PROSEDUR PEMERIKSAAN RADIOGRAFI OS HUMERUS PADA KASUS TRAUMA EMERGENCY DI INSTALASI RADIOLOGI RUMAH SAKIT PKU MUHAMMADIYAH KARANGANYAR

Abstract

ABSTRACT

Radiographic examination of the humerus in emergency trauma cases generally uses two projections, namely anteroposterior (AP) and lateral projections. However, at the Radiology Department of PKU Muhammadiyah Karanganyar Hospital, a single-exposure technique using an AP chest projection including the humerus is employed. This study aimed to determine the examination procedure, the rationale for using this technique, the effectiveness of the standard operating procedure (SOP), and the implementation of radiation protection measures. This study employed a qualitative descriptive method with a case study approach. The study was conducted at the Radiology Department of PKU Muhammadiyah Karanganyar Hospital from March to April 2026. Data were collected through observation, interviews with three radiographers, one radiologist, and one referring physician, as well as documentation. The data were then analyzed through data reduction, data presentation, and conclusion drawing. Radiographic examination was performed using an AP chest projection including the humerus, with the patient in the supine position and a single exposure. This technique allows the thorax and humerus to be visualized simultaneously, thereby supporting diagnostic assessment and surgical preparation. The single-exposure technique was effective in shortening examination time, reducing patient mobilization, improving patient comfort, and lowering radiation dose in accordance with the ALARA principle. Radiation protection was implemented through appropriate collimation and optimal exposure factors. However, a limitation of this technique is that it does not optimally demonstrate the lateral view of the humerus. The SOP for humeral radiographic examination using an AP chest projection including the humerus with a single exposure is effective for emergency trauma cases because it meets diagnostic needs, improves service efficiency, and optimizes radiation protection. A lateral projection may be added, when necessary, based on clinical indications.

ABSTRAK

Pemeriksaan radiografi os humerus pada kasus trauma emergency umumnya menggunakan dua proyeksi, yaitu anteroposterior (AP) dan lateral. Namun, di Instalasi Radiologi Rumah Sakit PKU Muhammadiyah Karanganyar diterapkan teknik satu kali eksposi menggunakan proyeksi AP thorax tampak humerus. Penelitian ini bertujuan mengetahui prosedur pemeriksaan, alasan penggunaan teknik tersebut, efektivitas SOP, dan penerapan proteksi radiasi. Penelitian menggunakan metode deskriptif kualitatif dengan pendekatan studi kasus. Penelitian dilakukan di Instalasi Radiologi Rumah Sakit PKU Muhammadiyah Karanganyar pada Maret–April 2026. Data dikumpulkan melalui observasi, wawancara terhadap tiga radiografer, satu dokter spesialis radiologi, dan satu dokter pengirim, serta dokumentasi, kemudian dianalisis melalui reduksi, penyajian, dan penarikan kesimpulan. Pemeriksaan radiografi dilakukan menggunakan proyeksi AP thorax tampak humerus dengan posisi pasien supine dan satu kali eksposi. Teknik ini mampu menampilkan thorax dan humerus secara bersamaan sehingga cukup membantu penegakan diagnosis dan persiapan operasi. Penggunaan satu kali eksposi terbukti efektif karena mempercepat waktu pemeriksaan, mengurangi mobilisasi pasien, meningkatkan kenyamanan pasien, serta menurunkan dosis radiasi sesuai prinsip ALARA. Proteksi radiasi diterapkan melalui pengaturan kolimasi dan faktor eksposi yang optimal. Keterbatasan teknik ini adalah belum mampu menampilkan gambaran lateral humerus secara optimal. SOP pemeriksaan radiografi os humerus menggunakan proyeksi AP thorax tampak humerus dengan satu kali eksposi efektif diterapkan pada kasus trauma emergency karena memenuhi kebutuhan diagnostik, meningkatkan efisiensi pelayanan, dan mengoptimalkan proteksi radiasi, dengan penambahan proyeksi lateral apabila diperlukan sesuai indikasi klinis.