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Naval Medical Center Portsmouth, VA 
620 John Paul Jones Circle
Portsmouth, VA 23708-2197
Phone: 757-953-5000; DSN: 377-5000

Radiology

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Naval Medical Center Portsmouth
  

Routine Radiographs

ROUTINE X-RAY STUDIES
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ABDOMEN, LT LAT DECUBITIS


   Patient lies on x-ray table on their left side, right side up, x-ray parallel to the table top.

        Indication:

           * Evaluate for free peritoneal air 

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ABDOMEN, SUPINE


   This view is also know as "KUB" which refers to "Kidneys, Ureters, Bladder."  This is a  limited exam because of the limited density difference of the various abdominal organs.

        Indication:

           * Primary indication is to evaluate for free air, gut distention and urinary track stones

           * Gut obstruction vs ileus

           * Kidney and urinary track stones

          * Free air from any cause

           * May be of value in identifying aortic aneurysm, if the aorta is calcified

           * Otherwise this is a limited study.  Usually ultrasound or CT is indicated for evaluation of specific abdominal organs.  

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ABDOMEN, UPRIGHT


   AP view of the abdomen with the patient in an upright position.
 
       Indication:

           * Air/fluid levels in the gut
          
           * Check for free air beneath the diaphragm

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ANKLE


   AP and lateral views of the ankle

        Indication:

           * Trauma, fracture, dislocation
          
           * Arthritis
          
           * Soft tissue injury of foreign body

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ARM


   AP and LAT view of the humerus.

        Indication:

           * Limited, mainly trauma for fracture
          
           * Bone tumor or metastasis

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CHEST, CXR (PA & LA, PA, AP, PORTABLE)


   Usually a PA projection, AP in the case of portables, include the entire chest and  diaphragms.  May include a LAT projection.

        Indication:

           * Primarily for lung disease such as: pneumonia, CHF, chronic disease of the lung, atelectasis, effusion, pneumothorax

           * Limited evaluation of the heart and mediastinum for:  cardiomegaly, pericardial effusion, aorta (trauma), adenopathy

           * Very limited evaluation of the skelton of the chest

          * Probably the single most over ordered test in radiology, CXR is very limited in directing patient management, however is very useful in confirming pneumonia, CHF, pleural effusion and pneumothorax.

           * Portable CXR are very helpful in management of ICU patients, mainly in determining proper position of arterial lines, ET tubes, NG tubes and chest drainage tubes, otherwise portable CXR's provide limited information.

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FACIAL SERIES


   Three views of the face consisting of: AP, Lateral and Angled view.

        Indication:

           * Trauma, fracture, and soft tissue
          
           * Bony deformities
          
           * Tumor

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FEMUR


   AP and LAT views of the femur.  Limited application.

        Indication:

           * Trauma
          
           * Bone tumor or metastasis

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FOOT


   Three views of the foot consisting of: AP, Lateral and Oblique views.

        Indication:

           * Trauma
          
           * Foreign body
          
           * Arthritis

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FOREARM


   AP and LAT views of the radius and ulna.

        Indication:

           * Trauma
          
           * Soft tissue foreign body

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HAND


   AP, LAT and Oblique views.  Limited application.

        Indication:


           * Trauma
          
           * Arthritis
          
           * Soft tissue tumor
          
           * Foreign Body

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HIP


   AP and LAT views of the hip.

        Indication:

           * Trauma, fracture, dislocation
          
           * Arthritis
          
           * Congenital dysplasis

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LUMBAR SPINE


   AP, LAT and Bilateral Oblique complete series views. 

        Indication:

           * Trauma, fracture, subluxation, compression
          
           * Degenerative disk changes
          
           * Arthritis
          
           * Congenital defects, spondylolysis

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MASTOID SERIES


   Three or four views of the mastoid bone, all somewhat angled.

        Indication:

           * Trauma
          
           * Mastoiditis
          
           * Tumor

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PELVIS


   AP and LAT views. 

        Indication:

           * Trauma
          
           * Bone tumor
          
           * Correlation with Bone Scan for evaluation of metastasis
          
           * Congenital defects

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RIBS


   Three views at different angles to demonstrate all the ribs.

        Indication:

           * Trauma, limited as many fractures may not be evident
          
           * Bone tumor
          
           * Correlation with Bone Scan for evaluation of metastasis

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SHOULDER


   AP and LAT views of the shoulder.

        Indication:

           * Trauma, fracture, dislocation
          
           * Arthritis

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SINUS


   Routine sinus studies consist of 4 views: AP, Waters, Lateral and SMV (feet-to-hand  view).  Good bone detail, sinus fluid and soft tissue masses within the sinuses.

        Indication:

           * Primarily used to evaluate for acute or chronic sinusitis, however limited CT studies of the sinus is better and more cost effective.
             
           * May be helpful with trauma, however, a standard facial series is probably  adequate.
             
           * Any detailed evaluation requires CT scan.

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SKULL


   There are many different x-ray views of the skull.  The most common routine skull  exam includes:  AP, Lateral and AP angled toward the occiput.   This exam is limited  to evaluation of the bone, some soft tissue, fluid in spaces normally occupied by air  and intracranial air.

        Indication:

           * Routine skull series is primarily indicated in the evaluation of trauma.

           * In pediatrics, used to evaluate congenital anomalies, head size and cranial  synostosis.
             
           * Correlation with bone scans for metastatic disease and evaluation of multiple  myeloma.

          * Further evaluation of the head/skull should be performed by CT scanning.

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TEMPORAL BONES


   AP and LAT views of the shoulder.

        Indication:

           * Trauma, fracture, dislocation
          
           * Arthritis

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THORACIC SPINE


   AP and LAT views of the thoracic spine. 

        Indication:

           * Trauma, fracture, compression, subluxation
          
           * Infection
          
           * Metastasis
          
           * Arthritis
            
           * Tumor

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TIB/FIB


   AP and LAT views of the tibia and fibula. 

        Indication:

           * Trauma, fracture, dislocation
          
           * Soft tissue mass or foreign body

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WRIST


   AP and LAT views of the wrist. 

        Indication:

           * Trauma, fracture, dislocation
          
           * Arthritis
          
           * Soft tissue mass or foreign body

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