Escanograma and overview of MMII - Member lower 40 length discrepancy; DLMI ) It is a relatively common diagnosis found in patients with disorders of the lower extremities and spine. When the lower part of the spine and pelvis not are level and the knees are not at the same level in a patient in standing position can speak of discrepancy. The DLMI may be due to differences real antomicas or positional differences. The causes of inequality in the length of the members include congenital deformity, trauma, infections, dysplasia and metabolic diseases.Can lead to the consequences of the DLMI do alterations of the March. do scoliosis would low back pain would osteoarthritis of the hip in the leg longest would decrease in the actividadLuego of the clinical evaluation confirmed the DLMI radiologicamente by two techniques main or complementary to the measurement: panoramic x-ray of the MMII from hips to ankles on long plate with the patient in standing position and the escanograma.?????ESCANOGRAMAEl escanograma is a technique for measurement of the DLMI which is usually done with the patient in supine position, with knees to the zenith. On the stretcher/table of exploration, previously a ruler has leaded centimetrada to facilitate measurement, according to the longitudinal axis of the table. The fixation of the rule can be made with fabric adhesive, making it coincide with the middle line of the table. Thus the rule will be in central position, with the patient up. Take three exposures on same chassis or cassette. The sequence of shots is hips, knees and ankles. Therefore the three exhibitions will be on a plate. (Fig. 1 ) Fig.1 measurement of chassis is 35 x 43 cm or 14 "X 17 " and it is divided in three for the exhibitions. While the patient and the rule are in a fixed position, the tube and the chassis move we must pay attention to the positioning of the patient, so it is good practice traccionarlo from the foot, firmly grasping the ankles. Also should be aligned pelvis preventing rotation. This last is difficult to achieve in obvious disproportion of the hemipelvis or pelvic vascular. For the measurement of the DLMI with 40 computed technique;Fig.2 ) apply graphic functions on a workstation by drawing lines of reference or landmarks: do the top of the femoral head would the distal edge of the condi it femoral interno. the bottom surface of the distal end of the tibia ( tibial plafond )?? Fig, 2 Escanograma. Landmarks to measure DLMI. The parameters to measure or landmarks must be included in the x-ray, if not the discrepancy can not be evaluated and you will have to repeat the technique. Panoramic view of MMII the RX panoramic of analog MMII can take a single exposure 30 x 90 cm long chassis. In the computed digital system or indirect digital, your image can be only once with long wheelbase or several chassis that will then bring each to compose in a single image of the MMII. (Fig 3-) Fig3 panoramic MMII computed system composition are unions of images ( 41 arrows; Direct digital system requires several exhibitions on the flat panel to a later composition. The panoramic view is performed with the patient standing, barefoot, face to the tube with knees pointing forward. The technician must pay attention to avoid the patient to bend the knee of the leg longer, and that the pelvis is level. This enhancement can be placed ( 41 wooden block; of the appropriate size. Often the orthopedist specifies in the order the size of enhancement and under which Member should be placed ( right or left ). Measurements in the panorama include the femoral length (41 F; measured from the top of the thighbone to the distal edge of the conditions it femoral interno. The tibial length (T ) It is measured from distal edge of the conditions it femoral internal, to the center of the tibial plafond. (Fig4. ) Fig 4 length F femoral and tibial T the total length of the lower limb (41 LTMI; It is measured from the top of the femoral head to the center of the tibial plafond (Fig.5 ). Fig 5 total length of lower limb (41 LTMI; The difference in height of the femoral heads ( 41 cm; It is the vertical distance between the aspects more proximal femoral heads, this is a very important parameter for not it is incurred errors in measurement, if the patient had a low boost Member shorter on the Rx, this enhancement measure joins the claculo of the difference above. The 40 mechanical axis deviation; DEM ) the Member is calculated in cm. Is defined as the distance from the center of condi them the femoral line that connects the center of the femoral head to the center of the tibial plafond (Fig 6 ) Fig 6 40 mechanical axis deviation; DEM ) A medial deviation of the mechanical axis, denotes a lower in Varo limb alignment and a lateral deviation of the mechanical axis alignment of the lower in valgus Member represents. To conclude we can say that although both techniques are reliable for the measurement of the DLMI, the difference is that the views are useful for the analysis of deformity.
