RadteraXR Ribs
XRNo contrastChest
Indications
- Rib pain/trauma
- Suspected rib fracture
- Suspected metastatic rib lesion
- Localized chest wall pain
Patient prep
- Remove radiopaque objects over thorax; gown
- Mark/note painful area to tailor projection
Contrast
None / non-contrast
Technique
- Tailor to area of injury (above vs below diaphragm) and anterior vs posterior ribs
- Ribs ABOVE diaphragm: erect, suspended INSPIRATION
- Ribs BELOW diaphragm: recumbent, suspended EXPIRATION
- Posterior ribs: AP with affected side closest to IR; anterior ribs: PA
- Oblique (RPO/LPO, 45 deg, affected side toward IR) to project axillary ribs free of spine
- SID 40 inches; grid; kVp ~65-75 (below diaphragm) / lower for upper ribs
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | AP (or PA) ribs | Frontal | AP for posterior ribs (injury side to IR); PA for anterior ribs; breathing per location relative to diaphragm |
| 2 | Oblique (anterior/posterior) | Oblique | 45 deg, affected side toward IR; projects axillary portion of ribs away from spine |
Key points
- Include affected ribs above the diaphragm on inspiration; below the diaphragm on expiration
- Always obtain a PA chest to exclude pneumothorax/hemothorax/effusion when trauma
- Demonstrating an isolated rib fracture often does not change clinical management
References
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.