7 Top Tips for taking radiographs in suspected cruciate patients!
We thought it might be useful to help avoid some of the common pitfalls involved in taking pre-operative radiographs for orthopaedic patients that you may wish to refer.
Whilst it is true that on many occasions surgeons will repeat radiographs, to aid pre-operative planning, this does not always need to be necessary if ideal views have been obtained.
This can potentially save the clients costs and the patent an additional anaesthetic to acquire the relevant or missing views.
If you suspect a cruciate surgery may be needed below are top tips to get the most out of your radiographs.
Take your time, it sounds obvious but planning good quality radiographs with a patient safety sedated or anesthetised is always best!
Take views of the affected limb and the contralateral limb for comparative purposes.
Take at least 2 views of the area of interest (orthogonal views of the stifle would include a mediolateral and a craniocaudal).
For advancement cruciate surgery such as TTA (Tibial Tuberosity Advancement) the lateral view should ideally be with the stifle at 135-degree angle. It helps to keep a goniometer near your radiographic area. For procedures such as a CWO (Closing Wedge Osteotomy), the lateral view should have a stifle angle of 90 degrees (see photos below). This helps the surgeon to calculate the tibial plateau angle (TPA) accurately to enable the size of the wedge or the size of the advancement that is needed to be removed.
Avoid rotation. Look to see if the condyles are superimposed. Placing a small hock wedge is ideal to achieve this. See photos below.
Include the central point of the tarsal joint in the radiograph! To do this you would centre approximately over the proximal third of the tibia in this instance. This enables a parallel line of the tibial shaft to be drawn, part of the pre-planning process in calculating TPA.
Please submit all radiographs with any orthopaedic enquiry. Preferably the original JPEGS or DICOMS as opposed to photographs of the views on your viewing platform if possible.
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