CAMRT Radiography Practice Exam

To best demonstrate a left axillary 6th rib fracture, how should the patient be positioned?

1. Upright posteroanterior (PA)

2. Upright and 45 degree left posterior oblique (LPO)

3. Prone

4. Supine and 45 degree left posterior oblique (LPO)

The correct answer is: Upright and 45 degree left posterior oblique (LPO)

To effectively visualize a left axillary 6th rib fracture, positioning the patient upright and at a 45-degree left posterior oblique (LPO) is optimal. This positioning allows for the ribs on the left side, particularly the 6th rib, to be projected more prominently over the imaging receptor. When the patient is positioned in an LPO, the left side of the rib cage is angled away from the receptor, while the right side of the body is positioned towards it. This angle increases the contrast between the rib shadow and surrounding tissues, making fractures more discernible. Additionally, being upright helps to eliminate rib compression that may occur in a supine position, thereby providing a clearer image for fracture assessment. In terms of imaging technique, this positioning facilitates a better view of the axillary region, where the fracture would typically be located, as it allows for the ribs to be imaged without overlapping structures obscuring the view. Other positions, such as prone or supine, may hinder visibility of the rib fracture due to overlapping structures or may not provide the necessary angles for optimal rib visualization. Therefore, the use of an upright and 45-degree left posterior oblique position maximizes the potential for accurately diagnosing a left axillary rib fracture