p.

Image Suite
Chiro/Ortho
Tools

Aug 15, 2012

 p.2

Tools without Steps….

Angle
Vertical Axis
Cobb Angle
Ellipse
Arrow
Polygon
Rectangle
Free area
Text
Ruler
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Line Extension

The Line Extension tool will measure the distance of a

line connecting 2 points. The line will be “extended” to
show how that line would extend through the anatomy.

Any view can be used with this measurement tool

Step 1: Click to place a point on the on anatomy

1
Step 2: Click to place a second point on the anatomy

The system will automatically draw a line connecting

14mm the two points placed in steps 1 and 2. The line will
also be extended past these two points – 50% longer
than the original line.
2
The system will calculate/display the length of the line
between points 1 and 2.
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Measure From Vertical

The Measure From Vertical measurement tool provides a
1 indication of how far two points are off from each other along
a vertical axis

Any view can be used with this measurement tool, but

10mm should be taken with the bottom of the cassette as
3a 3b perpendicular to the boy part as possible.

Step 1: Click to place a point on the image

Step 2: Click to place another point on the image.

2
The systems will automatically draw vertical lines from the
points placed steps 1 and 2, and then calculates the
distance between those two lines (distance from 3a to 3b).

Note: The user can move points 3a and 3b to rotate the

vertical axis, should the image not be perpendicular to the
cassette.
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Measure From Horizontal

The Measure From Horizontal measurement tool provides a
indication of how far two points are off from each other along
a horizontal axis

Any view can be used with this measurement tool, but

should be taken with the bottom of the cassette as
perpendicular to the boy part as possible.

Step 1: Click to place a point on the image

3a Step 2: Click to place another point on the image.

2
30mm The systems will automatically draw horizontal lines from
the points placed steps 1 and 2, and then calculates the
3b distance between those two lines (distance from 3a to 3b).
1
Note: The user can move points 3a and 3b to rotate the
horizontal axis, should the image not be perpendicular to the
cassette.
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Cervical Curve
The Cervical Curve measurement tool provides a curved
1 overlay to help with the measurement of the Cervical spine.

A lateral view of the C-Spine is required for this

measurement tool.

Step 1: Click to place a point on the center of the anterior

tubercle of the anterior arch.

Step 2: Click to place a point on the top center of the first

thoracic vertebrae

Step 3: Click to the left or right side of the spine and the
17o curve will flip to face that side. Move the center point left or
right to increase/decrease the radius of the curve.
3
The system will automatically draw a curved line, with an
initial 17 cm radius, connecting the points placed in steps 1
and 2. A center point will be placed by the system that can
be moved to adjust the radius and position of the curve.

2
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Lumbar Curve

1 The Lumbar Curve measurement tool provides a curved

overlay to help with the measurement of the lumbar spine.

A lateral view of the L-Spine is required for this

measurement tool.

Step 1: Click to place a point in in the center of the 12th

thoracic vertebrae.

Step 2: Click to place a point on the top center of the

sacrum.

Step 3: Click to the left or right side of the spine and the
22o 3 curve will flip to face that side. Move the center point left or
right to increase/decrease the radius of the curve.

The system will automatically draw a curved line, with an

initial 22 cm radius, connecting the points placed in steps 1
and 2. A center point will be placed by the system that can
be moved to adjust the radius and position of the curve.

2
 p.8

George’s Line

George’s Line measurement tool provides a

measurement of the space between multiple vetebrae
along the spinal column.
1 A lateral view of the C-Spine is required for this
measurement tool.

2 Step 1: Click to place a point on the on the top of a

.2mm 3 vertebral body.

Step 2: Click to place a point on the bottom of the

4
.2mm same vertebral body. Double click anywhere on the
5
image to complete.

6 The system will automatically draw a line connecting

.5mm 7 the two points placed in steps 1 and 2.

8 Continue repeating Steps 1 and 2 for each vertebrae on

.5mm 9 the spinal column. Double click anywhere on the image
to complete.
10
.4mm The systems will automatically calculate and display the
11
distances between each vetebrae.

12
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Cardiothoracic Ratio
Cardiothoracic ratio tool is used to calculate the ratio of the
maximum transverse diameter of the heart to the maximum
diameter of the thorax.

An AP view of the Chest is required for this measurement tool.

H: 119.85mm / C: 305.95mm / R: 39.2%
Step 1: Click to place a point on the highest point of the spine.
Step 2: Click to place a point on the lowest point of the spine
The system will draw a line connected the points placed in
steps 1 and 2
1 Step 3: Click to place a point on the right side of the heart at
its widest point.
Step 4: Click to place a point on the left side of the heart at its
widest point.
The system will draw 2 lines (one from point 3, and one from
3 point 4) perpendicular to the line through the spine. The
summation of these two lines represents the width of the heart
(H).
4 Step 5: Click to place a point on the right side of the chest at
its widest point.
5
Step 6: Click tp place a on the left side of the chest at its
6 widest point.
2 The system will draw 2 lines from the points placed in steps 5
and 6, perpendicular to the spine.
The summation of these two lines represent s the width of the
thorax/chest (C).
The system will then calculate/display the values for H, C, and
the HCR (heart to Chest Ratio)
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Lippman-Cobb

The Lippman-Cobb angle tool measures the agle between

two lines, this is especially useful when measuring the
curvature of scoliosis of the spine.

This tool can be used on any exam, but for scoliosis a PA

view of the spine is desired for this measurement tool

Step 1: Click to place a point on the left side of a vertebrae

above the spinal curvature.
39.2o
Step 2: Click to place a point on the right side of a
vertebrae above the spinal curvature.

The system will automatically draw a line connecting the

two points placed in steps 1 and 2.

Step 3: Click to place a point on the left side of a vertebrae

below the spinal curvature.

Step 4: Click to place a point on the right side of a

vertebrae below the spinal curvature.

The system will draw a line connected the two points and
calculate/display the angle of the curvature of the spine.
 p.11

Goniometry

The Goniometry tool will measure the angular alteration of the leg alignment.

Angle = 25.5o An AP view of the entire leg, from the femoral head to the astragal bone is required
Length = 17.70 cm for this measurement
1
Step 1: Click to place a point on the center of the femoral head
Step 2: Click to place a point on the medial femoral condyle
Step 3: Click to place a point on the lateral femoral condyle

C The system will draw a line connecting the two points of the femoral condyles (A).
Step 4: Click to place a point on the medial tubercle of the intercondylar eminence
Step 5: Click to place a point on the lateral tubercle of the intercondylar eminence
The system will draw a line connecting the two points on the intercondylar
4 5 3
2 3 2 A eminence (B).
E
Best point 4 B 5 The system will then use lines A and B to calculate the “best point” from which to
draw a line to the femoral head (C). “Best point” is the point where a line drawn
from the center of 4 and 5 intersects line 2 and 3 perpendicularly.

F Step 6: Click to place a point on the medial aspect of the astragal bone (Talus
bone)
Step 7: Click to place a point on the lateral aspect of the astragal bone(Talus
bone).
The system will draw a line connecting the two points on the astragal bone (D),
and then draw a line from the center of that line to the femoral head (E) and
6 D7 another line to the “best point” of lines A and B (F).

Finally, the system will calculate/display the angle of AB and the length of line E.
 p.12

Coxometry

The Coxometry tool will measure the horizontal misalignment of the hip
joints.
An AP view of the hip region, with the cotyls and femoral heads clearly
visible.

Step 1: Click to place a point on the inferior point of the right acetabular
roof
Step 2: Click to place a point on the inferior point of the left acetabular
roof.
3 The system will automatically draw a line connecting points 1 & 2
17.1o 1 4 creates a line through the superior part of the tri-radiate cartilage, also
2 17.2o known as “Hilgenrenier’s Line”
27.5mm
23.2mm 27.5mm Step 3: Click to place a point on the superior lateral edge of the right
23.2mm acetabulum roof
5
6
The system will automatically draw a line connecting points 1 and 3.
Step 4: Click to place a point on the superior lateral edge of the left
acetabulum roof
The system will automatically draw a line connecting points 2 and 4.
Step 5: Click to place a point on the most proximal point of the right
femoral neck.
Step 6: Click to place a point on the most proximal point of the left
The system will calculate/display the following measurements femoral neck.
- right/left acetabular angles Note: In normal infants, the vertical line from points 3 and 4 to points 5
- distance from point 1 to line between points 3 & 5 and 6 should be equal on both sides, and perpendicular to
- height (distance) from point 5 to “Hilgenrenier’s Line” Hilgenreiner's line
- distance from point 2 to line between 4 & 6
- height (distance) from point 6 to “Hilgenrenier’s Line”
 p.13

Gonstead
The Gonstead tool will measure various points of the hip
joints, using the published Gonstead measurement
techniques.

An AP view of the hip region, with the femoral heads

and ischial tuberosity clearly visible.

Step 1: Click to place a point on the highest point of the

right femoral head.

Step 2: Click to place a point on the highest point of the

left femoral head.

Step 3: Click to place a point on the highest point of the

right iliac crest.

Step 4: Click to place a point on the lowest point of the

right ischial tuberosity.

Step 5: Click to place a point on the highest point of the

left iliac crest.

Step 6: Click to place a point on the lowest point of the

left ischial tuberosity.

Step 7: Click to place a point on the S2 or S1 tubercle.

Step 8: Click to place a point on the center of the pubic

symphysis.
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Gonstead (cont.)

Step 9: Click to place a point on the right lateral aspect of

S1 facet base.

Step 10: Click to place a point on the left lateral aspect of

S1 facet base.

Step 11: Click to place a point on the most lateral aspect of

the right sacral wing.

Step 12: Click to place a point on the most lateral aspect of

the left sacral wing.
60mm 55mm
Step 13: Click to place a point on the most lateral aspect of 89mm 87mm
the right iliac wing.

Step 14: Click to place a point on the most medial aspect of

the right posterior superior iliac spine.
3MD
Step 15: Click to place a point on the most lateral aspect of 168mm
163mm
the left iliac wing.

Step 16: Click to place a point on the most medial aspect of

the left posterior superior iliac spine.

The system will calculate and display all necessary 2mm

measurements to complete the gonstead analysis.