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Pathology and Cast Technique Adjustments
Fluid, bone growth and dense tissue are additive, so raise technique; air, bone loss and wasting are destructive, so lower it.
Additive conditions
Some diseases make tissue harder to penetrate. These additive conditions need more technique than the chart's standard setting. In the chest they include pleural effusion, pneumonia, atelectasis, pulmonary edema, congestive heart failure, and cardiomegaly. In bone they include Paget disease, osteoblastic metastases, osteopetrosis, and acromegaly. In the abdomen, ascites and a large aortic aneurysm are additive, as are hydrocephalus and edema. A useful memory aid: added fluid, added bone, or added tissue means added technique. Many charts handle this with about a 15 percent kVp increase, or roughly 50 to 100 percent more mAs depending on severity, but follow your department chart.