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Radiographic Image Analysis

FIFTH EDITION

Kathy McQuillen Martensen,

MA, RT(R)
Associate of Radiology
Roy J. and Lucille A. Carver College of Medicine
University of Iowa
Iowa City, Iowa
Table of Contents

Cover image

Title Page

Copyright

Dedication

Reviewers

Preface

This Edition

Acknowledgments

Chapter 1 Guidelines for Image Analysis

Why Image Analysis?

Terminology

Characteristics of the Optimal Projection

Image Analysis Process

Chapter 2 Visibility of Details

 Digital Radiography

Quality Image (Resolution)

Postprocedure Requirements

Special Imaging Situations

Chapter 3 Image Analysis of the Chest and Abdomen

Image Analysis Guidelines

Pediatric Chest

Abdomen

Pediatric Abdomen

Chapter 4 Image Analysis of the Upper Extremity

Image Analysis Guidelines

Chapter 5 Image Analysis of the Shoulder

Image Analysis Guidelines

Chapter 6 Image Analysis of the Lower Extremity

Image Analysis Guidelines

Chapter 7 Image Analysis of the Hip and Pelvis

Image Analysis Guidelines

Chapter 8 Image Analysis of the Cervical and Thoracic Vertebrae

 Image Analysis Guidelines

Chapter 9 Image Analysis of the Lumbar Vertebrae, Sacrum, and

Coccyx

Image Analysis Guidelines

Sacrum

Chapter 10 Image Analysis of the Sternum and Ribs

Image Analysis Guidelines

Chapter 11 Image Analysis of the Cranium

Image Analysis Guidelines

Chapter 12 Image Analysis of the Digestive System

Image Analysis Guidelines

Stomach and Duodenum

Small Intestine

Large Intestine

Bibliography

Glossary

Index
Copyright
RADIOGRAPHIC IMAGE ANALYSIS, FIFTH EDITION ISBN:
978-0-323-52281-6

Copyright © 2020 by Elsevier Inc. All rights reserved.

No part of this publication may be reproduced or transmitted in

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on how to seek permission, further information about the
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This book and the individual contributions contained in it are
protected under copyright by the Publisher (other than as may be
noted herein).

Notice
Practitioners and researchers must always rely on their own
experience and knowledge in evaluating and using any
information, methods, compounds or experiments described
herein. Because of rapid advances in the medical sciences, in
particular, independent verification of diagnoses and drug
dosages should be made. To the fullest extent of the law, no
responsibility is assumed by Elsevier, authors, editors or
contributors for any injury and/or damage to persons or property
as a matter of products liability, negligence or otherwise, or from
any use or operation of any methods, products, instructions, or
ideas contained in the material herein.
Previous editions copyrighted 2015, 2011, 2006, and 1996.

International Standard Book Number: 978-0-323-52281-6

Executive Content Strategist: Sonya Seigafuse

Senior Content Development Manager: Luke Held
Content Development Specialist: Kathleen Nahm
Publishing Services Manager: Julie Eddy
Book Production Specialist: Clay S. Broeker
Design Direction: Ryan Cook

Printed in the United States of America

Last digit is the print number: 9 8 7 6 5 4 3 2 1

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Dedication

My lasting appreciation to Marilyn Holland, who believed in an

idea and jump-started this journey for me, and to my friend
Stephanie Harris, who again gave her time and talent to
Radiographic Image Analysis.
Reviewers
Stephanie Harris BS, RT(R)(M)(CT)
Diagnostic Imaging Manager
Mercy Medical Center
Cedar Rapids, Iowa
Preface
This textbook serves as a practical image analysis and procedure
reference for radiography educators, students, and technologists
by providing information to correlate the technical and
positioning procedures with the image analysis guidelines for
common projections; adjust the procedural setup for patient
condition variations, for nonroutine situations, and when a less-
than-optimal projection is obtained; develop a high degree of
radiography problem-solving ability; and prepare for the
radiography ARRT examination.
This Edition
The organization of the procedures for this edition has continued
with the changes introduced in the last edition to reduce
repeatable information and provide efficient access to specific
data. The new format includes additional quick, accessible tables
that summarize important details and can be used for easy
reference. This edition also includes many new and updated
projections with improved resolution.
Chapters 1 and 2 lay the foundation for evaluating all
projections, outlining the technical and digital imaging concepts
that are to be considered when studying the procedures presented
in the subsequent chapters.
Chapters 3 through 12 detail the image analysis guidelines for
commonly performed radiographic procedures. For each
procedure presented, this edition provides the following:

• Accurately positioned projections with

labeled anatomy.
• Photographs of accurately positioned
models.
• Tables that provide a detailed one-to-one
correlation between the positioning
procedures and the image analysis
guidelines.
• Discussions, with correlating projections,
on identifying how the patient, central ray,
or image receptor was poorly positioned if
the projection does not demonstrate an
image analysis guideline.
• Discussions of topics relating to
positioning for patient condition variations
and nonroutine situations.
• Illustrations and photographs of bones
and models, positioned to clarify
information and demonstrate anatomy
alignment when distortion makes it
difficult.
• Practice projections that demonstrate
common procedural errors.
Acknowledgments
I would like to thank the following individuals who have helped
with this edition.
The University of Iowa Hospitals and Clinics' Radiologic
Technology Classes of 1988 to 2019, who have been my best
teachers because they have challenged me with their questions
and insights.
Sonya Seigafuse, Luke Held, Kathleen Nahm, and the entire
Elsevier team for their support, assistance, and expertise in
planning and developing this project.
The professional colleagues, book reviewers, educators, and
technologists who have evaluated the book, sent me compliments
and suggestions, and questioned concepts in the previous
editions.
Kathy
CHAPTER 1
Guidelines for Image Analysis

OUTLINE

Why Image Analysis, 2

Terminology, 3
Characteristics of the Optimal Projection, 3
Image Analysis Process, 4
1. Demographic Requirements Are Visualized on the
Projection, 6
2. Projection Is Accurately Displayed on the Workstation
Screen, 6
3. Correct Marker Is Visualized on Projection and
Demonstrates Accurate Placement, 8
4. Appropriate Collimation Practices Are Evident, 12
5. Relationships Between the Anatomic Structures Are
Accurate for the Projection Demonstrated, 12
6. Projection Demonstrates Maximum Spatial Resolution,
28
7. Radiation Protection Is Present on Projection When
Indicated, and Good Radiation Protection Practices Are
Used During the Procedure, 29

OBJECTIVES
After completion of this chapter, you should be able to do the
following:

• State the characteristics of an optimal projection.

 • Properly display projections of all body structures.
• State how the patient is associated with the projections and explain what to do if
there is a misassociation.
• Discuss how to mark projections accurately and explain the procedure to be
followed if a projection has been mismarked or the marker is only faintly seen.
• Discuss why good collimation practices are necessary and list the guidelines to
follow to ensure good collimation.
• Describe how positioning of anatomic structures in reference to the central ray
(CR) and image receptor (IR) affects how they are visualized on the resulting
projection.
• State how similarly appearing structures can be identified on projections.
• Determine the amount of patient or CR adjustment required when poorly
positioned projections are obtained.
• Discuss the factors that affect the spatial resolution in a projection.
• Describe the radiation protection practices that are followed to limit patient and
personnel dose and discuss how to identify whether adequate shielding was
used.

KEY TERMS
ALARA

annotation

anterior

backup timer

contrast mask

decubitus

detector element (DEL)

distortion

dose creep

dose equivalent limit

double exposure
elongation

exposure maintenance formula

field of view (FOV)

flexion

focal spot

foreshortening

geometric factors

grid

grid cutoff

image receptor (IR)

inverse square law

involuntary motion

lateral

magnification formula

matrix

medial

midcoronal plane

midsagittal plane

motion unsharpness

nonstochastic effects

object–image receptor distance (OID)

picture archival and communication system (PACS)

pixel

posterior
profile

project

radiolucent

radiopaque

recorded detail

scatter radiation

size distortion

source–image receptor distance (SID)

source-skin distance (SSD)

spatial frequency

spatial resolution

stochastic effects

values of interest (VOI)

voluntary motion
Another random document with
no related content on Scribd:
The Project Gutenberg eBook of Arab and Druze
at home
 This ebook is for the use of anyone anywhere in the United
States and most other parts of the world at no cost and with
almost no restrictions whatsoever. You may copy it, give it away
or re-use it under the terms of the Project Gutenberg License
included with this ebook or online at www.gutenberg.org. If you
are not located in the United States, you will have to check the
laws of the country where you are located before using this
eBook.

Title: Arab and Druze at home

A record of travel and intercourse with the peoples east
of the Jordan

Author: W. Ewing

Release date: October 23, 2023 [eBook #71935]

Language: English

Original publication: London: T. C. & E. C. Jack, 1907

Credits: D A Alexander, David E. Brown, and the Online

Distributed Proofreading Team at https://www.pgdp.net
(This file was produced from images generously made
available by University of California libraries)

*** START OF THE PROJECT GUTENBERG EBOOK ARAB AND

DRUZE AT HOME ***
ARAB AND DRUZE AT HOME
 ARAB SHEIKH
(Photo: The Photochrome Co. Ld.)
 ARAB AND DRUZE
AT HOME
A RECORD OF TRAVEL
AND INTERCOURSE WITH THE PEOPLES
EAST OF THE JORDAN

BY
WILLIAM EWING, M.A.
FIVE YEARS RESIDENT AT TIBERIAS

THIRTY-ONE ILLUSTRATIONS AND MAP

LONDON: T. C. & E. C. JACK

16 HENRIETTA STREET W.C.
AND EDINBURGH
1907
 TO
MY FATHER
TIBERIAS FROM THE SEA
 FOREWORD
The number of books published regarding Palestine proves the
exhaustless fascination of the subject. Most of them, however, deal
with Western Palestine; and even of this, beyond the districts
traversed by the annual stream of tourists, comparatively little is
heard.
The lands beyond the Jordan are seldom visited. For the ordinary
sight-seer the difficulties and dangers are considerable; but these
almost entirely vanish before one who can speak the language and
is able to mingle freely with the people.
This book is an attempt to lift a little way the veil which still so largely
obscures that region, in spite of its great and splendid history; where
picturesque and beautiful scenery, the crumbling memorials of grey
antiquity, and the life of villager and nomad to-day, cast a mysterious
spell upon the spirit.
While the information given in the following pages is woven round
the narrative of a single journey, it is the outcome of frequent travel
and familiar intercourse with the peoples both east and west of
Jordan.
During a residence of over five years in Palestine the writer was
privileged often, quite alone or with a single native attendant, to visit
the peasantry and the Beduw, to share the shelter of mud hut and
goat’s-hair tent, to enjoy their abounding hospitality and friendly
converse in the medāfy, on the house-top, and around the camp-fire
in the wilderness.
What is here related regarding these strange but deeply interesting
peoples was either learned from their own lips or verified in converse
with them.
The author offers his tribute of affection and gratitude to the memory
of Dr. H. Clay Trumbull of Philadelphia, U.S.A., surely the most
generous and friendly of editors, who first moved him to write on
Oriental subjects.
For many of the photographs taken on the journey he is indebted to
his companions in travel, Rev. J. Calder Macphail, D.D., Edinburgh,
and Dr. Mackinnon of Damascus; for others, to Dr. Paterson of
Hebron and to the Committee of the Palestine Exploration Fund. He
also gratefully acknowledges assistance received from the Rev. J. E.
H. Thomson, D.D., and Oliphant Smeaton, Esq., M.A., F.S.A.,
Edinburgh.
Edinburgh, December 1906.
DAMASCUS FROM MINARET OF GREAT MOSQUE
 CONTENTS
CHAPTER I
PAGE
Damascus—Haurân Railway—Great Moslem
pilgrimage—The plains of Damascus—Great Hermon
—El-Kisweh—Bridges in Palestine—Ghabâghib—Es- 1
Sanamein—Medical myth—A Land of Fear—Grain-
fields of Haurân—An oppressed peasantry—Nowa
CHAPTER II
Arab courtesy—Sheikh Saʿad—Egyptian monuments—
Traditions of Job—El-Merkez—Religious
16
conservatism—Holy places—Sheikh Meskîn—A ride
in the dark—Zorʿa—El-Lejâʾ
CHAPTER III
A landscape of lava—Deserted cities—Caverns—
Cultivation—A land of ruins—The guide’s terror—
Damet el-ʿAliâ—The sheikh’s welcome—A state of
30
siege—An ugly incident—Druze hospitality—Arab
and Druze in el-Lejâʾ—St. Paul in Arabia—The well
of the priest—Story of the priest
CHAPTER IV
Hidden treasure—The Bedawy’s treasure-trove—The
sheikh’s farewell—A savage tract—Jebel ed-Druze—
Umm ez-Zeytûn—Tell Shihân—Shuhba—An ancient 48
house—A stingy entertainer—The ruins—Pharaoh’s
“grain-heaps”—The house of Shehâb
CHAPTER V
Ride to Kanawât (Kenath)—Impressive situation and
remains—Place-names in Palestine—Israelites and
63
Arabs—Education—A charming ride through
mountain glades—Suweida
 CHAPTER VI
Healing the sick—A strange monument—Telegraph and
post in Haurân—Cruel kindness—The Ruins of
Suweida—Turkish methods of rule—ʿIry—Sheyûkh 74
ed-Druze—Jephthah’s burial—Enterprise of Ismaʿîl
el-ʿAtrash
CHAPTER VII
The Druzes—Their religion—Their character—Druze
and Jew—Recent history in Haurân—Druze and 86
Bedawy—War
CHAPTER VIII
Bozrah—First Syrian mosque—The physician the
reconciler—The “House of the Jew”—The great
mosque—Cufic inscription—Boheira and Mohammed
102
—The fortress—Bridal festivities—Feats of
horsemanship—History—Origen’s visit—Capture by
Moslems
CHAPTER IX
Travellers’ troubles—A corner of the desert—The
mirage—Dangerous wadies—Lunch in the desert—A
“blind” guide—The clerk to the sheyûkh—A milestone
117
—Kalʿat Esdein—Thirst—The uplands of Gilead—
Search for water—A Bedawy camp—Terrific
thunderstorm
CHAPTER X
Morning on the mountains—Arab time—Tents and
encampments—The women and their work—Arab
wealth—Scenes at the wells—Dogs—Arabian
hospitality—Desert pests—Strange code of honour— 129
The blood feud—Judgment of the elders—Arab and
horse—The Arabs and religion—The Oriental mind—
Arab visit to Damascus
CHAPTER XI
Ride to Jerash—Magnificent ruins—Circassian 145
colonists—History—Preservation of buildings—East
 of Jordan—Sûf—A moonlight scene—Down to the
Jabbok
CHAPTER XII
“Time is money”—Rumamain—Priestly hospitality—Fair
mountain groves—Es-Salt—The springs—Relation to
Arabs—Raisins—Descent to the Jordan—Distant
view of Jerusalem—View of the river, the plains of 158
Jordan, the Dead Sea, and the mountains beyond—
The bridge—The “publican’s” shed—The men from
Kerâk
CHAPTER XIII
The banks and thickets of the Jordan—Bathing-place—
The Greek convent—A night of adventures in the
plains of Jericho—The modern village—Ancient
169
fertility—Possible restoration—Elisha’s fountain—
Wady Kelt—The Mountain of Temptation—The path
to Zion
 ILLUSTRATIONS
PAGE
Arab Sheikh Frontispiece
Tiberias from the Sea Facing iii
Damascus from Minaret ” vii
Pilgrimage leaving Damascus ” 2
The Cook’s Tent ” 8
Treading out the Corn ” 14
“Wild Ishmaelitish Men” ” 25
Peasant Ploughman ” 33
Well in the Desert ” 47
Shuhba: Baths and Roman Pavement ” 54
Kanawât: Ruins of Temple ” 66
Kanawât: Sculptured Doorway in Temple ” 70
Sheyûkh ed-Druze: a Council of War ” 83
Bozrah: Bab el-Howa ” 102
Bozrah: at the Cross Ways ” 114
Palestinian Shepherd and Flock ” 122
Arab Camp in Gilead ” 126
Arab Women and Children ” 133
Arabs at Home ” 136
Arab Horseman ” 140
Jerash: Gateway ” 145
Jerash: Temple of the Sun ” 148
Jerash: Street of Columns ” 152
Jerash: General View ” 154
Gorge of the Jabbok ” 156
Rumamain ” 159
Es-Salt: the Fountain ” 162
Jordan, showing Terraces ” 164
Fords of Jordan: Pilgrims Bathing ” 170
Elisha’s Fountain ” 175
Mouth of Wady Kelt ” 178
Map ” xii
MAP OF THE COUNTRY EAST AND WEST OF THE JORDAN
 CHAPTER I
Damascus—Haurân Railway—Great Moslem pilgrimage—
The plains of Damascus—Great Hermon—El-Kisweh—
Bridges in Palestine—Ghabâghib—Es-Sanamein—
Medical myth—A Land of Fear—Grain-fields of Haurân—
An oppressed peasantry—Nowa.
There is a pleasant excitement in the prospect of a journey through
long-forgotten lands, where hoary age is written on dark ruin and
carved stone, which lends its influence to while away the
monotonous days of preparation. But even amid surroundings of
entrancing interest in the queenly city on the Barada, the traveller
soon grows impatient to find himself in the saddle with his friends,
heading away towards the hills that bound the green plains of
Damascus. Fortunately, we could dispense with a dragoman, often
more an imperious master than an obliging servant, and were able to
arrange our routes and carry out our programme according to our
own wishes.
Leaving the city by Bawabbat Ullah, we took the Hajj road to the
south-west. This for many centuries was, what in the southern
reaches it still is, a mere track, not always clear, and often to be kept
only by observance of landmarks. To facilitate the passage of troops
to and from Haurân, the Government had made a fairly good road
from Damascus to some distance within that province. A railway has
now been built, and is in working order as far south as Mizerîb. One
day, perhaps, it will reach the sacred cities in el-Hejaz. If this do not
greatly expedite the hâjj’s enterprise, it will at least add variety to his
peril. The first trains east of the Jordan were objects of surpassing
interest to the camels. Unaccustomed to give way to anything else
on the road, a strange mingling of curiosity and pride brought many
of these “ships of the desert” to grief.