TEMPLATING RADIOGRAPHS

Taking radiographs which are able to be used for templating for TPLO or sizing of implants as part of the initial investigations is straight-forward with some knowledge of what is required and attention to detail, with the occasional repeated radiograph if required which is easy with digital xray machines.

A radiopaque marker, (The Left or Right marker or a 20 cent piece, with the size in mm) to allow sizing of implants.  

Ideally the marker should be placed at the same height as the bone being radiographed, to allow for magnification.

Positioning IS important, otherwise they WILL be non-diagnostic.  Take your time, you have DIGITAL NOW...

TPLO Templating

  • A lateral mid-femur to metatarsus is required, with a craniocaudal view for completeness.

  • A lateral of the 'good' will also indicate early stifle effusion and warn of possible impending injury. 

  • The patient is placed in lateral recumbancy with the leg to been radiographed closest to the table.

  • The other leg is pulled cranially and dorsally using ties or sandbags. 

  • A towel may be placed under the chest to rotate the patient slightly to aid positioning.

  • The stifle and hock are flexed to approximately 90deg using a sandbag against the foot.

  • Include the hock and distal femur.

  • Femoral condyles should be superimposed over each other, or as close as possible.

  • Patients with tibial torsion, femoral superimposition is easier said than done, but try elevating and rotating the hock or the stifle in either direction.

  • The tibial plateau should be as close as possible to lateral.

ELBOW Radiographs

  • Ideally a flexed lateral, standing angle lateral and craniocaudal projections.

  • Cost constraints - semi flexed lateral is the best

SHOULDER Radiographs

  • Lateral and craniocaudal projections

  • Cost constraints - lateral projection