Sternal XR Lateral: What You Need To Know [Explained]

Understanding the Sternal XR Lateral View: A Comprehensive Guide

This article aims to provide a clear and detailed explanation of the sternal XR lateral view, focusing on what you need to know about this specific radiographic projection. We will explore its purpose, procedure, interpretation, and potential limitations.

What is a Sternal XR Lateral View?

The sternal XR lateral view is a specific X-ray imaging technique used to visualize the sternum, also known as the breastbone, from a side perspective. It allows doctors to examine the structure of the sternum, including its body, manubrium, and xiphoid process. This view is particularly helpful in identifying fractures, dislocations, and other abnormalities that may not be easily seen in a frontal (AP or PA) X-ray. The term "sternal XR lateral" specifically denotes this lateral projection.

Why is a Sternal XR Lateral Performed?

A sternal XR lateral is typically ordered to:

• Evaluate Trauma: Assess for sternal fractures following chest trauma, such as from a car accident or fall.
• Investigate Chest Pain: Rule out sternal involvement as a cause of unexplained chest pain.
• Diagnose Dislocations: Detect any dislocations of the sternoclavicular or manubriosternal joints.
• Assess for Bone Abnormalities: Identify bone tumors, infections, or other skeletal abnormalities affecting the sternum.
• Post-Operative Evaluation: Check the healing of sternal fractures after surgery.

How is a Sternal XR Lateral Performed?

The procedure for a sternal XR lateral is relatively straightforward. Here’s a breakdown of the typical steps involved:

1. Patient Preparation:
   • The patient will usually be asked to remove any jewelry, clothing, or metal objects that could interfere with the X-ray image.
   • A hospital gown may be provided.
2. Positioning:
   • The patient will be positioned standing or lying on their side, depending on their mobility and the imaging equipment available.
   • The side of the patient being examined will be placed against the X-ray detector.
   • The arms are usually raised above the head to avoid obscuring the sternum.
3. Breathing Instructions:
   • The patient will be instructed to hold their breath during the X-ray exposure. This minimizes motion blurring and provides a clearer image.
4. X-ray Exposure:
   • The radiographer will position the X-ray beam to focus on the sternum.
   • A brief X-ray exposure is then taken.
5. Image Acquisition and Review:
   • The X-ray image is immediately available for viewing.
   • The radiologist will then interpret the image and provide a report to the referring physician.

Interpreting a Sternal XR Lateral: Key Anatomical Landmarks

Understanding the normal anatomy of the sternum in a lateral view is crucial for accurate interpretation. Key landmarks to identify include:

• Manubrium: The uppermost portion of the sternum.
• Sternal Body: The main, elongated portion of the sternum.
• Xiphoid Process: The small, cartilaginous projection at the inferior end of the sternum.
• Sternoclavicular Joint: The articulation between the sternum and the clavicle (collarbone).
• Manubriosternal Joint (Angle of Louis): The joint between the manubrium and the sternal body.

Potential Findings on a Sternal XR Lateral

The following are some potential findings that may be identified on a sternal XR lateral:

• Fractures: Discontinuities in the bone structure, indicating a break.
  • Types of fractures can include transverse, oblique, and comminuted.
• Dislocations: Displacement of the sternum or its joints.
  • Commonly seen at the sternoclavicular or manubriosternal joints.
• Osteomyelitis: Infection of the bone, which may appear as bone destruction or sclerosis.
• Tumors: Abnormal growths in or around the sternum.
  • These can be benign or malignant.
• Arthritis: Degenerative changes in the sternoclavicular or manubriosternal joints.

The following table summarizes some of these findings and their typical appearances:

Finding	Description	Appearance on X-ray
Fracture	A break in the continuity of the sternal bone.	Visible line of separation in the bone; may be accompanied by displacement.
Dislocation	Abnormal displacement of the sternum or sternoclavicular joint.	Malalignment of the bones at the joint; may see increased or decreased joint space.
Osteomyelitis	Infection of the sternum.	Bone destruction, sclerosis (increased bone density), and periosteal reaction.
Tumor	Abnormal growth within or around the sternum.	May appear as a mass or area of increased density.
Arthritis	Degenerative changes in the sternoclavicular or manubriosternal joints.	Joint space narrowing, bone spurs (osteophytes), and sclerosis around the joint.

Limitations of Sternal XR Lateral

While useful, the sternal XR lateral view does have limitations:

• Limited Soft Tissue Visualization: It primarily shows bony structures and provides little information about soft tissues, such as muscles or ligaments.
• Overlap of Structures: Other structures in the chest, such as the ribs or spine, can sometimes overlap the sternum and make it difficult to visualize small fractures or abnormalities.
• Obesity: In obese patients, the quality of the image may be compromised due to increased tissue density.
• Sensitivity: Small, non-displaced fractures can sometimes be missed, especially in patients with osteoporosis.

For these reasons, other imaging modalities, such as CT scans or MRI, may be necessary to further evaluate the sternum in certain cases.

So, there you have it – the basics of sternal xr lateral explained! Hopefully, this gives you a better understanding. Good luck with your journey to learn more!