Joined: January 31, 2005
Jeep- The marker has two small metal ball bearings in it. That portion is obscured per Alex's note above. In a weightbearing film (such as AC series, WB series of joints), the ball bearings are at the bottom of their circular container. In a nonweightbearing film, such as these, the bearings will appear in the middle of the container.
Each Xray tech has markers with their initials, a circular area where the bearings are kept, and the letters "R" and "L" on them. They use one of these markers on every film so you know what side is right or left, who shot the film, and if it is weightbearing or not. Hope that helps. J
Joined: February 19, 2004
I still don't see the L1 spinous fx, although I know Alex posted this with some pathology in mind. I'll call 'em as I see 'em, and although there has to be something funky going on somewhere, I just don't see it.
Don't see a compression fx, don't see clinically significant rotation, doggone it I don't see much to speak of at all. I'm looking though. Little hypolordotic lumbar curvature that I'm sure will come back to bite me.
Part of the learning experience is to be honest about what we see/don't see. We're all trying to learn what we can, and I won't make fun of anybody even when I think they're missing something obvious. But Alex, feel free to mock me a little, I'd mock me too.
Joined: March 29, 2003
[QUOTE]The marker has two small metal ball bearings in it. [/QUOTE]That is the marker I was taught to use(without fail), and personally used,(back in the days, when I used to take my own films), on EVERY film I took. Failure to do so was an automatic fail. However, that was in the days of "8 tracks"! I did not see one on the above films. However, in addition to the "right" I am familiar with, and understand, ---"CS" was noted. HMMMM.....I don't remember anything about "CS" in rad/clinic.....back in the "8 track" days" Am I getting "out-digitized"?........or is this some new marking system?.......HMMMMM? CS?...........HMMMM?........"CS?"......Alex said the patient was supine..........HHHMMMM????? CS? *C*orpse *S*upine?...........possible????HHHMMMM?????
Glad to hear that the old marker I was taught to use, and is used by the imaging center I order films from, are not out of date!! Some things are just fundamentally efficient. Now can we talk about those 8 tracks?!!! How about my VCR and cassettes??????? Oh Nevermind!!!LOL
Joined: February 7, 2006
JEEP thats because we all knew, (its a conspiracy) he he
I couldnt see the Fxr itself due to image quality(I said possibly a fxr)due to 1. the mech of injury 2. the way the upper dorsal really anterior tilts. almost as if its a flexion film, a compression frx would fit at that level. If it did evidence it self on plain film I would follow up with a lower dorsal scan to see if its active.
on the A-P the left illia is slightly larger than the right (if obtorators were shown you could really see the rotation) and the sacral apex is cocked over to the right, the vertebra are levorotated with a lumbar convexity to the left. This I deduced was caused by a slight pelvic torsion witht the left superior Illia being anterior. This could also cause the pelvic unleveling (not necessarily a short leg, need a tape measure to determine that) If this is true then the pt might have a left piriformis and quadratus tighter than the right in order to compensate. They might also present with a lateral foot flare on the left (D/T tight piriformis)
I would try and coordinate all the "possible" infor off the film with the physical pres.
Joined: December 22, 2003
[QUOTE] on the A-P the left illia is slightly larger than the right (if obtorators were shown you could really see the rotation) and the sacral apex is cocked over to the right, the vertebra are levorotated with a lumbar convexity to the left. This I deduced was caused by a slight pelvic torsion witht the left superior Illia being anterior. This could also cause the pelvic unleveling (not necessarily a short leg, need a tape measure to determine that) If this is true then the pt might have a left piriformis and quadratus tighter than the right in order to compensate. They might also present with a lateral foot flare on the left (D/T tight piriformis) [/QUOTE]Or.....drumroll please...........it could be that......
The patient was not lying on their back in a perfectly symmetrical fashion
Joined: March 1, 2004
The purpose of the history of this study was to draw your attention away from the small round densities in the lower pelvis. There is no fracture in this study.
Radiology report reads:
Lumbar spine [ 3] views:
There is no lytic or sclerotic lesion, with mild limitation in evaluation by overlying bowel gas. There is no significant disk space narrowing,with no significant degenerative changes. No fracture or subluxation observed. Small densities, most likely phleboliths, are visualized in lower pelvis. Recommend to correlate these findings clinically.
IMPRESSION: Normal lumbar spine [IMG][/IMG]
So the question is, what are phleboliths and should we be concerned? As a PT would you refer back to the physician? Is this worth a call to the referring physician?
< Message edited by David Adamczyk -- July 13, 2007 1:54:46 AM >
Joined: May 9, 2004
From: West Palm Beach
**** i got one right! it must be tha radiology course my DPT program made me take, just call me Pablo from now on! These little suckers are not emergencies. If your systemic review showed reason to think that there is some bloackage or that they may be kidney stones, which ours does, I would refer back to the doc and let them know these pains may be from the presence of these little suckers and may need a CT scan to further rule out. I do not think it is any medical emergency warranting immediate referral etc, but it should be referred back since this new onset off flank pain may be related. Thanks Alex for the case- Ben