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Rad Pro Ch 19

Special Procuders

QuestionAnswer
Arthrography Contrast media study of synovial joints and related soft tissue structures.
Venipuncture The percutaneous puncture of a vein for withdrawal of blood or injection of a solution such as contrast media for urographic procedures.
Knee Arthrography: - Tears in joint capsule. - Tears or degeneration of menisci. - Ligament injury.
An example of non traumatic pathologic process for arthrography is indicated is _____________. Baker cyst.
Arthrography Needle Placement and Injection 1. Site prepared. 2. Retropatellar, lateral, anterior, or medial approach. 3. Skin anesthetized. 4. Fluid aspirated.
Arthrography Needle Placement and Injection: 5. Contrast media instilled (5 mL of positive and 80-100 mL of negative CO2, or air). 6. Needle removed and knee wrapped. 7. Knee exercised.
Arthrography—Fluoro Imaging: - Lead gloves should be worn. - Protective apron. - Closely collimated views of each meniscus. - 20° rotation of knee between each exposure.
Shoulder Arthrography - Demonstrates soft tissue structures. - Single-contrast procedure: 10-12 mL of positive contrast media.
Shoulder Arthrography: - Dual-contrast procedure: 3-4 mL of positive contrast media and 10-12 mL of negative contrast media (i.e., room air). - Fluoroscopy guidance for needle placement.
Routine Shoulder Arthrography: - Scout AP projection. - Internal and external rotation. - Glenoid fossa (AP oblique). - Transaxillary OR Intertubercular groove (Fisk modification).
Postoperative (T-Tube or Delayed) Cholangiography: - Performed in radiology department. - T-tube that is placed in common bile duct during surgery and extending outside body clamped off. - Contrast media injected into T-tube catheter.
ERCP (Endoscopic Retrograde Cholangiopancreatography): Procedure: endoscopic inspection, cannulation, and injection of the biliary ducts with the use of a duodenoscope.
Clinical Indications—ERCP: - Patency (openness) of biliary/pancreatic ducts. - Undetected choleliths. - Small lesions or strictures within the biliary/pancreatic ducts.
Hysterosalpingography (HSG): - Infertility assessment. - Demonstration of intrauterine pathology. - Evaluation of uterine tube following tubal ligation or reconstructive surgery. - May serve as a therapeutic procedure.
Hysterosalpingography Positioning Routine: - AP scout. - AP post injection. - LPO and/or RPO.
Myelography Radiographic study of spinal cord and its nerve root branches that uses a contrast medium.
Clinical Indications for Myelography: - HNP. - Tumors. - Cysts. - Trauma (bony fragments).
Blood in the cerebrospinal fluid (CSF) The presence of blood in the CSF indicated probable irritation within the spinal canal which can be aggravated by the contrast medium.
Arachnoiditis Inflammation of the arachnoid membrane.
Increased Intracranial Pressure Tapping of the subarachnoid space with needle insertion may cause severe complications to the patient as the pressure equalizes b/w the areas of the brain and spinal cord.
Recent Lumbar Puncture (within two weeks of the procedure) May result in extravasation of the contrast medium outside the subarachnoid space through the hole left by the previous puncture.
Patient and Room Preparation: Myelogram - Pre-medication. - Informed consent. - R/F room. - 90°/15° tilting table. - Shoulder brace. - Ankle restraints (footboard).
Myelogram: Needle placement and injection process - Skin prep. - Lumbar puncture. - Prone or left lateral position. - CSF sample collected. - Contrast medium instilled. - Needle removed.
Myelogram: Cisternal puncture: - Erect. - C1-C2 level.
Myelogram Contrast media: - Nonionic preferred. - Water-soluble iodine based vs. oil based. - 1 hour radiopacity. - Excreted by kidneys.
AP Shoulder Measurement - CR to shoulder joint . - Arm extended, hand supinated.
AP Elbow Measurement - CR to mid-elbow joint. - Move IR to center elbow joint.
AP Wrist Measurement - CR to mid-wrist - Move IR to center wrist to lower third of IR
AP Hip measurement - Ruler beside limb. - No movement of ruler or limb. - CR to head of femu.
AP Knee Measurement - No CR angle, CR to knee joint. - Move IR to center knee.
AP Ankle Measurement -CR to ankle joint.
Created by: sassyrad
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