Adult Orthopedic Diagnostic Imaging Order Guide

Chandler D. Connell 5/24/2019

This document is meant to serve as a guide for ordering adult (patients over the age of 15), diagnostic imaging studies of the; Upper Extremity, and Hip, and Lower Extremity. If you have any questions regarding diagnostic imaging orders please contact x-ray extension: 5-4482. Table of Contents Upper Extremity ...... 2

Clavicle ...... 2

Scapula ...... 2

Shoulder ...... 2

Humerus ...... 2

Elbow ...... 2

Forearm ...... 2

Wrist ...... 3

Hand ...... 3

Finger(s) ...... 3

Pelvis and Hip ...... 4

Pelvis ...... 4

Pelvis and Hip ...... 4

Lower Extremity ...... 6

Femur ...... 6

Knee ...... 6

Tibia/Fibula ...... 7

Ankle ...... 7

Os Calcis (Calcaneous, Heel) ...... 7

Foot ...... 7

Toe(s) ...... 7

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Upper Extremity Patient Body Part Complaint/Indication IMG Code Code Description Views Notes IMG2586L XR Clavicle Left (Generic) 1. AP • Pain IMG2586R XR Clavicle Right (Generic) 2. AP Axial 30-35 Clavicle • Injury IMG2586B XR Clavicle Bilat (Generic) Deg. Cephalic IMG2758L XR Scapula Left (Generic) • Pain 1. AP IMG2758R XR Scapula Right (Generic) Scapula • Injury 2. Lateral IMG2758B XR Scapula Bilat (Generic) 1. AP Internal AP Grashey External Rotation view • /Scapula IMG2566L XR Shoulder Left (Generic) Rotation to include Mag Marker Pain, Injury IMG2566R XR Shoulder Right (Generic) 2. AP Grashey • TSA Shoulder External Rotation • Proximal Humerus IMG2566B XR Shoulder Bilat (Generic) 3. Scapular "Y" Fracture 4. Axial "Axillary"

IMG2670L XR Humerus Left (Generic)

• Pain 1. AP IMG2670R XR Humerus Right (Generic) Humerus • Injury 2. Lateral

IMG2670B XR Humerus Bilat (Generic)

XR Elbow 3 views Complete Left • Pain IMG2617L (Generic) • Injury 1. AP • Distal Humerus XR Elbow 3 views Complete Right IMG2617R 2. External Oblique (Generic) 3. Lateral • Proximal / XR Elbow 3 views Complete IMG2617B Bilat(Generic) • Radius and Ulna IMG2850L XR Left (Generic) Fracture 1. AP • Pain IMG2850R XR Forearm Right (Generic) Forearm 2. Lateral • Injury IMG2850B XR Forearm Bilat (Generic)

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Upper Extremity continued

XR Wrist Complete Min 3 views Note: Carpal Tunnel, suspected or IMG2821L Left (Generic) 1. PA diagnosed no imaging 2. Oblique • Wrist / Carpal Pain XR Wrist Complete Min 3 views IMG2821R 3.Lateral Wrist • Injury Right (Generic) 4. Scaphoid (Trauma XR Wrist Complete Min 3 views IMG2821B / Known Injury) Bilat (Generic) XR Min 3 views Left Note Specific Metacarpal if known. IMG2656L (Generic) 1. PA Image separately unless for • Pain 2. Oblique Arthritis. XR Hand Min 3 views Right • Injury IMG2656R 3. Fan Lateral Hand (Generic)) 4. Ball catchers XR Hand Min 3 views Bilat (Only for Arthritis) IMG2656B (Generic) XR Finger(s) Min 2 Views Left Specify Finger IMG2639L (Generic) 1. PA Hand 2. Oblique of • Pain XR Finger(s) Min 2 views Right IMG2639R affected Finger(s) Finger(s) • Injury (Generic) 3. Lateral of affected XR Finger(s) Min 2 views Bilat IMG2639B Finger(s) (Generic)

Home Pelvis and Hip Patient Body Part Complaint/Indication IMG Code Code Description Views Notes

Trauma, Pelvic Fracture IMG2827 XR Pelvis (Generic) 1. AP Follow-up

Pelvis Consult with provider to determine 1. AP Pelvis Judet versus Inlet Outlet. XR Pelvis (Judet or In/Out) 3 2. Judet Views or Known Pelvic Fractures IMG2740 views Inlet and Outlet Views

XR Pelvis w AP and Lat Hip Right 1. Full Pelvis w/Mag IMG72R (Generic) Marker XR Pelvis w AP and Lat Hip Left 2. AP Hip w/Mag Frog lateral: If the patient does not IMG72L (Generic) Marker have an obvious seen fracture on the AP image and is able to frog ED Hip Imaging (ED orders 3. Frog Lateral or only) XR Pelvis w AP and Lat Hip Bilat Shoot through Cross Shoot through cross table lateral: IMG72B (Generic) Table Lateral w/Mag When there is an obvious seen Marker fracture on the AP image or the patient is unable to frog XR Pelvis w AP and Lat Hip Left 1. THA Pelvis w/ • All Hip Imaging IMG72L (Excluding Dr. Ames (Generic) Mag Marker Patients) XR Pelvis w AP and Lat Hip Right 2. AP Hip w/ Mag Pelvis and IMG72R • New Hip Pain (Generic) Marker Hip • First THA Post Op XR Pelvis w AP and Lat Hip Bilat 3. Lauenstein Lateral IMG72B • Regular THA Follow-Up (Generic) w/ Mag Marker XR Pelvis w AP and Lat Hip Left Insert: .JBAHIPXRAY in the comment IMG72L (Generic) field. 1. AP Whole Pelvis XR Pelvis w AP and Lat Hip Right All Ames Hip Images do not require Dr. Ames New Hip Pain IMG72R 2. 45 deg Dunn View (Generic) a mag marker. 3. Lauenstein Lateral XR Pelvis w AP and Lat Hip Bilat IMG72B (Generic)

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Lower Extremity Patient Body Part Complaint/Indication IMG Code Code Description Views Notes

IMG2584L XR Femur 2 views Left (Generic) • Pain 1. AP • Known Fracture or XR Femur 2 views Right Femur IMG2584R 2. Lateral Injury (Generic) IMG2584B XR Femur 2 views Bilat (Generic)

1. AP Standing IMG2691L XR Knee 4 or more views Left Perform AP and Lateral with Mag 2. Lateral Marker New Knee Pain 16-39 IMG2691R XR Knee 4 or more views Right 3. Rosenburg

Standing IMG2691B XR Knee 4 or more views Bilat 4. Skyline

XR Knee Standing Alignment AP 1. Standing Standing Alignment is not needed if IMG2891L Lat Rosenburg Skyline Left Alignment performed in the past 3 years. • New Knee Pain Over 2. AP Standing In this case then only perform AP XR Knee Standing Alignment AP 40 IMG2891R 3. Lateral and Lateral of effected Knee(s) non • Pre-Op TKA Lat Rosenburg Skyline Right 4. Rosenburg weight bearing with the mag XR Knee Standing Alignment AP Standing marker. IMG2891B Lat Rosenburg Skyline Bilat 5. Skyline XR Knee Standing Alignment AP IMG2889L Knee Lat Skyline Left 1. Standing Perform AP and Lateral with Mag Alignment Marker XR Knee Standing Alignment AP First TKA Post-Op Visit IMG2889R 2. AP Standing Lat Skyline Right 3. Lateral XR Knee Standing Alignment AP IMG2889B 4. Skyline Lat Skyline Bilat

IMG2686L XR Knee 1-2 Views Left (Generic) Perform AP and Lateral with Mag Marker • ER Patients XR Knee 1-2 Views Right IMG2686R 1. AP • Regular TKA Follow- (Generic) 2. Lateral up XR Knee 1-2 Views Bilat IMG2686B (Generic)

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IMG1533L XR Tibia Fibula Left (Generic) • Pain 1. AP • Known Fracture or Tibia/Fibula IMG1533R XR Tibia Fibula Right (Generic) 2. Lateral Injury IMG1533B XR Tibia Fibula Bilat (Generic) XR Ankle Min 3 views Left Weight Bearing for all studies unless IMG2561L (Generic) Known Fracture or Injury. • Pain 1. AP XR Ankle Min 3 views Right Known Fracture or Injury: Weight • Known Fracture or IMG2561R 2. Mortise (int. Obl) Ankle (Generic) Bearing to tolerance Injury 3. Lateral XR Ankle Min 3 views Bilat IMG2561B (Generic) IMG1534L XR Ankle Stress views Left Ankle Stress Known Injury, Questioning IMG1534R XR Ankle Stress views Right Mortise (int. Obl) Views Joint stability IMG1534B XR Ankle Stress views Bilat XR OS Calcis Min 2 view Left Lateral View: Weight Bearing to IMG616L (Generic) 1. Harris tolerance Os Calcis • Pain XR OS Calcis Min 2 view Right (Plantodorsal • Known Fracture or IMG616R (Calcaneous, (Generic) Semiaxial) Injury XR OS Calcis Min 2 view Bilat 2. Lateral Heel) IMG616B (Generic) XR Min 3 views Left Weight Bearing for all studies unless IMG2010L • Foot Pain or Injury (Generic) Known Fracture or Injury. 1. AP • New Toe Pain or XR Foot Min 3 views Right Known Fracture or Injury: Weight IMG2010R 2. Oblique Foot Injury (Generic) Bearing to tolerance 3. Lateral XR Foot Min 3 views Bilat IMG2010B (Generic) XR Toe(s) Min 2 view Left Weight Bearing for all studies unless IMG1582L (Generic) Known Fracture or Injury. 1. Ap Foot • Pain XR Toe(s) Min 2 view Left Known Fracture or Injury: Weight IMG1582R 2. Oblique Toe Toe(s) • Known Toe Fracture (Generic) Bearing to tolerance 3. Lateral Toe or Injury F/U XR Toe(s) Min 2 view Bilat IMG1582B (Generic)

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