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X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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FINGERS 2-5 |
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PA |
40 ” |
1/3 10 X 12 |
Palmer surface down |
CR perpendicular to film @ PIP |
IP joints open. Tuft to distal 1/3 of metacarpal. |
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PA OBL. |
40 ” |
1/3 10 X 12 |
3-5 45 degree lateral rotation. 2nd digit- medial rotation. |
CR perpendicular to film @ PIP |
IP joints open. Tuft to distal 1/3 of metacarpal. |
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LATERAL |
40 ” |
1/3 10 X 12 |
90 degree lateral rotation. 2nd digit medial rotation. |
CR perpendicular to film @ PIP |
IP joints open, must visualize base of digit. Tuft to distal 1/3 of metacarpal. |
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THUMB |
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AP |
40 ” |
1/3 10 X 12 |
Posterior surface on film |
CR perpendicular to film @ 1ST MP joint |
No rotation, IP joint open. Include trapezium. |
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PA OBL. |
40 ” |
1/3 10 X 12 |
Pronate hand, 45 degree lateral rotation |
CR perpendicular to film @ 1ST MP joint |
IP joint open. Include trapezium. |
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LATERAL |
40 ” |
1/3 10 X 12 |
Abduct thumb |
CR perpendicular to film @ 1ST MP joint |
IP joint open. Include trapezium. |
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HAND |
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PA |
40 ” |
1/2 10 X 12 |
Pronate hand |
CR perpendicular to film @ 3rd MP joint |
Inc. all digits, distal radius & ulna |
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PA OBLIQUE |
40 ” |
1/2 10 X 12 |
Pronate hand, lateral oblique 45 degrees |
CR perpendicular to film @ 3rd MP joint |
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FAN LATERAL |
40 ” |
8 X 10 |
Hand on medial surface. Digits not superimposed. |
CR perpendicular to film @ 2nd MP joint |
Metacarpals true lateral, laterals of digits |
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EXTENDED LATERAL |
40 ” |
8 X 10 |
Hand on medial side. Digits extended. |
CR perpendicular to film @ 2nd MP joint |
Metacarpals lateral, digits superimposed for foreign body and alignment of fractures. |
UPPER EXTREMITY
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X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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WRIST |
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PA |
40 ” |
1/3 10 X 12 |
Pronate hand, wrist fingers in fist |
CR perpendicular to film @ Mid carpals |
Proximal ½ of metacarpals, distal radius and ulna |
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PA OBLIQUE lateral rotation |
40 ” |
1/3 10 X 12 |
Pronate hand, rotate lateral 45 degrees |
CR perpendicular to film @ Mid carpals |
Scaphoid and trapezium, carpals, trapezium, distal radius and ulna superimposed, proximal ½ of metacarpals |
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AP OBLIQUE medial rotation |
40 ” |
1/3 10 X 12 |
Forearm supine, rotate medially 45 degrees |
CR perpendicular to film @ Mid carpals |
Carpals medial side of wrist, triquetrium, hamate, pisiform free of superimposition, distal radius and ulna, proximal ½ of metacarpals |
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LATERAL |
40 ” |
1/3 10 X 12 |
Flex elbow 90 degrees, medial surface on film |
CR perpendicular to film @ Mid carpals |
Head of ulna superimposed on radius, Matacarpals superimposed and aligned |
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ADDITIONAL PROJECTION |
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STECHER |
40 ” |
8 X 10 |
Palm down, fingers extended. Ulnar flexion.
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1. CR perpendicular to film @ scaphoid. 2. CR angled 20 degrees to elbow @ scaphoid. Enters 3/4 ” proximal to and 3/4 ” lateral to 1st MP joint |
Scaphoid free of superimposition Minimal superimposition of radioulnar joint |
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FOREARM |
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AP |
40 ” |
1/2 10 X 12 or 1/2 11 X 14 |
Supinate forearm. Wrist to distal humerus in same plane |
CR perpendicular to film Mid forearm |
Wrist to distal humerus, radial head, neck and tuberosity slightly superimposed on ulna. |
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LATERAL |
40 ” |
1/2 10 X 12 or 1/2 11 X 14 |
Flex elbow 90 degrees. Wrist to distal humerus in same plane |
CR perpendicular to film Mid forearm |
Head of distal ulna superimposed and centered over radius, humeral epicondyles superimposed. |
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UPPER EXTREMITY
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X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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ELBOW ALL forearm and humerus in the same horizontal plane |
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AP |
40 ” |
1/2 10 X 12 |
Supinate hand, extend elbow. Line between epicondyles parallel to film. |
CR perpendicular to film at joint |
Portion of radial head and 1/2 of radial neck superimposed on ulna. |
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INT. OBL. |
40 ” |
1/2 10 X 12 |
Internal rotation 45 degrees. |
CR perpendicular to film at joint |
Coronoid process in profile, clear of radial head. |
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EXT. OBL. |
40 ” |
1/2 10 X 12 |
External rotation 45 degrees. |
CR perpendicular to film at joint |
Radial head and neck free of superimposition on ulna. |
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LATERAL |
40 ” |
1/2 10 X 12 |
Flex elbow 90 degrees, Line between epicondyles perpendicular to film. |
CR perpendicular to film at joint |
Superimposition of humeral epicondyles, olecranon process in profile. |
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COYLE for TRAUMA |
40 ” |
8 X 10 |
Flex elbow 90 degrees, Line between epicondyles perpendicular to film |
CR angled 45 degrees toward shoulder. Center to radial head |
Radial head an neck free of superimposition, joint space between radial head and capitulum open. |
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HUMERUS Include elbow and shoulder joints |
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AP |
40 ” |
14 X 17 Lengthwise |
Supinate hand, extend elbow. Line between epicondyles parallel to film. |
CR perpendicular to film. Center mid humerus. Suspend respiration |
Humeral head and shoulder joint to proximal radius and ulna. |
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LATERAL |
40 ” |
14 X 17 Lengthwise or crosswise |
Line between epicondyles perpendicular to film |
CR perpendicular to film. Center mid humerus. Suspend respiration |
Humeral head and shoulder joint to proximal radius and ulna. |
UPPER EXTREMITY
|
X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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SHOULDER Include total length of clavicle. |
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EXTERNAL |
40 ” |
10 X12 GRID Crosswise |
Line between epicondyles parallel to film. |
CR perpendicular to film Suspend respiration |
Greater tuberosity in profile laterally. |
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INTERNAL |
40 ” |
10 X 12 GRID Crosswise |
Line between epicondyles perpendicular to film |
CR perpendicular to film. Suspend respiration |
Lesser tuberosity in profile medially. |
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ADDITIONAL SHOULDER PROJECTIONS |
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TRANS- THORACIC LATERAL |
40 ” |
10 X 12 Lengthwise GRID |
Erect or supine. Injured side against film Shoulder is in neutral position. |
CR perpendicular to film. Center to exit surgical neck of side down. BREATHING |
Humerus through thorax. Ribs and lung markings blurred. |
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GRASHEY METHOD |
40 ” |
10 X 12 Lengthwise GRID |
RPO OR LPO Position Oblique 35-45 degrees, injured side down |
CR to film. Center glenohumeral joint. Suspend respiration |
Open glenohumeral joint space |
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“Y” VIEW RAO or LAO |
40 ” |
10 X 12 Lengthwise GRID |
Injured side down Obl. pt. 45- 60 degrees. Shoulder neutral, humerus at side |
CR perpendicular to film. CR vertebral border of scapula. Suspend respiration |
Relationship of humeral head, glenoid, acromion. Humeral shaft on body of scapula. |
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“Y” VIEW RPO or LPO |
40 ” |
10 X 12 Lengthwise GRID |
Injured side up Obl. pt. 45 – 60 degrees. Shoulder neutral, humerus at side. |
CR perpendicular to film. CR lateral border of scapula. Suspend respiration |
Relationship of humeral head, glenoid, acromion. Humeral shaft on body of scapula |
UPPER EXTREMITY
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X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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CLAVICLE CR mid clavicle |
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AP |
40 ” |
10 X 12 Crosswise GRID |
Erect or supine. |
CR perpendicular to film. Inspiration. |
Lateral aspect above scapula. Medial aspect over ribs. |
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AP TANGENTIAL |
40 ” |
10 X 12 Crosswise GRID |
Erect or supine. |
CR angle cephalad 15 - 45 degrees. Hypersthenic =
less angle. Asthenic = more
angle. Full Inspiration. |
Clavicle more horizontal. Lateral aspect above acromion. Medial aspect over 1st and 2nd ribs |
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SCAPULA |
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AP |
40 ” |
10 X 12 Lengthwise GRID |
Erect or supine. Abduct humerus 90 degrees to body. |
CR perpendicular to film. 2” Inferior to corocoid process. Breathing Technique |
Ribs and lung markings blurred. Lateral aspect of scapula off the ribs. |
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LATERAL RAO or LAO |
40 ” |
10 X 12 Lengthwise GRID |
Erect or supine. Obl. 45 - 60 degrees. Place side of interest hand on opposite shoulder. |
CR perpendicular to film. CR mid vertebral border side down. Suspend respiration. |
Lateral and vertebral borders superimposed. Include corocoid, acromion, superior and inferior angles. Humerus off scapular body. |
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LATERAL RPO or LPO |
40 ” |
10 X 12 Lengthwise GRID |
Erect or supine. Obl. 45 – 60 degrees. Place side of interest hand on opposite shoulder. |
CR perpendicular to film. CR mid lateral border side up. Suspend respiration. |
Lateral and vertebral borders superimposed. Include corocoid, acromion, superior and inferior angles. Humerus off scapular body. |
UPPER
EXTREMITY
|
X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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ACROMIOCLAVICULAR
JOINTS |
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AP WITH / WITHOUT WTS. |
72 ” |
2- 14 x 17 Crosswise GRID |
Erect |
CR perpendicular to film. CR 1 1/2 “superior to jugular notch. Expiration |
R & L acromioclavicular joints. Weights only with approval. |
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CHEST
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X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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PA |
72 ” |
14 X 17 GRID |
Erect. Hands on hips, shoulders down and forward. |
CR perpendicular to film. CR to T-7. & MSP. 2nd inspiration. |
Lung fields apices to bases. Scapula off lung fields. SC joints = from spine. |
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LATERAL |
72 ” |
14 X 17 GRID |
Erect. Hands on head, elbows together. |
CR perpendicular to film. CR to T-7. MSP parallel to film. 2nd inspiration. |
Lung fields apices to bases. No rotation = ribs superimposed. |
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AP |
72 ” |
14 X 17 GRID |
Supine. Shoulders forward. |
CR perpendicular to film. 4” inferior to sternal notch = T-7 & MSP. 2nd inspiration. |
Lung fields apices to bases. Scapula off lung fields. SC joints = from spine. |
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R or L DECUBITUS |
72 ” |
14 X 17 GRID |
R or L side down. |
CR perpendicular to film with horizontal beam. CR to T-7 & MSP. Mark side up. 2nd inspiration. |
Lung fields apices to bases. Scapula off lung fields. SC joints = from spine. |
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LORDOTIC |
72 ” |
14 X 17 GRID |
Standing one foot away from film holder. Lean back with shoulders against grid. Shoulders rolled forward. |
CR perpendicular to film @ T-7 & MSP. 2nd inspiration. |
Clavicles projected above apices. |
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AP SEMI-AXIAL |
72 ” |
14 X 17 GRID |
Erect or Supine |
Cephalad angle 15 - 20 degrees. |
Clavicles projected above apices. |
ABDOMEN
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X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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AP |
40 ” |
14 X 17 GRID |
Supine. |
CR perpendicular perpendicular to film. CR to iliac crest and MSP. Expiration. |
Kidneys, psoas muscles, superior rim of pubic symphysis, pelvis, lumbar spine and lower ribs. |
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ERECT |
40 ” |
14 X 17 GRID |
Erect. |
CR perpendicular to film. CR 2” superior to iliac crest at MSP. Expiration. |
Liver, spleen, kidneys, diaphragms. Free intra-abdominal air. |
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LATERAL |
40 ” |
14 X 17 GRID |
Left side down. |
CR perpendicular to film. CR to crest at MCP. Expiration. |
Demonstrates abdominal aortic aneurysm. |
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LATERAL DECUBITUS AP/PA PROJECTION |
40 ” |
14 X 17 GRID |
Left side down. In position at least 5 minutes. |
CR perpendicular to film with horizontal beam. CR 2” superior to iliac crest at MSP. Expiration. |
Stomach side down. Demonstrates free air side up, fluids side down. |
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DORSAL DECUBITUS Right or Left Lateral |
40 ” |
14 X 17 GRID |
Supine. |
CR perpendicular to film with horizontal beam. CR 2” superior to iliac crest at MCP. Expiration. |
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LOWER EXTREMITY
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X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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TOES |
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AP |
40 ” |
1/3 10 X 12 |
Plantar surface on film. Phalanges parallel to film. |
CR 10 degrees cephalad or place toes on angle sponge. CR MP joint. |
Tuft to distal 1/2 of metatarsals. IP joints open. Single digit: inc. toe on either side. |
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INT. OBL. |
40 ” |
1/3 10 X 12 |
Medial rotation 45 degrees. |
CR perpendicular to film. CR MP joint. |
Oblique of digit. |
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LATERAL |
40 ” |
1/3 10 X 12 |
Lateral aspect on film. Dorsiflex foot. |
CR perpendicular to film. Great toe IP joint. 2-5 MP joint. |
Digit of interest not superimposed. |
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FOOT |
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AP |
40 ” |
1/2 10 X 12 |
Plantar surface on film. |
CR 10 degrees cephalad to base of 3rd metatarsal. |
Phalanges, metatarsals. |
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MEDIAL OBL. |
40 ” |
1/2 10 X 12 |
Internal/medial rotation 30 - 45 degrees. |
CR perpendicular to film. CR to base of 3rd metatarsal. |
3-5 metatarsal free of superimposition. Cuboid and base of 5th metacarpal. |
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LATERAL Mediolateral |
40 ” |
10 X 12 |
Lateral aspect on film. Dorsiflex foot. |
CR perpendicular to film. CR mediolateral at 1st cuneiform. |
Entire foot. Distal tibia-fibula. |
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LATERAL OBL. |
40 ” |
1/2 10 X 12 |
Lateral/external rotation of foot 30 - 45 degrees. |
CR perpendicular to film. CR to base of 3rd metatarsal. |
1-2 cuneiform space open. Navicular. No overlap of the base of the 1st and 2nd metatarsals. |
LOWER EXTREMITY
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X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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ANKLE |
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AP Dorsiplantar |
40 ” |
1/2 10 X 12 |
Dorsiflex foot. |
CR perpendicular to film. CR mid malleoli. |
No rotation. Include distal tibia-fibula and proximal metatarsals. |
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INTERNAL OBLIQUE. |
40 ” |
1/2 10 X 12 |
Dorsiflex foot. 45 degree medial/internal rotation of leg and foot. |
CR perpendicular to film. CR mid malleoli. |
Include distal tibia-fibula and proximal metatarsals. Calcaneus not superimposed on lateral malleolus. |
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LATERAL |
40 ” |
10 X 12 |
Dorsiflex foot. Lateral surface on film. |
CR perpendicular to film. CR Mediolateral to medial malleolus. |
Talus and calcaneus entirely visualized. Include distal tibia-fibula and proximal metatarsals. |
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MORTISE |
40 ” |
8 X 10 |
Dorsiflex foot. Internal rotation 15 - 20 degrees. Intramalleolar line parallel to film. |
CR perpendicular to film. CR mid malleoli. |
Ankle mortise open. No overlap between distal tibia and fibula or between tibia and talus. |
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TIB-FIB |
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AP |
40 + |
Screen 14 X 17 Diagonal |
Supine. Dorsiflex foot. Line between femoral condyles parallel to cassette. |
CR perpendicular to film. CR to mid leg. |
Include 1” distal femur and proximal talus. (Joint space is 1” inferior to apex of patella) Proximal and distal tib-fib overlap. Shafts of tib-fib separated. |
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LATERAL |
40 + |
Screen 14 X 17 Diagonal |
Dorsiflex foot. Lateral aspect of leg on film. Femoral condyles ┴ to cassette. Flex knee 45 degrees. |
CR perpendicular to film. CR to mid leg |
Include 1” distal femur and proximal talus. Proximal and distal tib-fib overlap. Distal fibula over posterior 1/2 of tibia. Slight overlap of tibia on fibular head. Tibia shaft anterior and separate from fibula. Medial and lateral condyles superimposed. |
LOWER EXTREMITY
|
X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
OS CALCIS |
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Axial-plantodorsal |
40 ” |
½ 8 X 10 |
Supine. Dorsiflex foot. |
CR perpendicular to film @ joint space. |
Sustentaculum tali seen medially, trochlear process seen laterally. Talocalcaneal joint space. |
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Mediolateral |
40 ” |
½ 8 X 10 |
Lateral position/lateral aspect of foot down. |
CR perpendicular to film. CR ¾ ” inferior to medial malleolus. |
Inc. distal tib-fib. Lateral malleolus superimposed over post. ½ of tibia and talus. Sinus tarsi and calcaneocuboid joint space open. |
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KNEE > 10 cm use grid |
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AP |
40 ” |
10 X 12 |
Supine. Internal rotation 5 degrees. Inter-epicondylar line parallel to film. |
CR angle cephalad 5 degrees. CR ¾ ” distal to apex. |
Width of interspace between the medial tibial plateau and the medial femoral condyle EQUALS the width of the interspace between the lateral femoral condyle and the lateral tibial plateau. |
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INTERNAL / MEDIAL OBLIQUE |
40 ” |
10 X 12 |
Internal rotation 45 degrees. |
CR angle cephalad 5 degrees. CR ¾ ” distal to apex. |
Lateral condyles of femur and tibia. Tibiofibular articulation open. Margin of patella projected beyond the edge of the medial femoral condyle. |
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EXTERNAL / LATERAL OBLIQUE |
40 ” |
10 X 12 |
External rotation 45 degrees. |
CR angle cephalad 5 degrees. CR ¾ ” distal to apex. |
Proximal fibula superimposed over proximal tibia. Medial condyles of femur and tibia. Margin of patella projected beyond the edge of the lateral femoral condyle. |
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LATERAL |
40 ” |
10 X 12 |
Flex knee 15 - 30 degrees. |
CR angled cephalad 5 degrees. CR ¾” distal to medial epicondyle. |
Interspace between patella and femoral condyles demonstrated. |
LOWER EXTREMITY
|
X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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TUNNEL / INTERCONDYLOID
FOSSA |
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BECLERE AP axial |
40 ” |
10 X 12 |
Use curved cassette. |
CR perpendicular to lower leg at distal apex. |
Intercondyloid fossa in profile with no superimposition of
the patella. Medial and lateral condyles of femur symmetrical. |
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HOMBLAD PA axial |
40 ” |
10 X 12 GRID |
PA kneeling on table. Lean forward 20 –30 degrees = 60 – 70 degree knee flexion. Lower leg parallel to film. * May be done standing. |
CR perpendicular to lower leg at popliteal crease. |
Intercondyloid fossa in profile with no superimposition of
the patella. Medial and lateral condyles of femur symmetrical. |
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CAMP-COVENTRY PA axial |
40 ” |
10 X 12 GRID |
Prone. Femur parallel to film. Knee flexed 40-50 degrees. |
CR angle caudal, ┴ to the lower leg at popliteal crease. |
Intercondyloid fossa in profile with no superimposition of
the patella. Medial and lateral condyles of femur symmetrical. |
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PATELLA |
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PA |
40 ” |
8 X 10 GRID |
Prone. Patella parallel to film. No rotation. |
CR perpendicular to film at popliteal crease. |
Patella superimposed over distal femur. Symmetrical condyles of the femur. |
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LATERAL |
40 ” |
8 X 10 GRID |
Femur parallel to film Mediolateral position. Flex knee 5 – 10 degrees. |
CR perpendicular to film & anterior to medial condyle. (femoropatellar joint space) |
Patella projected anterior to distal femur and in a lateral position. Femoral condyles superimposed. |
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LOWER EXTREMITY
|
X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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FEMOROPATELLAR JOINT |
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HUGHSTON |
40 ” |
8 X 10 Screen |
Prone. Knee flexed 55 degrees
with foot resting on tube housing. |
CR perpendicular to mid patellofemoral
joint space 45 degrees cephalad. |
Patella anterior to distal
femur. No rotation. Joint space between patella and femoral condyles
demonstrated. |
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SETTEGAST Tangential , Skyline, |
40 ” |
8 X 10 Screen |
Prone., sitting or supine. Flex knee more than 90 degrees. |
CR perpendicular to mid patellofemoral joint space. Tube angle 15 – 20 degrees
from the long axis of the lower leg. |
Patella anterior to distal femur.
No rotation. Joint space between patella and femoral condyles demonstrated. |
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FEMUR |
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AP 2 exposures a. from 2” below knee & up b. hip |
40 ” |
a. 14 X 17 b. 10 x 12 GRIDS |
Supine. Internal rotation 5 degrees. |
a. CR perpendicular to mid film to include knee joint. b. CR to mid femoral neck for AP hip. |
Must visualize hip and knee joints. |
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LATERAL 2 exposures a. from 2” below knee & up b. hip |
40 ” |
a. 14 X 17 b. 10 X 12 GRIDS |
a. Lateral position. Flex knee 45 degrees, femur on table, other leg flexed over and in front. b. Flex knee and abduct femur laterally. Rest foot near opposite knee. |
CR perpendicular to film. a. to include knee joint. b. CR to mid femoral neck for lateral hip. |
Must visualize hip and knee joints. |
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LATERAL |
40 ” |
14 x 17 GRID |
Supine. Rotate towards side of interest until femur is lateral on table, knee flexed 45 degrees. |
CR perpendicular to film mid-femur. |
Must visualize hip and knee joints. |
LOWER EXTREMITY
|
X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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HIP |
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Include prosthetic
devise. |
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AP |
40 ” |
10 X 12 GRID |
Supine. Internally rotate leg 15-20 degrees for non-trauma. |
CR perpendicular to film. CR to mid femoral neck. Suspend respiration. |
Hip joint and proximal 1/3 of femur. Lesser trochanter should NOT be seen. (Femoral neck is 2 1/2” inferior and perpendicular to the midpoint of a line drawn between the ASIS and pubis) |
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AP OBLIQUE FROG LATERAL |
40 ” |
10 X 12 crosswise GRID |
Supine. Flex knee and abduct femur laterally. Rest foot near opposite knee. |
CR perpendicular to film. CR mid femoral neck. Suspend respiration. |
Acetabulum, inferior ilium, greater and lesser trochanters and proximal femur. Greater trochanter superimposed over femoral neck. |
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Modified Cleaves IF bilateral |
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14 x 17 |
Supine. Flex knees bilateral and abduct femurs laterally |
CR perpendicular to film at MSP and symphysis pubis. Suspend respiration. |
Axial projection of femoral heads bilaterally. |
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LATERAL Lauenstein & Hickey Method |
40 ” |
10 X 12 GRID |
Supine. Flex knee, abduct femur and rotate to affected side. Femur lies on table. |
CR perpendicular to film. CR mid femoral neck Suspend respiration. |
Femoral neck. No foreshortening. Partial superimposition of greater trochanter over femoral neck, lesser trochanter over femoral shaft. |
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CROSS-TABLE LATERAL HIP Transfemoral Danelius-Miller Method |
40 ” |
10 X 12 GRID |
Supine. Flex hip and knee of unaffected side. Elevate leg from field of view. |
Grid parallel to femoral neck. CR horizontal and perpendicular to grid and femoral neck. Suspend respiration. |
Femoral neck. No foreshortening. Partial superimposition of greater trochanter over femoral neck, lesser trochanter over femoral shaft. |
LOWER EXTREMITY
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X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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PELVIS |
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AP |
40 ” |
14 X 17 GRID |
Supine. Internal rotation of feet 15 - 20 degrees. Cassette 1 ½” above crest. TRAUMA: No internal rotation of leg. |
CR perpendicular to film. CR MSP and midway between the ASIS and symphysis pubis. |
No rotation. Greater trochanters equal in size. Lesser trochanters should NOT be visualized. |
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ANTERIOR RIBS |
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PA ProjectionAbove Diaphragm |
40 ” |
14 X 17 GRID |
Erect. Center side of interest. |
CR perpendicular to film. CR midway between spine & lateral rib margin. Cassette 1 ½” - 2” above shoulder. Inspiration. |
Upper 10 posterior ribs above the diaphragm. No motion or rotation. |
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AP Projection Above diaphragm |
40 ” |
14 X 17 GRID |
Erect. Center side of interest. |
CR to T-7 CR midway between spine & lateral rib margin. Cassette 1 ½” 2” above shoulder. Inspiration. |
Upper 10 posterior ribs above the diaphragm. No motion or rotation. |
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OBLIQUE POSITIONS |
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RAO
LAO RPO LPO |
40 ” |
14 X 17 GRID |
Erect. Oblique 45 degrees affected side away. Erect. Oblique 45 degrees affected side down. |
CR perpendicular to film. Film. 1 ½” – 2” above shoulder. CR midway between spine & lateral rib margin. Inspiration. |
Upper 10 ribs. Axillary ribs free of superimposition. Anterior rib ends. |
LOWER RIBS
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Below diaphragm |
40 ” |
10 X 12 GRID |
Supine. |
CR perpendicular to film midway between xyphoid and lower rib margin. Bottom of cassette @ top of crest. Expiration. |
2” overlap with upper rib film. |
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X-RAY |
SID |
FILM |
PATIENT POSITION |
CENTRAL RAY TUBE ANGLE |
DEMONSTRATES |
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RAO |
30 ” |
10 X 12 GRID |
Erect or recumbent. Oblique 15 – 20 degrees to the right side. Hypersthenic = less rotation. Asthenic = more rotation. |
Cassette 1 ½ ” above jugular notch. CR perpendicular to film. CR left of midline between jugular notch & xyphoid. Breathing Technique |
Sternum along-side vertebral column. No superimposition, sternum anterior to spine superimposed over heart shadow. Manubrium to xyphoid tip. Lung markings blurred. |
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LATERAL |
72 ” |
10 X 12 GRID |
Lateral erect (shoulders/ arms drawn back), lateral prone, dorsal decubitus. |
CR perpendicular to film. Cassette 1 ½” above jugular notch. DEEP Inspiration. |
No rotation. Ribs off sternum. Manubrium to xyphoid. |
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LPO Trauma |
40 ” |
10 X 12 GRID |
Supine. Oblique 15 – 20 degrees left side down. Hypersthenic = less rotation. Asthenic = more rotation. |
CR perpendicular to film. CR MSP between jugular notch & xyphoid. Breathing Technique |
Sternum anterior to spine in heart shadow. |