Landmarks for finding the appropriate locations during x-ray examination can be crucial to a great image.
Miss your mark and find your area of interest off-center on your image.
With a population getting more morbidly obese over time, zeroing in on the best landmarks to find a deep iliac crest is becoming more important to radiographers.
Here are several landmarks to help you nail the perfect image.
The Elbow
Anatomically speaking, the elbow is approximately level with the iliac crest. Similarly, wrists are typically level with the pubic symphysis (regardless of body habitus.)
This technique is favored by technologists who prefer to touch the patient as minimally as possible.
Digging Deeper
In some cases, you are just going to need to press harder than normal to find anatomy. The mild discomfort of pressing down on the crest region is nothing compared to what the patient will go through if you can’t image the fracture for surgery.
Ask the patient to take e a breath in and blow it out while palpating. As they blow out, press in until you feel the crest. The exhale helps the oblique abdominal muscles relax enough to find the crest.
The Leg Lift
Ask the patient to point to their own belly button to remove their arms from the sides of the body while lying supine. Then, if possible, ask the patient to slightly lift their leg while you palpate the femoral head. Center on the head and you will get the crest.
Bonus tip: prone the patient to reduce the gonadal dose.
The Belly Button
Often times the anatomical location of the belly button corresponds with the top of the crest.
This will vary with abnormal panniculus size or other variants in the midsection.
The Assist Request
Explain that you try to reduce poking and prodding on patients in pain. Then ask if they would mind putting their hands on their hips.
Do you have an alternative? Post in the comment section below.
