Radiology Forums

NAT · Posted: Sun Jul 16, 2006 11:22 am Post subject:

Here's my 1-second patient assessment when it comes to the KUB;

1. Is the patient large? If so, I use two cassettes crosswise, putting the iliac crest at the bottom of the upper cassette and at the top for the bottom cassette. Unless the patient is the size of Shaquille O'Neal, you'll easily get the kidneys & symphysis pubis.

2. Is the patient a medium or small female? If so, I'll explain to the patient that I need to ensure I get the 'pubic-bone' on the film and that it's located at the bottom of the bladder, where then I'll ask them to "touch the bottom of their bladder". If their english is limited [or non-existent], I'll gently rotate the right leg back & forth with my right hand while palpating the patient’s greater trochanter with my left hand. The greater trochanter is at the same level as the SP.

3. Is the patient a medium or small male? If so, I'll go into the "pubic-bone at the bottom of the bladder" rap, but I'll palpate to make sure. If the patient's english is limited or non-existent, I'll just palpate.

As a 1st-year student, I think I’m on the right path.

jwitte · Joined: 29 Jun 2007 Posts: 4

Heres a good way, I havent clipped a symphisis yet since I have been doing this. First of all find the crest center like you normally would, then find the greater trochanter if you have light that extends down to the same plane the trochanter is in youll have symphisis. The trochanter lies directly across from the symphisis.

Rajih · Joined: 18 Oct 2007 Posts: 2

Hi,

I am always using the center which is 2cm below the ASIS and open the collimaition

Radtechredneck · Joined: 06 Jan 2008 Posts: 5

Palpate the greater trocanter of the femur. It almost always lies in the same plane as the SP. Rotate the foot medially, which everts the head of the femur, making palpation of the GT easier.

So long as everything else is in order, this should give you a near perfect KUB every time.

If the pt. is overly hypersthenic, and palpation of the GT is impossible, bending the knees gives you the hip location, of which the GT is a part.

The 2 cassette method works, but unless the pt is extremely tall, you're probably dosing your pt more than necessary.
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