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MurphyMobile
Moderator
Joined: 26 Aug 2006
Posts: 148
Location: WNC
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 Posted: Tue Oct 17, 2006 9:44 am Post subject: |
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hjhogle:
| Quote: | | And aside from being unprofessional, something tells me that this "And if he does not understand - then take him to the room and tell him to position him self on the table in the Homblad position" would not have the desired effect. |
I have worked for an orthopedic office for 8 yrs while working FT at a hosp.
Their equipment was not the best. And it was never an "art" in my book
when they would expect certain images that they learned in school with
and their office equipment could not re-produce the image.
When I mention about telling the "dr. to get on the table" it is because
he/she is 20 yrs or more younger than the patient.
I just believe there are other ways to "skin a cat."
MM
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Ann T Ver RT
Guest
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| Posted: Fri Dec 15, 2006 9:16 am Post subject: Holmblad modification |
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You can do this as a "cross table method", by maintaning the same CR part relationship...the patient will lay on thier side with the affected knee being the one farthest from the table...With the patient in a lateral that looks like the L-spine lateral, start with the long axis of the femur aligned with the long axis of the table and bend the tib/fib at 90 degrees so their feet hang off the bucky side of the table (their leg will be in an "L" shape) -place the IR at the knee on the patellar side with the tube at the head end of the table, angle the tube down the long axis of the table parallel to the floor *& directed to the IR (of course!). You may have an increased SID from what you are used to...but if you go from 40" to 48" the mas distance formula comes out to about 1.5x the original MAs you normally use at 40"...easy! Or you can just do the MAS distance formula if it is an odd change of SID. HOPE THIS WORKS. |
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Guest
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| Posted: Sun Jan 13, 2008 3:15 am Post subject: |
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| MurphyMobile wrote: | pseudotech-
There are such things as curved cassettes.
I think I would let that orthopedic know my feelings. And if he does not
understand - then take him to the room and tell him to position himself
on the table in the Homblad position.
The only other thing is to get special pads and place under there knees.
I had to tell your orthopedic dr. that he could do more harm to his patient
than he realizes. And with the BIG heads they have (I have had my
share of jolly coversations in the OR  ), they sure do not want what
they think is a measley tech telling them hos to do the job.
NM  |
Agree! Orthopods conveniently forget they we perform exams on patients with "issues" verses having them pose for the latest edition of Merrill's Atlas 
I never used curved cassettes even though they were available. Instead, utilized the Beclere method for a Tunnel View. The patient was supine on the table with a film/CR cassette in the Bucky |
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vhrt
Joined: 07 Sep 2008
Posts: 4
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| Posted: Mon Sep 15, 2008 10:33 pm Post subject: Standing Holmblad |
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I work at an orthopedic office where one Dr. requests a view of the intercondlyar fossa. I lower the chest board down to knee height and have the patient stand in front of the chest board facing it. Have the patient bend the affected knee till they are resting the tips of their toes only on the floor. Have the patient lean slightly into the chest board placing the knee in contact.They can hold onto the column for support. The tube is pulled down and 40" away from the back of the knee and angled about 20-30 degrees to enter at the crease behind the knee (popleteal area). Be sure to align the bucky.
If you look in the Merrill's Atlas under intercondylar fossa you can get the visual for positioning the patient but they are standing instead of kneeling.
Hope this helps. |
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