Protocol: HSS Hip (Metal, 1.5T Only)

Intravenous Route: None Gain intravenous access using a 20ga, 22ga Angiocath Access central venous devices per protocol

Patient Identification:

Checklist

Safety questionnaire done

Correct patient selected on scanner

Patient ID checked

Sent to PACS

ICD-9 completedProtocol Information

Scanning Technologist:

Contrast : None

Comments

Accession #:

Reviewing Technologist:

RIS completed

Plane Sequence name FOV Siemens 1. 3-Plane Scout 40 gre_r 2. Axial PD Ax fs (TE high 20s) 32-36 tse 3. Coronal STIR Coro 18 tse ir 4. Axial STIR Ax 18 tse ir 4. Coronal PD Coro (TE high 20s) 18 tse 5. Axial PD Ax (TE high 20s) 18 tse 6. Sagittal PD Sag (TE high 20s) 18 tse fs __________________________TIPS_____________________________ - Plug in Cardiac Coil and position it on patient at beginning of study - Series 1 through 3, use Body Coil (not Torso Coil) - Series 4 through 6, use Cardiac Coil - Bandwidth high on sequences due to joint replacement

John Carrino, M.D / T1908

USR > MSK > ORTHO

CORO

SAG

AXIAL (inferior extent to

cover iliopsoas tendon)

Last updated 2/24/11

CD given to patient (if requested)