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CRITIQUE
SUGIYANTO
Terminology
Positioning and anatomical placement terms.
Anterior (antero-) Frequently used combinations
Distal (disto-) – Anteroinferior
Inferior (infero-) – Anterolateral
Lateral (latero-) – Anteromedian
– Anteroposterior
Lateral position
– Anterosuperior
Medial (medio-) – Inferolateral
Oblique position – Inferosuperior
Posterior (postero-) – Lateromedial
Proximal (proximo-) – Mediolateral
Superior (supero-) – Posteroanterior
– Posteroinferior
– Posterolateral
– Posteromedian
– Posterosuperior
– Superoinferior
– superolateral
Terms for body planes
Coronal
Midcoronal
Midsagittal (median)
Sagittal
Longitudinal
Transverse, horizontal, or crosswise.
General terminology
Abduct Condyle
Adduct Convex
Align Cortical outline
Articulation Depress
Artefact Detail
Caudal Deviate
Cephalic Dorsiflex
Concave Elongate
elevate
General terminology
Extension Profile
Flexion Pronate
Foreshorten Protract
Lateral (external) rotation Radiographic image
Magnification Radiolucent
Medial (internal) rotation Radiopaque
Object-image-distance OID. Retract
– This is OFD Source-image-distance
Palpate – This is FFD
Plantar flexion Superimpose
Supination
Symmetrical
Trabecular pattern
Hanging radiographs
Before any critiquing is done the
radiograph should be correctly hung on the
viewing box.
Or displayed correctly on viewing monitor
in a CR department.
Hanging radiographs
Torso, vertebral, cranial, shoulder and hip x-rays.
– As if patient is standing in upright position
Finger, wrist, and forearm x-rays.
– As if patient is hanging from fingertips
Elbow, humerus x-rays.
– As if hanging from shoulder
Toes, AP/Oblique foot x-rays.
– As if patient is hanging from toes
Lateral foot, ankle, lower leg and femur x-rays.
– As if hanging from hip
Decubitus chest and abdominal x-rays.
– As x-ray radiograph was acquired, i.e. if left side up then with left side
up.
Axiolateral positions of the shoulder and hip x-rays.
– Anterior surface up, and posterior surface down.
Hanging radiographs
Anteroposterior(AP), Posteroanterior (PA) and oblique.
– AP/PA projections or oblique should be placed on viewing box
as if patient and radiographer are facing each other.
– Marker should appear in its correct orientation regardless of
projection
Lateral positions of the torso, vertebrae and cranium.
– Marker to be placed on the lateral aspect representing side
closest to film.
Extremities.
– Viewed in the same manner as the photons went through the
region
Radiographic evaluation
The radiographic critique form
Once correctly viewed (hung/displayed). The
radiograph should be assessed for positioning
and technical accuracy
this should follow a consistent method, this will
ensure that all aspects of the radiograph are
evaluated
Identification.
– Facility identification (name of institution)
– Patient ID (Name, DOB)
– Exam ID (date of examination, and time of
examination)
– ID placement (not obscuring and anatomy of interest)
(Mcquillin-Martensen, Radiographic Critique. 1996.)
Radiographic critique form
Radiographic Critique form
Examination…………………………………………………………………………….
ID requirements
………………………………………..…………………………………………………
……………………………………………….…………………………………………
Correct use of markers
…………………………………………………………………………………………
Anatomy of interest on radiograph?
…………………………………………………………………………………………
…………………………………………………………………………………………
Are the anatomical features in the correct alignment for this projection?
…………………………………………………………………………………………
…………………………………………………………………………………………
Is collimation adequate? Keeping ALARA in mind.
…………………………………………………………………………………………
…………………………………………………………………………………………
Radiation protection, present, obscuring anatomy?
…………………………………………………………………………………………
…………………………………………………………………………………………
Bony cortical outline, bony trabecular pattern and or soft tissue structures sharply
defined?
…………………………………………………………………………………………
…………………………………………………………………………………………
Radiograph demonstrated without distortion?
…………………………………………………………………………………………
…………………………………………………………………………………………
Correct film size, correct alignment of anatomical region of interest?
…………………………………………………………………………………………
Correct image receptor utilised?
…………………………………………………………………………………………
Density and penetration adequate?
…………………………………………………………………………………………
adequate contrast?
…………………………………………………………………………………………
Preventable artefacts?
…………………………………………………………………………………………
The desired outcome (i.e. ordered x-ray demonstrates region of interest
diagnostically)?
…………………………………………………………………………………………
Radiograph is:…………………..Acceptable…………………….Unacceptable.