Opal-Rad Chiro Advanced Orthogonal Analysis v 1.0 Opal v2.3.3

Transcription

1 1 Step 0a Image Acquisition for Lateral/Horizontal Angle View (Optional): Take a lateral/sagittal view of the patient and acquire that image into the OpalRAD software. Please note that acquisition of images from an Orex, Point of Care, Opal-CR, or other CR product is out of the scope of this document. Please refer to the procedure(s) regarding image acquisition for the CR product installed at the site. Step 0b Calculating Horizontal Angle (Optional): Use the Horizontal Angle Tool to find the proper angle for the Frontal shot. Double left click or drag the lateral/sagittal view thumbnail so it appears in the image viewing Find the Horizontal Angle Tool in the Chiropractic menu. Left click on the image to plot the first point. Left click on the image to plot the second point. Upon plotting the second point, the angle displayed is the angle that will yield the best frontal shot as shown in the figure below. Step 1 Image Acquisition for Vertex and Nasium Views: Take vertex/horizontal and nasium/frontal) views of the patient and acquire those images into the OpalRAD software. Please note that acquisition of images from an Orex, Point of Care, or other CR product is out of the scope of this document. Please refer to the procedures on your CR in order to acquire images.

2 2 Step 2 Vertex/Horizontal Analysis A. Use the Vertex Skull Line Tool to find the Horizontal Cephalic Line (HCL): Double left click or drag the vertex/horizontal view thumbnail so it appears in the image viewing Find the Vertex Skull Line Tool in the Chiropractic menu Advanced Orthogonal section. Left click on the image. The Vertex Skull Template will appear, as shown in the Before/Wile Moving figure below. To move the template; hover the cursor over the small box in the center of the template. When the template turns pink and the 4-arrow crosshair appears, hold the left mouse key down and move the mouse around to position the template (template will appear red while moving). Resize and rotate; use - and + to resize the template and < and > to rotate the template. Once properly positioned, press the / key on the keyboard to calculate/draw the HCL as shown in the After figure below. Before/While Moving After

3 3 B. Use the Vertex Atlas Line Tool to find/calculate the Atlas Horizontal Plane Line (AHPL). With the vertex/horizontal image still in the image viewing area, use the Zoom, Pan, Window and Level tools to adjust the image until there is a good view of the atlas and axis. Find the Vertex Atlas Line Tool in the Chiropractic menu Advanced Orthogonal section. Left click on a left atlas point and then a right atlas point. A line will connect the two points as shown in the figure to the right, and the software will calculate a Pre Y value. C. Use the Vertex Calculations Tool to display the Pre-Y value: Find the Vertex Calculations Tool in the Chiropractic menu Advanced Orthogonal section. Left click on a portion of the image unobstructed by the image. The AO Vertex calculation annotation will then appear on the image (keep this number for use in Step 3): Notes: o The calculation box may be moved by hovering over it (turns pink and the 4 arrow crosshair appears) and using the left mouse button to move it to its new location. o If any adjustments are made by deleting and replacing the HCL or moving any of the AHPL points, the calculation will automatically update. Step 3 Nasium/Frontal Plane Analysis A. Use the Main Calculations Tool to transpose the Pre-Y number from Vertex Calculations. It appears on the calculations list now. Double left click or drag the nasium/frontal view thumbnail so it appears in the image viewing Find the Main Calculations Tool in the Chiropractic menu Advanced Orthogonal section. Left click on a portion of the image unobstructed by the image. The AO calculations annotation will then appear on the image. Further calculations will automatically append this annotation.

4 4 Double click on the annotation and enter the Pre-Y value from the previous step and the main calculations box will display this value. B. Use the Frontal Cephalic Line Tool to find the Frontal Cephalic Line (FCL). Find the Frontal Cephalic Line Tool in the Chiropractic menu Advanced Orthogonal section. Left click on the image. The Frontal Cephalic Template will appear, as shown in the Before/While Moving figure below. To move the template; hover the cursor over the small box in the center of the template. When the template turns pink and the 4-arrow crosshair appears, hold the left mouse key down and move the mouse around to position the template (template will appear red while moving). Resize and rotate; use - and + to resize the template and < and > to rotate the template. Once properly positioned, press the / key on the keyboard to calculate/draw the FCL as shown in the After figure below. Before/While Moving After

5 5 C. Use the Atlas Frontal Plane Line Tool to find the Atlas Frontal Plane Line (AFPL). With the nasium/frontal image still in the image viewing area, use the Zoom, Pan, Window and Level tools to adjust the image until there is a good view of the frontal atlas features. Find the Atlas Frontal Plane Line Tool in the Chiropractic menu Advanced Orthogonal section. Left click on a left atlas point and then a right atlas point. A line will connect the two points as shown in the figure to the right, and the software will calculate the ACD and AFP angles and measurements. D. Use the Condyle Circle Template Tool to find the Condyle Circle value. Find the Condyle Circle Template Tool in the Chiropractic menu Advanced Orthogonal section. Left click on the image. The Condyle Circle Template will appear as shown in the figure to the right. To move the template; hover the cursor over the small box in the center of the template. When the template turns pink and the 4-arrow crosshair appears, hold the left mouse key down and move the mouse around to position the template (template will appear red while moving). Rotate; use < and > to rotate the template. Once properly positioned, press the / key on the keyboard to enable the Enter Discovered Value box and enter the value as indicated on the template. The Main calculations annotation will now append itself to reflect the C value.

6 6 E. Use the Axial Circle Template Tool to find the Axial Circle value. Find the Axial Circle Template Tool in the Chiropractic menu Advanced Orthogonal section. Left click on the image. The Axial Circle Template will appear as shown in the figure to the right. To move the template; hover the cursor over the small box in the center of the template. When the template turns pink and the 4-arrow crosshair appears, hold the left mouse key down and move the mouse around to position the template (template will appear red while moving). Rotate; use < and > to rotate the template. Once properly positioned, press the / key on the keyboard to enable the Enter Discovered Value box and enter the value as indicated on the template. The Main calculations annotation will now append itself to reflect the A, C/A and A/C values. F. Use the Axis Spinous Process Tool to calculate to find the Axis Spinous (AxSP) and Cervical Spine Line (CSL) values. Find the Axis Spinous Process Tool in the Chiropractic menu Advanced Orthogonal section. Left click on the following points in the order listed below to plot them for calculation: o 1. Left base of dens/odontoid or Left lateral C-2 body. o 2. Right base of dens/odontoid or Right lateral C-2 body. o 3. Tip of Spinous process. o 4. Left lateral body of C-6 or C-7. o 5. Right lateral body of C-6 or C-7. G. During the AxSP plotting, several new calculations are automatically appended to the Main Calculations Annotation:

7 7 Step 4 Aberrant Analysis (Optional) A. Use the Aberrant Tool to analyze a Nasium/Frontal shot that appears aberrant. Double left click or drag the nasium/frontal view thumbnail so it appears in the image viewing Find the Aberrant tool in the Chiropractic menu Advanced Orthogonal section. Left click on the image. Aberrant Analysis Template will appear as shown in the figure below. To move the template; hover the cursor over the small box in the center of the template. When the template turns pink and the 4-arrow crosshair appears, hold the left mouse key down and move the mouse around to position the template (template will appear red while moving). Rotate; use < and > to rotate the template. Once properly positioned, press the / key on the keyboard to enable the Enter Discovered Value box and enter the value as indicated on the template. The Main calculations annotation will now automatically update several of the Atlas Orthogonal calculations: