow lateral. This is best achieved PA. Is your xray machine so poorly designed that there is significant radiation outside the primary beam? Have you tested to see how much extra focal and scatter from the collimator and filtration there is? If you test for it more than 6 inches away from the edge of the primary beam, you will find nothing. I can understand that men need more protection as their gonads are not surrounded by flesh and bone, but the ovaries are in a very secure place, well protected from radiation damage
Thank you so much
Garcia Joseph Martinez Matthew Garcia Timothy
H my Names Abdulaahi kaariye REALY IAM VERY SEC AND IFIL PIEN MY LUCK IDIN SLEEP WELL LONG TIME I AN NOT SIT IAN WORK REALY I EED HELPY
Iva Mountain
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Bettie Court
Odie Isle
Please make more videos
Isn't collimation supposed to be open to include entire clavicle on AP??
You can, depending on the complaint, injury and pain sensitivity portion of the patients. But remember this, the clavicle does not take part in the shoulder joint.
Wish it was this easy in the ER 😂. Most of the patients refuse to be sat this upright 😂😅
😊 excelente
In the days of film and chemistry, I would put axial and lateral both collimated to fit on an 18x24cm. Centring points are useless. Just collimate to the region of interest to cut dose, complication and scatter. For speed and efficiency, I would do standing axial
Thanks for demonstrating how pointless centring points are. Just collimate to the cassette or less. For women like this in the old film and chemistry days we would use a cassette 30x35cm and for wider women 35x35cm. We would never collimate and use a 35x43cm cassette partly due to the dose, but partly due to the cost of film and chemistry
im a second year student and i am absolutely terrible at the Y. this video is REALLY helpful.
I'm a tech and I'm still terrible at Ys
👏
❤
It's necessary to provide this video with radiograph for more understanding
You're amazing Thank you❤
You are AMAZING!!
Isnt there 3 views? 30°, 60° and 90°?
Super explain thank you
I did an x-ray of my chest. My eyes remained open during the x-ray. Is there damage to the eyes.... and should we close our eyes during the x-ray?
How do we move there hand in Extreme and painful patients
Rotation should be 30 degrees to bring scapula parallel to the cassette. Anyway good view🙏🙏
You're thinking of the Grashey method.
Do I have to remove clothes for hip x ray ?
They should be gowned, but can keep their underwear on as long as there's no metal.
Nice video.. Well explained
If it is well collimated, don't use centring points. All that is required is to get the symphysis pubis on the bottom of the image and the light from the LBD will allow you to do that.
Tnx
Don't include the arms in the primary beam. Shrug the shoulders forward to keep scapula off the image, and to prevent geometry issues if the patient leans back as they take in a big breath.
Can you just do a frog leg for proximal lateral?
Guys i need anatomy and radiology fb groups .
Guys i need anatomy and radiology fb groups .
any book to help me with positioning?
I'm a new student for x-rays
The entire day I was only doing chest x-rays and right as I was about to clock out the doc ordered a shoulder AP and scap Y. The AP turned out great, the Y on the other hand was fail haha
Ys and lateral knees are the most difficult for me and I've been doing this for 10 years.
@@danielbrownielomg I’m a student and I hate lateral knees. Even the experienced techs say some days are bad lat knee days lol
@@getrealhood One thing that helps is to pay attention to how the condyles are on the AP view. Not everyone has the same anatomy. A cross-table with the IP between the knees is a quick and dirty way to get a high chance of nailing it on the first shot but then you are technically exposing both knees. It's hard to feel guilty though when these hospitals give us cheap rooms that have tubes with limited movement. I had an easier time doing lateral knees when I was a mobile tech. With most mobile tubes you have absolute freedom to angle the tube however you want.
@@getrealhoodim also a student but I've been throwing a 7 degree angle on the tube cephalic on my lateral knees to get those condyles superimposed.
Umm, you clipped half of her clavicle...
Thanxxx big mother
HI, QUICK QUESTION , WHAT IF THE PATIENT IS PREGANANT??? FOR THE PROXIMAL HOW WOULD I SHIELD????? I WOULD NOT XRAY BUT IF SHE FELL???
You shouldn’t be doing anything on a pregnant individual.
How are you, doctor, I am a student of radiology techniques and I want to communicate with you, I am from Iraq, do you have WhatsApp
Exquisite
I wish you would upload more videos in positioning, because you are such an amazing teacher. Thank you.
True
True
Useful
Thank you, this was very helpful
You're really good! Ty!
I'm a Korean radiologist. Your video was very helpful for inexperienced people. Especially it was impressed to tell the location. Thank you.
Btw hi 👋🏻. I'm future radiographer from Malaysia
Even experienced.. I'm 10 years in and all 10 I have worked alone. My first 3 I did mobile, almost everything was by eye. Every scapular Y was done in a reclining chair. And for some reason it was easy. Now I work in an urgent care. The tube has a more restricted motion. It became very difficult. Some people have very different anatomy, some older people have shoulders nearly in the Y position when they are facing you. Sometimes the patient is large and it is impossible to feel any boney landmark. So we need to brush up occasionally on great videos like this.