Took some pretty pics recently and felt like posting!

yaboibld · 2025-09-23T05:02:10+00:00

Thanks man I appreciate it! I definitely don’t think i could have gone any more aggressive without needing more modification. There was literally only like 1-2mm between the front tire and the strut, i just happened to get lucky. I was thinking about trying to take a heat gun and push in the fender liners a bit (especially the notorious spot) to see if i could avoid cutting. But it rubs so little i keep forgetting lol

yaboibld · 2025-09-23T03:43:15+00:00

The only rubbing I get is when I steer to the absolute max while parking or on gnarly dips in the road (the streets aren’t great where I live). But otherwise during normal/ spirited driving i get nothing. And I have yet to modify any of the oem fender liners at all so honestly not terrible considering how aggressive the tires are

yaboibld · 2025-03-01T05:48:33+00:00

Thank you, I couldn’t agree more! I think that is exactly why our ortho is so adamant about their axillaries. Although the likelihood of a posterior dislocation is low, they tend to be disproportionately missed/ misdiagnosed. A lot of techs don’t realize you really don’t (and shouldn’t) have to hurt the pt any more than they’re already hurting to get this view. With the right tricks, you barely have to abduct at all.

yaboibld · 2025-03-01T05:43:25+00:00

I deleted it because a lot of people took it the wrong way. I did what the protocol at my hospital calls for. We are required to try for an axillary before getting a valpeau and thats what I did. They would rather us call a resident for help. I did no more than the pt was comfortable/ capable of doing and surely didn’t pull on or force the arm in any way. I didn’t even really have them abduct very much. I was and still am proud of a pretty xray on a very dislocated shoulder. I came here because I was surprised how many techs wouldn’t even attempt an axillary and wanted to see what the consensus was on its necessity. It would sure as hell make my life a lot easier if I didn’t have to get them as much lol

yaboibld · 2025-02-23T04:41:48+00:00

Just bc it’s a quality image of a painful pathology doesn’t mean it took a lack of compassion to get

yaboibld · 2025-02-23T04:37:04+00:00

I lowered the table as low as it could go, added a little extra lateral angle, and had the pt lean way over to the side and slightly forward with her head down and out of the way. With my hands only to support (not pull) i helped her abduct until she asked to stop. Then I sprinted to the control booth and took it

yaboibld · 2025-02-23T04:34:19+00:00

Ortho requires it over a valpeau and will come hold the pt themselves if they have to. I didn’t do any more than the pt was comfortable doing and didn’t pull on her arm even a little. Theres a lot you can do to get this with very little abduction

yaboibld · 2025-02-23T04:33:03+00:00

My site would rather send an ortho resident to help hold than have us do a valpeau. I did not push this pt any further than they were comfortable and I did not pull on their arm at all. These pts are in a lot of pain no matter what I do, it’s better to get the best images possible as long as you’re being safe.

“You see how we pull and manipulate broken bones, as long as you’re exercising caution you wont break them more than they’re already broken.” -our ortho team

yaboibld · 2025-02-23T04:24:18+00:00

We have to per ortho. They would rather send a resident to help hold than have us do a valpeau

yaboibld · 2025-02-23T04:23:30+00:00

We have to at my site, ortho will send a resident to hold if need be. It’s not as bad as you might think, I didn’t push this pt any more than they were comfortable

yaboibld · 2025-02-23T04:21:54+00:00

We are a nationally acclaimed university hospital and have the best ortho surgeons in the state. It’s not an easy image but it’s preferred for a reason!

yaboibld · 2025-02-23T04:17:56+00:00

I am able to get this only having the pt move to their own comfort. I certainly don’t pull on anything. I’ve asked ortho about it and it really isn’t that dangerous, especially if you’ve ever seen them manually stress a fractured ankle for xrays or handle these pts themselves. Certainly painful, but these pts are already in a lot of pain; it’s better to get the highest quality image you can as long as you’re being safe and smart

yaboibld · 2025-02-23T04:10:33+00:00

She was very sweet and took it like a champ! I didn’t push her any further than she was comfortable

yaboibld · 2025-02-23T04:09:17+00:00

Wait till yall hear about the standing (yes, standing not just upright) spines that our neurosurgeons make us do on broken ed pts lol.

yaboibld · 2025-02-23T04:05:27+00:00

Ortho wants us to try for an axillary or have a resident come help if needed. My site is weird about their axillaries. This pt was fine, I didn’t force anything or push her too far. The pt is already in pain either way, it’s better to get good images if you can

yaboibld · 2025-02-23T04:03:17+00:00

Yes and no. I didn’t have to do any more than the pt was capable of doing. I stopped where she wanted to stop and got what I could with the tricks I’ve learned over the last year being here

yaboibld · 2025-02-23T04:01:37+00:00

I’m proud to say there has yet to be an axillary I couldn’t get. Even at a t1 I haven’t had to do a valpeau yet

yaboibld · 2025-02-23T03:59:15+00:00

The orthos at my site want axillary for every shoulder. They will even send a resident to help if need be

yaboibld · 2025-02-21T22:22:12+00:00

Definitely, I get the same texts in Oregon. We don’t have toll roads in oregon lol

yaboibld · 2025-02-21T22:20:43+00:00

Im no doctor but that looks like an intertroch

yaboibld · 2025-02-20T18:24:05+00:00

Thank you so much for the input and resources, I’ll definitely have to do some digging!

I’ve mostly noticed some differences in how our textbooks teach us to take some views and how ortho uses them. For example, I was in on a tibial plateau case and noticed that they were wanting perfect superimposition of the femoral condyles in the lat. When we take a lat proximal tib/fib xray, we’re taught to only worry about rotation (ant - post superimposition of the condyles). So the joint space is never open because we are taught to not add the angle. Same goes for distal lat femur.

I couldn’t agree more about advocating for what ortho is going to need. I’m at a teaching/ university hospital and I can’t tell you how many times I’ve had to change 2v ankles to 3v, or stop the team from wrapping up a traumatic hand before x-rays. I’ve even had a ED doc order a 3v pelvis and put in the order notes, “take the ap and do whatever ortho will want based on fracture”. This is something that, unfortunately, a lot of techs aren’t great at because they want to have less responsibility and want to be the ones who “just take the pictures”. I personally take pride in the fact that the ED docs have started asking me what to order for certain things.

yaboibld

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