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Comprehensive Overview of Sacrum and Coccyx Imaging Techniques and Myelogram Procedures

This chapter discusses the anatomical structure and significance of the sacrum and coccyx, including key features like fused vertebrae, articulating processes, and the implications for imaging. It provides detailed protocols for routine sacrum and coccyx imaging via AP and lateral views, focusing on patient positioning and tube angles. Furthermore, the chapter outlines myelogram procedures, including indications, contraindications, and post-exam care, emphasizing the significance of monitoring CSF and potential complications. This guide is essential for radiologists and medical professionals involved in spinal imaging.

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Comprehensive Overview of Sacrum and Coccyx Imaging Techniques and Myelogram Procedures

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  1. Chapter 9/19 Sacrum/Coccyx

  2. Sacrum • 5 fused vertebrae • 4 sets of ________________ • Pelvic (Anterior) & Posterior

  3. Sacrum • _________ – Wings of sacrum • Superior articulating process • ______________formed with 5th l-spine vertebra inferior articulating process

  4. Sacrum • _____________ • Anterior protrusion • _____________ • Continuation of vertebral Foramen

  5. Sacrum • ________________ • Fused spinous processes • _______________ • Joint surface of SI joint • ______________ • Inferior articulating process

  6. Coccyx • Tailbone • ___________coccyx segments • Most distal aspect of spinal column

  7. Coccyx • Transverse process • _________ • _________ • Larger at the base and cones toward apex

  8. Imaging the sacrum Routine • AP • Lateral • 80 kVp

  9. AP Sacrum • Pt supine • _____________tube angle • Between _________________ • CR mid sagittal and _________to ASIS

  10. Lateral Sacrum • Pt in true lateral • Flex knees • CR at the __________and __________to posterior sacral surface • Or _____________to ASIS

  11. Imaging the Coccyx Routine • AP • Lateral • 75 kVp

  12. AP Coccyx • Pt supine • ___________angle • _____________to Symphysis Pubis • CR Mid sagittal and ______________

  13. Lateral Coccyx • Pt in true lateral • Knees flexed • ______________to ASIS • ______________to ASIS • Collimate Close all 4 sides

  14. Chapter 22 Myelogram

  15. Myelogram • Study to look at spinal cord and nerves root branches • Indications • _____________ • ____________________

  16. Myelogram • Requires an injection into the ________________ • Menenges • Dura Mater • _________ • Pia Mater

  17. Contraindications • Sensitivity to Iodine • Blood in ___________ • Arachnoiditis • Increased _____________ • Recent _________

  18. Equipment • Myelogram tray • X-ray table that can ______________ • Foot board • Shoulder holder • X-table cassette holder

  19. Equipment • _______ • X-table holder • Pillow for abdomen • ______________________

  20. Contrast • Water Soluble – ___________ • Marked for ____________ Use

  21. Injection • X-table and AP scout • Done by radiologist • Lumbar • ________ • Through ______________

  22. Injection • Cervical • _______________bone • Injected _____________to avoid excessive mixing of contrast and _____

  23. Lumbar injection • Generally ___________ • Spinal cord branches and not solid • Pt prone • Pillow ____________to open disc spaces • Lt Lateral with spine __________ • Sterile

  24. Cervical Injection • Done if Lumbar is contraindicated • Pt sitting ________ with neck _________ • Or pt __________ with neck flexed • Contrast should not enter _________ • ___________the neck

  25. What happens • A ___________is done first • Evaluates appearance of CSF (blood present) • Contrast injected • Make sure it is __________use

  26. What Happens • Needle is removed • Pt is tilted _________________________ • By gravity contrast is spread through the spinal canal

  27. Imaging • __________ has taken over • Cervical • X-Table, X-table swimmers • Thoracic • Lateral, X-Table, AP/PA • Lumbar • Semierect X-Table, X-table lateral, AP/PA, Obliques

  28. Post Exam Care • Bandage the injection site • Place pt semi erect _______________. • Restricted to the bed.

  29. Complications • Air into the ____________ of the brain • Spinal needle irritating nerves • Excessive ______________ bleeding • Contrast into ventricular areas • Can cause _______________ • Reaction to contrast

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