SYED MUHAMMAD RAZA
SYED MUHAMMAD RAZA
syedmuhammadraza65@[Link]
Pir Mehr Ali Shah - Arid Agriculture University
Rawalpindi (PMAS-AAUR)
RESTRAINTS
MANUAL MECHANICAL CHEMICAL
Tech or Vet hands Foam wedges, V/ U troughs Tranquilizers
Sandbags, Wooden spoons
Tape & Gauzes
Radiation safety: Time, distance, and shielding. Short time, distance from the x-ray source and patients, and
shielding by using the proper gloves, thyroid protectors, and aprons. (Bucky tray & collimation). Air blocks alpha,
plastic stops beta radiations.
Maximum permissible dose: expressed in silvert units (SV). 0.05 SV/ Year. (5rems= 0.05 SV)
ALAR stands for as low as reasonably achievable & refers to the level of occupational radiation exposure.
As the minimum radiography, all led protective devices once a year (annually) to look for any breaks in the lead
protection or any areas of wear that would minimize the efficiency. Gowns should never be folded as this can
crack lead protection. They may be rolled for transport. Gowns should be hung between uses and gloves should
be stored open so that the lead does not become cracked ( plus this helps minimize smell in the gloves
Focal film distance (FFD) is the distance between the tungsten
target & surface of the x-ray detector.
FFD influence many factors
• x-ray beam intensity
• image details
Radiographs are the part of patient’s medical record and
belongs to the practice. They mist be kept for a special period
of time.
The absorbed dose of ionizing radiation by a unit mass of
irradiated material is measured in GRAY (Gy)
Key components of x-ray exposure include focal-film distance, Milliampere-seconds, and kilovoltage. X-ray films
should be stored at a vertical position, in a cold room with low humidity.
Radiographic density from the least dense to most dense: air, fat, water, bone, and metal.
An increase in distance between the film and x-ray source decreases the x-ray intensity by a factor of four.
Milliampere-seconds: Milliampere multiplied by the time. Example: 300milliamperes for 1/20th of second.
Milliampere-seconds equal: 300 * (1/20) = 15mAs
Kilovoltage (kV): has the greatest influence on radiographic contrast. Controls the penetrability of the x-ray.
(HIGHER the kVp --- LOWER the contrast)
Overexposed radiograph (very dark): occur if milliampere-seconds (mAs) or kilovoltage (kV) are set to high or if
the speed of an intensifying screen is too fast. (Also, by incorrect measurement of body part thickness or too
short a focal distance from x-ray tube to the patient.)
overexposed radiography, it has too much exposure to the x-ray, and it will be darker. The patient body stops
some x-rays from penetrating all the way to the x-ray film which lies under the patient, then the underlying film
will be whiter paler lighter. when there is nobody, radiography will be darker or blocked because x-ray
penetrates and expose film without any tissue to stop them.
Underexposed radiograph (very light): long distance between the x-ray tube to the patients, low mAs, or low
kV. Soft Tissue x-ray: lower kVp and higher mAs setting. That is due to the relatively low contrast between viscera
and adipose tissue.
Thorax x-ray: high kVp
Bone x-ray: lower kVp and higher mAs setting.
Blurring: might be caused by poor film-screen contact, patient movement or poor centering of the primary x-
ray beam. To minimize blurring use high mAs and low time.
Distortion: if the distance between the object and the film is increased
Magnification: if the distance between the x-ray source and the film is increased.
Black Spots: appear if the developer solution falls on an undeveloped x-ray film.
White Spots: appear on developed film from defective cassette screens and the presence of dust or grit on the
film surface.
Grey Films: too much scatter or if the light is turned on while undeveloped films are out.
Yellow film: if the fixation is too short or if the fixer solution is exhausted.
Tree pattern (linear dots): caused by static electricity production due to low humidity.
Radiographic Landmarks: of the left side include gas bubbles in the stomach fundus, caudal kidney, descending
colon, and the apex of the heart.
Anticlinal vertebra: anatomical landmark usually at T11 in dogs where the spinous process is upright or vertical.
It is the vertebra where the incline of the spinous process changes from caudal to cranial pointing.
Hair clip: this should be done to decrease ultrasound reflection because hair traps air.
Fluoroscopy: use to evaluate dynamic processes and moving structures, such as regurgitation, tracheal collapse,
esophageal motility, myelography, CVS studies, fracture reductions, catheter/stent placement.
Screen films are not very sensitive to x-rays (but are sensitive to visible light) and require SHORT exposure time
than non-screening films.
Non-screen films require LONG exposure times and produce radiographs with superb detail being great for
dental studies. They are sensitive to X-rays!
Digital radiography (DR): systems are divided into direct and indirect systems. Direct DR has no light
intermediate and x-rays are directly converted. Indirect DR, the X-ray results in a light flash from a scintillation
plate that is then registered into an electrical signal.
Developing order: developing solution, rinse baths, fixer, and wash bath.
Developing solution: converts silver halide crystals exposed to x-rays in the film to black metallic silver.
First, wash bath: Stop the film developing process
Second wash bath: prevent contamination of the fixer.
Fixer solution: removes and cleans away the unexposed silver crystals and hardens the film. The film should
soak in the fixer bath for twice as long as it was in the developer.
Wash bath: removes processing chemicals from the film and prevents film discoloration.
Potter Bucky Grid: diaphragm is a moveable x-ray grid. When using it increase the kVp by 20% or increase
exposure by a factor of 4.
Grid: like the focusing in a camera. A high-ratio grid permits fewer x-rays to pass through it from the animal and
fewer x-rays reach the film needing longer exposure time, but you get a better (high resolution) radiograph.
Should always be used in thicker tissue (>10cm thick).
Collimator: beam-restricting device that decreases the production of scatter radiation. It improves safety and
image quality.
Low voltage electrical circuits: provide the electricity needed to heat the filament.
Glass and aluminum filters: removes less-energetic x-ray from primary beam
Intensifying screen: decrease the amount of radiation needed for a diagnostic radiograph.
Stationary anodes are used for dental units. They have smaller capacity for x-ray production as compared to
rotating anodes so not useful for large body parts.
MYELOGRAPHY: It is used to diagnose the spine and spinal cord.
MAGNETIC RESONANCE IMAGING(MRI): Preferred imaging modify for the brain to the spinal cord. With MRI a
radiography pulse disrupts hydrogen nuclei within tissues. The intensity of radio waves signal produced from
this disruption creates the image. MRI requires no ionizing radiation to create an image. Also, MRI provides
superior image resolution and anatomic definition compared to CT. Also, MRI provides superior image resolution
and anatomic definition compared to CT. Like COMPUTED TOMOGRAPHY (CT), MRI provides a cross-sectional
image of the patient's anatomy.
CT : X-ray beam passes transaxially through a small segment of patient; an image is created by measuring x-ray
attenuation (drop off) at sequential sites b. compare construct data and show image.
It is best for imaging the internal architecture of the nasal cavity. It is also useful for the throat, abdomen,
vasculature and musculoskeletal system.
DIGITAL RADIOGRAPHY: A specialized detector panel converts x-ray into electrical signals; an analog image is
created which is digitalized. image display on a computer screen can be enhanced with magnification rotation
and adjustment in brightness contrast and zoom.
Computed radiography uses a photostimulable storage phosphor (not the film) in a protective cassette that is
then electronically read.
Digital imaging & communication in medicine (DICOM) is a universal digital image that allows sharing of
electronic images with hospitals, specialists. (teleradiography)
Digital images are stored on a remote HARD DRIVE called PICTURE ARCHIVAL COMPUTING SYSTEM.
Nuclear Medicine: Technetium 99 (radionuclide) is administered to a patient; photon emission is defected and
recorded with a gamma scintillation camera. Used to detect tumor metastasis of bones so-called Bone scan. It
is useful to locate bone lesions, pulmonary emboli, thyroid evaluation, kidney & lung function.
Focused assessment with sonography for trauma (FAST): Dx thoracic trauma in dogs & cats.
ULTRASONOGRAPHY: The transducer emits a short pulse of sound into the patient. when this wave hits the
echogenic structure, some of the waves are reflected back to the transducer and create the image. strength of
sound reflected determines the brightness.
Doppler ultrasounds are used to visualize moving [Link] can be used to determine cardiac outflow or
regurgitation, presence or absence of vascular thrombi, and detection of portal vascular anomalies. Doppler
emits ultrasonic waves from a piezoelectric crystal in the probe and is placed over the peripheral artery.
Ultrasound mode: A mode is for one-dimensional display and shows in echoes as spikes on-screen (amplitude
mode). B mode brightness mode or 2-dimensional imaging. M mode ultrasonography the motion of the organs
is displayed as a wave line across the screen is used for echocardiography.
Linear array ultrasound probe for rectal palpation. & Sector array
Anechoic or sonolucent: structures that produce few or no echoes. Both are dark on ultrasound.
Echogenic or sonodense: structures produce strong echoes, so these are bright on the ultrasonic image.
Hyperechoic: the structure that produces more echoes than nearby structures.
Hypoechoic: structure that produce fewer echoes than nearby structures.
Through transmission (Acoustic enhancement): when the ultrasound hits non-attenuating structures. Usually
happens in the gallbladder.
Reverberation artifact (Comet tail): occurs when ultrasound meets strong reflector like gas, usually in lungs or
bone. Shadowing: occurs when ultrasound hits highly reflective structures like uroliths.
Radiolucent: means clear and appears black in the radiograph. Air is radiolucent.
Radiopaque positive contrast media: Barium and iodine. Appear white in the radiograph.
CONTRAST MEDIA
Soluble ionic organic iodides soluble nonionic Insoluble inert Radiolucent gases
radiopaque radiopaque
Examples iothalamate, diatrizoate lohexol, iotolan, barium sulfate nitrous oxide, air, and
and iopamidol carbon dioxide
USES • gastrointestinal Myelograms Gastrointestinal • cystograms
studies Blood vessels motility studies. • Gastrograms.
• intravascularly Fistulography
• in joints, the Salivary ducts
• urinary tract Urinary tract
• abdomen
• wounds
• salivary ducts.
Not used intrathecally for myelography. Can cause aspiration
pneumonia
Bronchial pattern: irregularly thickened walls of bronchioles that look like donuts. End-on bronchioles are
normal in the hilar region unless there is an abnormal thickening of bronchiole walls.
Interstitial pattern: decreased visualization of pulmonary vessels, cardiac and diaphragm silhouettes.
Alveolar pattern: air bronchograms.
Vascular pattern: this can suggest either hypervascularity or hypervascularity.
Hypovolemia: the heart is small and lifted off the sternum. The pulmonary vasculature, as well as the aorta and
caudal vena cava, may also be reduced in size. The lungs will also appear darker.
Pneumothorax: notice dark airspace below the lungs, between them and the chest wall. The heart is not
touching the sternum. Decreased to absent lung sounds are also characteristic. Aspiration pneumonia:
radiographic changes in dependent lung fields (cranio-ventral).
Heartworm: Radiographically, look for right ventricular enlargement and bulging of the main pulmonary artery.
The pulmonary knob sign in the VD view is present in 60-70% of cases. A severe case may exhibit the “reverse
D” signs on the VD view.
Peritoneal effusion: distended abdomen with poor peritoneal detail throughout the abdomen.
Foreign body: multiple loops of enlarged small intestine associated with loops filled with gas and fluid.
Linear foreign body: plicated loops of bowels with eccentric comma-shaped gas bubbles.
Ringbone: is exostosis (bone growth) in the pastern or coffin joint of a horse, associated with periostitis and
osteoarthritis. High ringbone occurs on the lower part of the large pastern bone or the upper part of the small
pastern bone. The low ringbone occurs on the lower part of the small pastern bone or the upper part of the
coffin bone. Low ringbone is harder to see as it occurs in the hoof of the horse.
Wobbler syndrome/ cervical vertebral instability/ caudal cervical spondylomyelopaty
Cervical vertebral canal stenosis (congenital). Dx by myelography.
Cortical Stress Fracture: Common in young racing horses. Treatment is screw fixation (+/- osteostixis).
Hemivertebra: a wedge-shaped vertebra, which can be an asymptomatic finding or may present with scoliosis,
kyphosis, paresis, and ataxia. Typically, thoracic.
Avascular/Aseptic necrosis of the femoral head (Legg Perthes):
Salter-Harris: fractures involving the physis (growth plate).
S I Straight Fracture straight across cartilage of physis. Also known as capital physeal fracture.
A II Above Fracture above physis
L III Lower Fracture below physis in the epiphysis
T IV Through Fracture through metaphysis, physis and epiphysis
R V Rammed Crushed physis
Planking artifact: overexposure or plate saturation results in linear striations in the background of the image.
Uberschwinger artifact results in a lucent halo around metal implants. This can be mistaken for bone lysis around
metal implants.
Severe underexposure results in grainy appearance also called “noise” or “quantum mottle”.
Improper use of heel effect will result in the non-uniform appearance of the image. Heel effect occurs when the
x-ray beam is more intense at cathode than anode side, resulting in uneven x-ray photo distribution.
Overexposure causes the disappearance of soft tissues surrounding bones.
Foreshortening artifacts: structures being radiographed is not in contact with table causing structures to appear
shorten than actual size.
Elongation artifacts occur when the beam is not centered.
Gridlines occur if the lead strip in the grid is too thick.
Ghost image occurs while taking the 2nd radiograph after 1st that required high exposure.
RADIOGRAPHIC POSITIONINGS
Shoulder joint To allow its full visualization, the top leg needs to be rotated out of the field of view so
that it is not superimposed over the area of interest. The affected leg is down closest to
the tabletop.
Chest Foreleg elbows can be superimposed over the lateral views of the heart, extend the
foreleg forward to allow better chest visualization.
Lateral spinal film It is important to remove all rotation of the chest wall, either by use of positioning aids.
Long bones Also, include joints proximal and distal to the bone of interest.
The tabletop technique can be used for limbs in small animals because they tend to be
less than 10 cm thick.
Cat Thoracic Caudal to border of scapula
radiograph Center beam at 5th & 6th rib
The caudal border of the film should be the L1 vertebral body.
Lateral pelvic Measure (midline over acetabulum)
radiograph Center beam (caudal portion of pubis)
Heart DV & R-Lateral
DV place heart closet to film
Small animals R-Lateral is preferred.
Metastasis 3 views.
R-LATERAL, L-LATERAL, VS/DV
Pleural effusion VD is best
PE obscures the heart completely on a DV radiograph and at least partially on a lateral.
VD positioning usually moves the pleural fluid away from the heart and allows a
radiographic vie of the heart.
If animal is dyspneic do not prefer VD.
