RADIOGRAPHY RADIOGRAPHY RADIOLOGY PROCEDURESRADIOLOGY PROCEDURES

ByByMasood AhmedMasood Ahmed

Radiographer Aga Radiographer Aga Khan University Khan University Hospital KarachiHospital Karachi

General X-Ray UnitGeneral X-Ray Unit

X-RAY HANDX-RAY HAND

OA changesOA changes FractureFracture Dislocation Dislocation Foreign bodyForeign body

X-RAY WRISTX-RAY WRIST

OA changesOA changes FractureFracture Dislocation Dislocation Foreign bodyForeign body

X-RAY ELBOWX-RAY ELBOW

OA changesOA changes FractureFracture Dislocation Dislocation Foreign bodyForeign body

X-RAY SHOULDERX-RAY SHOULDER

OA changesOA changes FractureFracture Dislocation Dislocation Foreign bodyForeign body SublexationSublexation Frozen Frozen

shouldershoulder

X-RAY FOOTX-RAY FOOT

OA OA changeschanges

FractureFractureDislocation Dislocation Foreign Foreign bodybody

X-RAY KNEEX-RAY KNEE

OA changesOA changes FractureFracture Dislocation Dislocation Foreign Foreign

bodybody

X-RAY HIP JOINTX-RAY HIP JOINT

OA changesOA changes FractureFracture Dislocation Dislocation Foreign bodyForeign body

CHEST PA ViewCHEST PA View•Lung pathology

•Tuberculosis

•Plural effusion

•Pneumothorax

•Pneumonia

•Foreign body

•Ribs fracture

PA Erect T.BPA Erect T.B

Lateral ChestLateral Chest

Collimation top to Collimation top to bottom: bottom: slightly less slightly less than film size.than film size.

Collimation side to Collimation side to side: side: skin of chestskin of chest

Breathing Breathing instructions: instructions: “Take “Take a deep breathe and a deep breathe and hold it.” Inspirationhold it.” Inspiration

Make exposure and Make exposure and have patient have patient breathe and relax.breathe and relax.

Lateral Chest FilmLateral Chest Film

Should see apical Should see apical area of chest.area of chest.

Respiratory effort Respiratory effort down to tenth ribs.down to tenth ribs.

No rotation: ribs No rotation: ribs superimposed.superimposed.

Evidence of Evidence of collimationcollimation

Trauma Patient (Lateral shoot Trauma Patient (Lateral shoot through)through)

ABDOMEN SUPINEABDOMEN SUPINE•Kidney stone (KUB)

•Foreign body

•Fetus

•Abdomen distention

•Air under diaphragm

•Abdominal perforation

ABDOMEN ERECTABDOMEN ERECT

X-Ray ABDOMEN for FETUSX-Ray ABDOMEN for FETUS

SPINESPINE

Fracture Fracture Dislocation Dislocation Arthrosclerosis Arthrosclerosis OA changesOA changes Muscles spasmMuscles spasm

ABDOMEN DECUBITUSABDOMEN DECUBITUS

Surgical C-ArmSurgical C-Arm

Treatment, Garden I-II: Treatment, Garden I-II: PinsPins

Treatment, Garden III-IV: Treatment, Garden III-IV: HemiarthroplastyHemiarthroplasty

Treatment: Treatment: Dynamic Dynamic

Compression Compression ScrewScrew

Conventional TomographyConventional Tomography

SKULL (PA 15`Degree)SKULL (PA 15`Degree)

SKULL (AP view)SKULL (AP view)

SKULL (Lateral View)SKULL (Lateral View)

SKULL (Lateral dorsal SKULL (Lateral dorsal decubitus View)decubitus View)

Barium SwallowBarium Swallow

Barium Barium EnemaEnema

Barium Barium MealMeal

Barium small bowel EnemaBarium small bowel Enema

Barium Meal Follow ThroughBarium Meal Follow Through

FLUOROSCOPY UNITFLUOROSCOPY UNIT

Barium SwallowBarium Swallow INDICATIONSINDICATIONS Difficulty in swallowing (dysphagia, Esophagitis), Difficulty in swallowing (dysphagia, Esophagitis), Heartburn (dyspepsia), Heartburn (dyspepsia), Pain on swallowing (odynophagia),Pain on swallowing (odynophagia), CONTRAINDICATIONSCONTRAINDICATIONS Esophageal perforationEsophageal perforation Aspiration in to the bronchial tree.Aspiration in to the bronchial tree. Surgical point of view (esophagactomy)Surgical point of view (esophagactomy)

Barium MealBarium Meal

•INDICATIONS•Dyspepsia•Unexplained weight loss•Upper GI bleed•Palpable mass in upper abdomen•Anemia•CONTRAINDICATIONS•Complete Large Bowel Obstruction•Suspected Perforation of Upper GI Tract

SMALL BOWEL FOLLOW THROUGH

•INDICATIONS•PAIN•ABDOMINAL MASS•ANEMIA•Upper GI BLEED•PARTIAL OBSTRUCTION•CONTRAINDICATIONS•COMPLETE BOWEL OBSTRUCTION•SUSPECTED PERFORATION

Small Bowel EnemaSmall Bowel Enema •INDICATIONS•Pain•Diarrhea•Bleeding•Partial obstruction•Anemia•Abdominal mass•CONTRAINDICATIONS•COMPLETE BOWEL OBSTRUCTION•SUSPECTED PERFORATION

Small Bowel EnemaSmall Bowel Enema

•INDICATIONS•Change in bowel habit•Pain•Mass•Anemia•Constipation •CONTRAINDICATIONS•Pseudo membranous colitis•Rectal biopsy with in 48 – 72 hours•Recent barium meal, it is advise to wait for 7-10 days

DOUBLE CONTRAST BARIUM ENEMA

AREA COVERED IN THIS PROCEDURE

25 y male, prior jejunal resection and 25 y male, prior jejunal resection and abdominal pain, constipationabdominal pain, constipation

ERCP (Endoscopic Retrograde ERCP (Endoscopic Retrograde CholangiopancreatographyCholangiopancreatography

CT ScannerCT Scanner

Radiology ModalitiesRadiology Modalities

Computed TomographyComputed Tomography AttenuationAttenuation DensityDensity EnhancementEnhancement

Hounsfield UnitsHounsfield Units -1000 air ***-1000 air *** -100 fat-100 fat 0 water ***0 water *** 20-80 soft tissues20-80 soft tissues 100’s 100’s

bone/Ca/contrastbone/Ca/contrast >1000’s metal>1000’s metal

Large radiation doseLarge radiation dose

Gama Camera for Nuclear Gama Camera for Nuclear MedicineMedicine

Radiology ModalitiesRadiology Modalities Nuclear MedicineNuclear Medicine

Counts or ActivityCounts or Activity

Physiologic imagingPhysiologic imaging RadionuclideRadionuclide

TechnetiumTechnetium RadiopharmaceuticalsRadiopharmaceuticals

““Choletec”Choletec” Radioactivity stays Radioactivity stays

with the patient until with the patient until cleared or decayedcleared or decayed

Bone Minerals DensityBone Minerals DensityDual Energy X-Ray Absorbimetry Scanner, commonly known as a DEXA

Ultrasound Ultrasound EquipmentEquipment

Radiology ModalitiesRadiology Modalities UltrasoundUltrasound

EchogenicityEchogenicity ShadowingShadowing Doppler for flowDoppler for flow

No radiationNo radiation Can be portableCan be portable Relatively Relatively

inexpensiveinexpensive

MRI EquipmentMRI Equipment

Radiology ModalitiesRadiology Modalities MRIMRI

Signal intensitySignal intensity T1T1 T2T2 EnhancementEnhancement

No radiationNo radiation Strong magnetic fieldStrong magnetic field

No pacemakersNo pacemakers No electronic implantsNo electronic implants

Small, loud tube and Small, loud tube and patients must be able patients must be able to hold stillto hold still

Relatively expensiveRelatively expensive

Vesicular Intervention Vesicular Intervention RadiologyRadiology

VIRVIR

OPG / CEPHELOMETERYOPG / CEPHELOMETERY

Don’t forget to use the radiation Don’t forget to use the radiation shielding devicesshielding devices

THANKS FOR THANKS FOR YOUR ATTENTIONYOUR ATTENTION