The Following Abbreviations Are Used throughout the Pocket Guicie [Rebreviation Definition | Abbreviation Definition Ant ‘ MiP M ap ‘ ott or Sis A Oni 6 c Ger p EAM Bs RAO Right Inch RPO Ri 10M Tifa i RUg Right upp KV Kilovolt (peak 5 Sacrum 1 Lamba spine sib s | seep iA Taft anirior oblique i Thoracic 3 LPO Left posterior oblique iM Tempexomandi Cry eR ru coir Rolo Fonthickness mA kvp Timo Image Receptor HF ae > . % speodTU rrr rl 14a ee OV LTS) [AtC Foctors | | | $ | Se SWS ATU TUT OUS LANL it Coed pete Rote) Foteorm: retry ere crea pony ener eee ae) eens Sete ae ew) Cr ror eer Cee ting poureimintesonar tric) Deer sd yay] biliPotion! Position Part Position have! firmly against IR ated Central Ray * Ditwet perpendicular sint of digit being ex * Collimate to digit being examin DIGITAL RADIOGRAPHY -a of IR with four collimator margins * Place digit in central @ Cover exposed and unexposed areas with feast ‘Reference: 10h edition ATLAS pp, 1102-108 Patient Position Port Position val f 1K + Rest di a possible OID. Central Ray + Collimate to digit being examined DIGITAL RADIOGRAPHY + Place digit in o 3 of IR with four collimator » Cover exposed and unexposed arcas with fea ral at argins Rederence. 110 elton ATEAS pp. 1:10.08 kVp: S4 kVp: stPatient Position Part Position \ Central Ray Dirt perpen DIGITAL RADIOGRAPHY * Place digit in central arca of IR with n ‘© Cover exposed and unexposed areas ith Ie ae Referemce: 1th ction ATLAS pp 1106-107 kVp: 54 Im elm ured AP Patient Position 1 patient a end of ra Parl Position + Place affected hand in exireme internal rtatio centered to IR area. + Adjust position of hand to secure true AP projection of first digit and secure digits two through five to climinate superimposi tion over first digit with first digit + Employ lead shielding for radiation safety ‘Central Ray. * Direet perpendicular entering MCP joint of frst dit. DIGITAL RADIOGRAPHY '= Place digit in central area of IR with four collimator margins. "= Cover exposed anid unexposed areas with lead, Reference: 10h edition ATLAS p. 1108. kVp: stPatient Position * Seat patient at end of radiographic table. Part Position + Have patient rest palmar surface + Adjust arching of hand wntil true lateral position of first digit is achieved. + Employ lead shielding for radiation safety Central Ray + Direct perpendicular entering MCP joint of first digit. DIGITAL RADIOGRAPHY + Place digit in central area of IR with four collin = Cover exposed and unexposed areas with lead. Reference: 11th etion ATEAS p.1:108. kVp: 54 Gaur) Patient Position + Seat patient at end of radiographic table Part Position + Abdu fit digit * Place palmar surface of hand firmly against IR, and adjust first digit to oblique position = Employ lead shielding for radiation safety ‘Central Ray += Direct perpendicular entering MCP j DIGITAL RADIOGRAPHY += Place digit ip central area of IR with four collimator margins. = Cover exposed and unexposed areas with lead. at of first digit. ‘Reference: 1th eon ATIAS p. 1109. kvp: 54Patient Position * Seat patient at-end of radiographic Part Position + Rest forearm on table with palmar surface firmly against IR. + Spread digits slightly. + Employ lead shielding for radiation safety ‘Central Ray rect perpendicular to third MCP joint DIGITAL RADIOGRAPHY + Place hand in central area of IR With four collimator margins * Cover exposed and nonexposed areas with lead for two images on one IR. “Reference: th edion NIIAS pp 1116-117. Patient Position * Rest forearm on table with hand on IR in prone position, palm down, Part Position * Rote hand laterally (externally), and place digits on 45-degree cphalangeal joints. radiolucent support to demonstrate Adjust ci ts parallel with TR. etacarpals are area of primaty interest, rotate hand laterally ertips touch IR Centro! Ray + Direct perpendicular to third MCP joint. DIGITAL RADIOGRAPHY lace hand in central area of IR with four collimator Cover exposed and nonexposed areas with lead for two ‘one IR Reference: 1h eiton ATLAS pp 1118-119. 3Patient Position + Res ulmar surface of fore position Patt Position + Extend! digits with first digit (thumb) placed at right angles to palm of hand. As an option, have “fat fingers and place on positioning sponge to reduce superimposition of pi iMustated). + Center MCP joints to IR, and adjust palmar surface of hand perpen: dicular to 1R Central Ray * Direct perpendicular to second MCP joint. DIGITAL RADIOGRAPHY "Place hand in central area of IR with four collimator margins, + Cover exposed and nonexposed areas with lead fortwo images on one FR. m on table With hand in true lateral eferences Ith edition ATLAS pp. 1:120-122 kVp: 60 Patient Position * Seat patient at end of table with axilla in contact with table + Have patient rest forearm on table. Part Position + Center wrist to IR + Flex digits slightly to place wrist Central Ray * Direct perpendicular to midcarpal a DIGITAL RADIOGRAPHY lace wrist in central area of IR with four collimator margins. * Cover exposed and nonexposed areas with lead for two images on one IR, contact with IR. Reference: 11th edition ATLAS p. 1224. kvpi saPatient Position = Fey elbow 90 depres, with f Part Position + Center carpals to IR, aid adjust hand so that wrist is ‘Central Ray iGitaLraviograrHy 3) * Place wrist in central area of IR. rnexposed ares wr collimator margins. ead fo Before: S1th eon ATEAS pp. 1126427 Patient Position + Seat patient at énd of table with axilla in contact with table + Rest anterior surface of wrist on IR Part Position + Center wrist to IR area From true PA, rotate wrist approxin nally) and support on sponge. Central Ray + Direct perpendicular io IR entering midcanpal area just i ridivs. DIGITAL RADIOGRAPHY + Place wrist in central area of IR with four collimator margins, + Cover exposed and nonexposed areas with lead for two images on one IR. sely 45 degrees laterally (exter References Hah cation ATIAS p. 1128.Patient Position + Flex elbow 90 degrees, with forearm sind arm in contact with Pat Position +c * Bend hand outward until wrist isin extreme ul Central Ray + Direct pes NOTE: If necessary to delineate fr 15 degrees proximally (toward elbow) or distally DIGITAL RADIOGRAPHY + Place ‘wrist in central *-Cover exposed and ‘one IR. nter wrist t0 IR a Anguaiion of cular to scaphoid entra Oy collimator margins ih lead for two images on Reference: 1th edition ATEAS p.1:130. IR Reread Patient Position + Seat patient with arm and axilla in contact with table | Part Position + Place one end of IR.on a st elevated 20 degrees. * Center wrist to center of IR ‘Central Ray + Direct perpendicular to table, and position to enter scaphoid, DIGITAL RADIOGRAPHY + Place wrist in central area of IR with four collimator margins. + Cover exposed and nonexposed areas with Tead for two images on fone IR. port, and adjust so that finger end is Reference: th edition ATLAS pp. 1132-133. kVp: 54Carpal Canal lcs icueinG lsd [Sas Part Position se + Hyperextend wrist, and center it to © * Place Yinch radiolucent pad under lower forearm for ong axis of the hand as vertical as + Adjust hand position to make posible + Have patient grasp digits with opposite b position, or pull with a band (as shown. ‘Central Ray = Direct to palm Of hand t | 25. 10 A0-depree angle nd to hold in extended Jn distal to base of third metacarpal Reference: 11th alition ATLAS pp. 11382139. kyp: 65 err Patient Position + Seat patient al end of table with aim ester same plane, Part Position + Supinate hand, and center forearm to IR to include joina(s) of interest. + Adjust rotation o place humeral epicondyles equidistant from IR Central Ray = Direct perpendicular to midpoint of forearm, pigALRaoIoGrAPHY + Four collimator margins must be shown or none at all. Reference: 11h edtion ATLAS pp. 140-141.Patient Position ‘Seat patient at end of table with humerus and forearm in contact with table + Have patient flex elbow, and position entire limb in same plane Part Position + Fey elbow 90 degrees, and adjust hand to lateral position (thumb up), + Center Forearm to-IR to include joini(s) of interest. Central Ray = Direst perpendicular to midpoint of forearm, DIGITAL RADIOGRAPHY + Four collimator margins must be shown or none at atl Reference: 1th edit ATLAS p. 1142 kVp: 60. Patient Position + Seat patient at end of vith ann extended and entire Bim in ane Part Position ¥ + Extend elbow, supinate hand, and center elbow joint 1 IR. + Adjust humeral epicondyles to be equidistant from IR {Have patient lean stightly laterally if necessary to ensure AP alignment. ‘Central Ray + Direct perpendicular to elbow joint DIGITAL RADIOGRAPHY + Four collimator margins must be shown or none « Reference: 110 lion ATLAS p.1:143. kvp: 60Patient Position + Seat patient at end of table with elbow M nt rest humerus and forearm on table and position entire od 90 degrees, + Have pat mb in same plane Patt Position » Cenier 9O-degree flexed elbow joint to IR, and adjust wrist and hand {in Iateral position, ‘+ Adjust humeral epicondyles perpendicular to IR. ‘Central Ray * Direct perpendicular to elbow DIGITALRADIOGRAPHY 2Mem 3105 degrees cephalad (large pelvis) ; ‘Reference: 110 eltion ATLAS pp. 302-303. kyp: 65Patient Position = Position patient uprig distributed on feet Part Position = Adjust center of IR 14 inch (1.3 em) below level of pat ily separa Facing x-ray tube with weight equally = Have patient point toes straight ahead and sli ‘Central Ray = Direct horizontal and perpendicular to IR, entering midway between knees at level '4 neh (1.3.em) below patellar apices. ‘Reference: 1h edition NTLAS p.1:308. kypi6sPatient Position * Position patient supine with hip of unaffected vide elevated and affected knee extended. Part Position + Rotate affected limb externally until 45-degree rotation is achieved. = Cemier knee to IR at a level 14 inch (1.3 em) below apex of patella | Central Ray + Direet 4 inch (1.3 em) inferior to apex. Angle vaties a6 follows. depending on ASIS to table top measurement <19em 3 105 degrees cauelad 190 24 em O degrees >2aem 3 to degrees cephalad ‘Reference: 11h editon ATLAS p. 12310. kvp: 65 Patient Position + Position patient supine with affected knee internally rotated and extended. Part Position + Rotate the limb medially until 4S-degree + Center knee to IR ata level '4 inch (1.3.cm) below apex of patella Central Ray + Direct !4 inch (1.3 em) inferior to patellar apex. Ang follows, depending on ASIS to table top measurement: achieved, <1924em 3t0 5 degrees cephalad Reference: Ith edition ATLAS p.1:311 kvp: 65Potiont Position contact with Port Position * Center knce to IR by’ pla pen = Flex nee 70 degrees f ‘Central Ray * Dirwst perpen oF IR kVp: + Ad Control Roy = Dine perpen popliteal dep Releeom: 1th eaten ATLASPatient Position prone with knee extended. * Center patella and adjust leg to be parallel with IR plane. Heel is ‘generally rotated 5 to 10 degrees laterally Central Ray + Direct perpendicular, entering midpopliteal arca. Reference: 1th edition ATLAS p. 1:317. kp: 65 Patella Lateral (mediolateral) Patient Position + Position patient lying on affected side. Part Position + Adjust affected knce to be flexed S to 10 degrees. + Center IR to patella jst body rotation so patella is perpendicular to IR, Central Ray Reference: 14h edition ATLAS p. 13318. kvp: 65Patient Position + Posit Part Position + Have patient flex affected knee slowly until patella is perpendic to IR, if condition permits. «+ Adjust leg so that no medial or lateral rotation occurs, and, immobilize Central Ray + Direct perpendicular to joint space between patella and femur if patella is perpendicular. If patella is not perpendicular, angulation depends on degree of flexion of knee, usually 15 t0 20 degrees. picirat raiogaarny Ol 1 Pha ht colton f cxemey lode woven beet Eafe asked deh poopie Reference: [lth edition ATEAS pp. 1:324-325 kup: 65 Patient Position + Adjust pelvis to place ASISs equidistant from table Part Position * Center affected femur to midline of grid. + Image distal femur by placing botomn of IR 2 inches ($ em) betow Knce joint. + Rotate limb i + Apply gonad shielding. Central Ray + Direct perpendicular to mi ur and center of IR. 3ee ATEAS p.1:337 for proxinal femur Reference: 11th edition ATIAS pp. 1326-327. kVp: 70aa eel Pationt Position * Position pat with knee flexed about Part Position + Center affected femur to midline of gri + Image Al femur by drowing uppermost lim forward and supporting it at hip Jeve + Adjust femur so epicondyles are perpendicular to ible top, + Place bottom of IR 2 nches (5 em) below kace joint + Apply gonad shielding Central Ray + Direct perpendicular to midfemur Reference: 1th ction ATLAS pp, 1:328:329. Femoral Necks AP oblique MODIFIED CLEAVES METHOD Patient Position + Posit Part Position pelvis so no rotation + Have patient flex hips and knees. + Abduct thighs. approximately 45 degrees from vertical; brace ether Obtain radiograph dori ‘Central Ray = Direet perpendicular, entering midline approximately 1 inch (25 em) superior to symphysis pubis. = Direct ray to enter affected joint for unilateral central ray. NOTE: Adapt for unilateral examination by flexing and abducting affected limb. suspended respiration Reference: 11th edition ATIAS pp. 1:350-331.Pationt Position + Position patie + Adjust ASISs equidistant from ta Port Position 10 20 degrees medially; center hip 1018, Respiration: ‘Obtain t Central Ray = Direct perpendicular to 2 point 2.5 inches (6.4 em) distal o ‘drawn perpendicular to midpoint of line between ASIS and pubic line symphysis Reference: Ht edition ATIAS pp. 1: 384-385 rT Lateral LAUENSTEIN AND HICKEY METHODS Patient Position + Start with patient supine, an > posterior ablique body’ pos side Part Position + Flex affected knee and of grid ‘and rest on table: center affected hip to + Have patient extend unaffected += Shield gonads. Respiration: ‘Obtain radiograph duri Central Ray + Direct perpendicular to hip at a point midway between ASIS puibic symphysis for Lauenstein method and at a cephalic angle of 20 to 25 degrees for Hickey method ‘Reference: 14th edition ATLAS pp. 1.356357,nl Pee ean aie muedaalnes Patient Position + Position patient supine with level of center of IR Part Position = Have patient flex knee and hip of unaffected side. = Elevate patient's foot, and rest on suitable suppor = Aaljust pelvis so no rotation Gecurs J Rotate affected leg medially 15 to 20 degrees unless contraindicated renter trochanter elevated t0 Respiration: Obtain radiograph dur 2 suspended respiration. ndicular to long axis of femoral neck and IR. COMPENSATING FILTER + Image is improved and can be performed with one projection if a Reference: Ath tion ATIAS pp. 1358389 kyp:80 Part Positi Respiration “ontrat RayPA IE 1" accu Patient Position ies, shoulders uth vide; adjust head vo Tne from lower edge of upper mastoid process is perpendicular to TR, Respiration: Have patient phona Central Ray += Direct perpendicular to center of IR, entering open mouth, ‘ah” during exposure Reference: 1th edition ATIAS pp, 15393-30. kvp: 75rr ae usu Patient Position + Position patient supine Port Position + Adjust head so th tal plane is perpendicular to IR, {extend chin until a line between chin and Gp of mastoid process is perpendicular to IR. + Genter IR to level of tips of mastoid process. Respiration: Obiain radiograph during suspended resp Central Ray + Direct perpendicula distal © tip of chin mid center of IR, ering milsagittal plane just Reference: 10h ition ATLAS p. 1392 eee RCL lied ren Patient Position Part Position + Center midsagittal plane co IR + Have patient place arms at sides. 1 Genter IR at level of C4, and adjust a fine between upper occlusal plane and mastoid tip perpendicular IR Respiration: (Obtain radiograph during Suspended respiration. Central Ray, + Direct 15 t0 20 dk es cephalad, entering slightly inferior to thyroid References Ith edition ATLAS pp. 1398.39 kVp: 75ero) eerie wuts. Patient Position «= Position patient seated or standing in lateral p Part Position + Center coronal plane through mastoid processes to IR. {Adjust shoulders to same horizontal level and body to tn position. + Have patient elevate chin slightly, and relax shoulders. 1 attach weights to wrists to help lower shoulders, Respiration: Obiain radiograph during suspended expiration. Central Ray + Direct horizontal and perpendicular to IR, entering C4 2 Use SID of 72 inches (180 cm), which is recommended measure ¢ lateral Reference: 11th edition ATLAS pp_ 1400-401, Respiration Centro! Ray ‘ R ec » Use SI 8 wtuch ts cccomencnded mieaiane VBSeee Co Poe eGinekaslned ys Patient Position + Position pat Part Position + Rotate body to ave patient ext + Center spine t0 IR. + Center IR to C3. + Take both side obliques. Respiration: Obtain radiograph daring suspended respiration. ‘Central Ray + Direct 15 to 20 degrees cephalad, entering C4 + Use SID of 60 10 72 inches (152 to 183 cm), which: measure. farther from IR. ‘while looking forward ecommended Reference: Iith edltion ATLAS pp. 1:$04-108. Patient Position + Positic Part Position = Rotate body 45 degrees with side of + Extend chin slightly werest closer to IR. = Genter spine 1 IR +Cenrer IR to C5. Take both side obliques Respiration: Obtain radiograph during suspended respiration, ‘Cental Ray «Direct 15 t0 20 degrees caudad, entering C4. J Lise SID of 60 to 72 inches (150 to 180 em), which is recommended, measure, Reference: 11th eiltion ATEAS pp. 1406-107.Cervical Vert Dele ek cc Patient Position + Do not move patient or reme + without consul physician Part Position «Place IR next to patient's shoukler, and center at level of 4 = Do not rotate or extend neck. Depress shoulders as much as possible, If necessary; loop a bandage ariel patients feet and affix ends to wrists so that extending, knces depresses shoulders. Respiration: Obtain radiograph during suspended expiration. Central Ray = Direct horizontal and perpendicular, entering C: 1 Use SID of 60 t0 72 inches (150 t6 180 cm), which is recommended measures kVp: 75 Refeecnce: 11th edition ATLAS p.2:35. Cervical Vertebrae et Chios) Patient Position or remove cervical collar without consulting Do mot move patient physician Part Position Brace head and |cck and lift only enough to slide IR under neck, 1 place IR under backboard if patient is on backboard. J Center IR to mastoid on side opposite x-ray tube. (This allows: to projéet image of side of interest in center angled central ray Central Ray = Direct 45 level of C4. and 15 16 20 degrees cephalad, entering Reference: Hah edition ATLAS p. 2:37.Fert Mreellaelorolio Peete Patient Position + Position patient seated, standing, oF lat Part Position + Cenier mideoronal plane to IR recumbent, Elevate arm adjacent to vertical IR holder, and rest it om h + Rotate this shoulder forward or backward according to patient condition. + Rotate opposite shoulder in opposite direction, + Adjust head and body so midsagittal plane is parallel with IR. Respiration: Obtain radiograph during suspended respiration, Central Ray + Direct perpendicular to C7-T1 interspace. + Use 5-dearee caudal angulation if shoulders cannot be adequately depressed, COMPENSATING FILTER + Always perform with a specially designed compensating filter Reference: ith edition ATIAS pp. 1413414. Patient Position + Position patient recumbent oF spin Part Position = Center midsagittal plane (0 IR {Position top of IR 178 10 2 “ Hhve patent hold arms at sies, shoulder in same plane 1 Flex hips and knees to reduc Respiration Obtain radi sentral Ra = rane Tee aie to the IR. The central ray should be approxi= rately midway between jugular notch and xiphoid process AU COMPENSATING FILTER J = Always perform with a specially designed compensaung filter iiches (3.8 40 5 em) above shoulders dorsal kyphosis. ph during shallow or suspended expiration. Reference: 11th edition ATLAS pp. 1:415417-Patient Position Part Position + Center posterior half o + Place top of IR 1 shoulders + Elevate head to spin + Extend arms forward, + Place radiolucent support uncler lower thoracie region until s horizontal tots Respiration: Obtain radiograph during shallow or suspended expiration Central Ray + Direct perpendicular to center of IR at level of posterior half of thorax. 17. Central ray enters Reference: 11th ediim ATLAS pp, 1418420. AP Patient Position + Position patient supine + Flex hips and knees for londoss, Part Position “enter midsagittal plane to grid. ek knees and hips enovgh to place back in fem contact with table ter IR at itiac crests (L-4), sduee Humbar suspended respiration. Central Ray + Direet perpendicular to 6 +r of IR, entering at level of iliac crests. ‘Reference: 11th eltion ATLAS pp TeA24827.Patient Position » Position patient late Part Position + Center IR 10 level of iliae < + Center midvoronal pla + Extend arms forward + Place radiolucent st ort under Tower thorax adjust spine parallel tw table + Place lead rubber behind patient to absort radiation Respiration: ph during suspended expiration. Central Ray + Dineet perpendicular to IR, tine crests z midcoronal plane at level of Reference: 10h edition ATLAS pp, 1428-829, Patient Position += Position patient lateral » Ae Pait Position = Extend arms forward, + Place radiolucent support under lower thorax: adjust spine parallel ith hips and knees extended or slightly tw table. = Chock for true Respiration: Obtain radi Central Ray citer on coronall plane 2 inches (5 em) posterior to ASIS andl iph during suspended respiration. 1 inch (2.5 cm) superior to ASIS, + Have central ray parallel to interiliac line; caudal or e&ph angulation of 5 to 8 degrees may be required. * Collimate tightly Reference: 11th eltion ATLAS pp, 1430-431. kVp: 95FAvoleler nye AP oblique (RPO and LPO) Patient Position + Po on patient posterior obliqu le Part Position + Adjust and support body: obliquity to 45 degrees oH tomidline of grid, + Take both side obliques. fe patients place arms in a comfortable position, and center spine Respiration: Obiain radiograph during a suspension at et Central Ray + Direct perpendicular and entering 2 inches (5 cm) medial to elevated AS iches (3.8 em) above iliac crest (L3). + Center IR to central ray. of expiration. ‘Reference: IIth editon ATLAS pp. 1:432-433. Patient Position + Position patient sup Part Position + Center midsagittal plane to gr + Extend lower limbs or lex hips and abduct to remove from path ‘of central ray Respiration: Obtain radiograph during Central Ray. Direct 30 10 35 degrees cephal that central ray enters about 1’/ pubic symphysis. = Center IR to eemtral ray, trough lumbosacral je hes (3.8 em) superior 10 Reference: 11th edition ATLAS pp. 1436-437. kVp: 85Patient Position + Position patient supine ar led Sieh Part Position * Elevate and supp + Align sagittal plan ASIS, and center to grid + Take both side obliques. + Center IR at evel of ASIS. Respiration: Obtain radiograph during Suspended respiration, Central Ray * Direct perpendicular to IR, clevated ASIS. side of intere 0 degrees from table, 2.5 cm) medial to elevated passing 1 inc entering 1 inch (2.5m) medial to. rence: 1th edition ATLAS pp. 1438-839. Patient Position Part Position Rospiratos Central RayPatient Position + Position patient lateral with hips and knees Part Position + Support Body to place Tong axis of spine horizontal B « Prepare for positioning of central ray by centering sacrum to ; midline of Respiration: Obtain radiograph during suspended respi Central Ray + Direct perpendicular to feyel of ASIS and at a (9:em) posterior. += Center IR to central ray. Reference: 1th eltion ATLAS pp. 1467, ois Patient Position Port Position Centro! RoyPat Pesiion midline o Respiration: Obtain radiograph during | 5 i . ' 1 Central Ray + Direct perpendicular to a point 3/4 inches (9 em) post ‘and 2 inches (5 cm) infenor + Center IR to central ray Keference: 11th eon ATLAS pp. 1446-447, Thoracolumbar Spine: Pe ial EU AoM ec comicu incl) Patient Position + Posi Part Position += Use two images: * Postion bottom of IR to include approximately 1 inch (2. ens) iliae crests, + Adjust midsagittal ‘Have patient relax arms at sides + Obtain first exposure with patient in normal + Elevate foot or hip of convex side of curve 10 em) for second image. * Do not suppor patient i Respiration: Obiain radiograph during suspended respiration. Central Ray + Direct perpendicular to midpot ane perpendicular to midline of gr. right position 310 4 inches (7.6 10 s position, of IR. Reference: 1th edition ATLAS pp 12452453:SYS DD BD DO a Crete Da nd La dvchiah onbaiacenaite tad PA oblique (RAO). 212 sci alco ori co eee Er id Local iy ool cecal vachalepc aca q Te seer] Deo Geek deer Eton Tone aor) Patient Position of bands on hips, + Position patient standing or seated ith b Part Position = Center midsagittal plane with chin extended and eyes straight ahead. = Have patient roll shoulders forward. TPlace top of IR 124 to 2 inches (38 to 5 cm) above relaxed shoulders «+ Have patient flex arms and rest backs of hands on hips. Respiration: a radiograph during suspended full inspiration (afier second Central Ray + Perpendicular to the center of the IR, Use SID of 72 inches (183 em), which is recon Reference: Lth-edition ATLAS pp, 1:510-S12, 518-521, 532-538. kp: 110.Chest i PA oblique (AG Patient Postion + Position patient standin Side farther from IR is usually side of primary interest Part Position = Adjust coronal plane 45 degrees from plane of IR. 1 piace top of IR 134 to 2 inches (3.8 (0 5 em) above shoulders, Have patient roll shoulder nearest IR posteriorly and place Irand on hip. « Have patient place arm farther from IR. on top of IR holder + Center thorax to ER. Bath 45-degree obliques may be taken. ‘adiograph during suspended full inspiration (after second Central Ray = Direct perpendicular to IR at level of T7. Use SID of 72 inches (183 cm), which is recommended meastire. Aeference: Fth edition ATLAS pp. 1:526-529. ce i PRPs AG nok Patient Position + Position patient erect or supine primary interest. Part Position + Adjust coronal plane 45 «Place top of IR, 11 to 2 inches ( + Have patient roll shoulder nearest IR anterior! ‘on head. « Have patient place arm farther from IR on hip. c Center thorax to IR. Both 45-degree obliques may be Respiration: Obtain radiograph doring suspended full inspiration (after second inspiration). Central Ray ‘ Direct perpendicular to center of IR ata level 3 inches (B em) below jugular notch (level of 77). Use SID of 72 inches (183 em). wish is recommended measure. Reference: 1Mh edition ATLAS pp. {530531 s IR is usually side of sees from plane of IR. to S em) above shoulders, 1d place hand enPatient Position = Position patient supine or Part Position » Center IR 10 mids a 2 inches (3.8 to 5 em) above shoulders pe flex elbows. pronate hands. and place hanes al plane, and iadjust upper border to be 114 to + If possible, have pati hips ration: —_ a h during suspended full inspiration (after second ey Central Ray + Direct perpendicular to center of IR at level 3 inches (8 em} below vulur notch (level of T7), Use SID of 72 inches (183 em), which is nited mess Reference: 11th editon ATLAS pp- 1:532-533. ae As es Reekorco Patient Position + Position patient standin x . front of ; IR. When patient is p si top of IR should be approx imately 3 inches (8 em) above shoulde Part Position + Center mids + Have patient flex elbows, hands wil * Have patient Jean backward in extre Respiration’ Obtain radiograph during suspended full inspiration (after second Inspiration. Central Ray ‘ al plane with no rotation lms out on hips ¢ londotic position. “= + Direct perpendicular to IR entering midstemum. Use SID of es (18 DIGITAL RADIOGRAPHY * Envure collimation is extremely clove to prevent unnecessary radiation from reaching IR phosphor. Reference: Ht edition ATIAS pp, 1534-535, mn), which is recommended measure.rire BGrd eA Cslicc Patient Position Part Position condition + Elevate th chest on firm pad, (Generally “fluid down” or ait up”) + Have patient extend arms above head: adjust thorax in trae ateral position, + Place top of IR approximately 116 t0 2 inches (3.8 to 5.em) above shoulders Respiration: ‘Obain radiograph during suspended full inspiration (after second inspiration) Central Ray + Direet horizontal and perpendicular to center of IR at level 3 inches (8 cin) below jugular notch (at T7 for PA). Reference: th edition ATLAS pp. T:538539. Lungs and Pleurae ~ eleenGoes koe con! Patient Position + Position patient prone or Part Position + Elevate thorax 2 Sto Sem) and center with affected sid + Ha + Place top of IR. | (level of thyroid cartilage). Center mideoronal plane to center of grid Respiration: Obiain radiograph during suspended full inspiration (afler second \spiration). Central Ray + Direct horizontal and midcoronal plane and 3 inches (8 ch ventral decubitus) S.em) above top of shoulders ntered to IR, Central ray will be at fevel of below jugular notch (17 for Reference: [Ith etion ATLAS pp. 1-540. kVp:125 a SOEe Patient Position | | Part Position + Center midsagittal plane to grid witly chin extended and eyes straight ahea + Place top of IR approximately 1/6 inches (3.8 em) above shoulders + Have pationt roll shouklers forwaird and rest back of hands on hips. Respiration: Obiain radiograph diaphragm. Central Ray * Direct perpendicular to «« level of 17, ing suspended full inspiration 1 depress er of IR, This places the central ray at Reference: 11th edition ATEAS pp. 1488-489. AP Patient Position Part Position + Center midsagittal plane to m 1 Above diaphragon: Place top of IR-1/A inches (3.8 cm) above relaxed. shoulders. + Below diaphragm: Cent + Rotate shoulders anteriorly Respiration: ‘Above diaphragm: Obwain radiograph during suspended ful Below diaphragm: Obtain radiograph during suspended full expiration, Central Ray + Direct perpendicular to center of IR. thorax with bottom of IR at level of iliac aspiration, Refecence: Lith edition ATLAS pp. 1:490-491.ern Patient Position = Position patient Part Position * Rotate patient's bo 45 degrees with affected side toward TR. n midsagittal plane and lateral = Center plane m of body + Atduet arm nearer IR, and place hand on b + Absluct opposite lim, and place hand on hip. Genter top of IR 1/4 inches (38 cm) above Felaxed shoulder (for above diaphr (for betow diaphragm. Respiration: Above diaphragor: Obtain radiograph during suspended fall inspiration, Below diaphragm: Obtain radiograph during suspended full expiration. Central Ray + Direct perpendicular to center of IR. ) and with lower edge of IR at level of ile crest Reference: 11th edition ATLAS pp. 1:492-193- Patient Position Part Position ‘middsagittal plane and Tateral body + Abdlct and extend arm nearer IR and rest on hip. 7 Abuluct opposite drm and rest on film holder or head. inches (3.8 em) above relaxed shoulder (for enter top of IR I above diaphragm) and (for below diaphragm). Respiration ‘Above diaphragen: Obtain rediogfaph doring suspended fall inspiration, ‘Below diaphragm: Obtain radiograph during suspended full expiration. Central Ray + Direct perpendicular to center of IR. with lower edge of IR at level of iliac erest Reference: 11th edition ATEAS pp 1494-95.CU) k PA oblique (RAO) Patient Position + Position 1 Part Position * Center stera = Rotate patient's body 15 prevent superimposition vertebral and sternal imag « Center IR midway between jugular notch and xiphoid process at level of 77 Respiration: Obtain rad z or suspended expiration, Central Ray Central tely 1 inch (2.5 + Direct perpendicular exiting at T7 midst elevated side of posterior thorax approxim lateral to midsagittal plane. Reference: L1dh etion ATLAS pp. 1472473. KV: 65 CUT) Lateral Patient Position Part Position + Place top of IR | Have patient rotate shoulda rans above head for recumbent position inches (3.8 em) above jugolar noteh ing; pl . «+ Cenier sternum to grid, Adjust to true lateral position. Respiration: Gbiain radiograph during suspended dsp inspiration. Central Ray + Direct perpendicular to center of IR en mum, Use SID of 72 inches (183 em). Imeastire to reduce sternal magnification DIGITAL RADIOGRAPHY «Ensure that collimation is extremely close 0 prevent unnecessary radiation from reaching IR phosphor. Reference: 11th ection ATLAS pp. 1:476-872. lateral border of mid- ‘which is recommendedcron ott 8 TMCNET Patient Position + Position pater Part Position * Center IR + Have patient 2 sides of body with palms faci upward + For bilateral examination. have patient rest chin on tabl + For unilateral examination, have pati turn head towar affected Side and rest cheek on table Respiration: Obi Central Ray idiograph during suspended expiration + Direct perpendicular to center of IR entering T3. NOTE: Same proj Reference: 11 edition ATIAS p. :480. Patient Positi + Position pati Part Position + Keep project the ve + Center joint Respiration: Oban ra Central Ray + Direct perpendicular to stemnoc fay enters T2 to T3 and 1 to 2 inches ( joint ion ph do affected side adjacen ‘Reference: 11h edition ATIAS p. 1-481 be obtained by placing patient prone and ng centeal ray 15 degrees. {cular joint closer to IR. fall expiration to obtain move: uniform Javicular joint loser 19 IR. Central to $ cm) laterally toward, keypi 65Ey ou Ee oreo r Ce ere) AP oblique (RPO or LPO) 272 eee} eee. mcm) Patient Position + Position patie supine Part Position = Center midsagital plane to grid {Maintain shoulders in same transverse plane Support under knees, a Carlee IR at level of iliac crests, and ensure that pubic symphysis will be included = Apply gonad shielding & appropriate Respiration: Obtain radiograph during suspended expiration Central Ray «= Direct perpendicular to IR midline at level of iliac erests NOTE: This positioning is also used for intravenous and retrograde rography. ‘Reference: 1Ith edition ATLAS pp. 2102-108:Abdomen AP (upright), Patient Position Part Position + Center midsay 1 Maintain shoulders in same transverse pI + Gamer IR 2 inches (5 em) above iliac crests to include + Apply gonad shielding as appropriate Respiration: ‘Oblain radiograph during suspended ex Central Ray + Direct horizontal a center of IR al ph aphragm. piration. 2 inches (5 cm) superior to iliac crests 10 ‘Reference: 11th eition ATLAS pp. 2:102-103. Pree Alecks cocoon: Patient Position knees slightly ‘ prace patient's arms above leve Part Position penajuse mideagittal plane perpendicular w and centered to grt deviee ter IR at level of iliae eres + GEME > inches (5 em) abore ili cress if diaphragm is to Be includ «= Apply gonad shielding as approP™ Respiration: suspeneded expiration: radiagraph dri Central Roy «= Dircet horizontal and perpen NOTE: Demonstrate side up for cular to midpoint of IR rand side down for fh 204105. ‘Reference: [1th edition NTLAS pp.Patient Position + Position patien Part Position 5 Conter I plane « + Have patie 1 Comet IR at level of ili crests or approximately 2 inches (S em) superior (crests if diaphragm is to be included. Respiration: ‘Obtain radiograph during. suspended expiration Gentral Ray = Direct perpendicular to midpoint of IR NOTE: This positioning is also used for intravenous and retrograde uurography Reference: 1th edition ATIAS p,2:108. Perel) dorsal Patient Position + Position patient sup Part Position wer head. Patient = Center vertical grid device to midcoronal plane at level 2 inches Respiration’ ‘Obtain radiograph during susp Central Ray wled expiration = Direct horizontal and perpendicular to center of IR, entering idcoronal plane 2 inches (S em) above iliac crests, DIGITAL RADIOGRAPHY + Because of the higher kVp used for this projection, ensure Collin tign is extremely elose to prevent primary from reaching IR phosphor and Causing computer artifacts Reference: Lt edisian ATUAS ps kvp:95eed aN Patient Position Part Position £ Center rid Eps ave te headin comfortable postion. “Have patient place arms above the Hea in Gon Adjust shoulders and hips equidistant front Teac tapor IR at level of mouth ; x Jhily to facilitate drinking barium mixture, am at barium to pa Respiration: Obtain radiozrap Central Ray = Direct perpendicalar t0 mi h during suspended expiration: iadpoint of IR at level of T5-T6, ‘Reference: Vth edition ATLAS pp. 23138-139: Esophagus Eo AGE) Patient Position Part Position lente let side t y of 3510 40 degrees + Support patient on flexed knee and elb + Place top of IR at level of mouth * Align esophagus and center clevated side through plane 2 inches: (S-em) lateral 19 mid . * Give barium to patient Respiration’ Oban radiograph dui Central Ray + Direct perpendicular to midpoint of IR a level of TS oF TO. NOTE: If patient cannot assume prone position, a similar imige ean be ‘obiained by using LPO position, modified as described above, g suspended expiration. Reference: 1h eliiin ATLAS pp 2138-159 kyp: 110,not the pillow Part Position + Cenier midcoronal plane to grid. «+ Have patient bring arms forward and slightly Nex hips and knees. * Place top of film at level of mouth. + Give barium mixture to patient, Respiration: Obiain radiograph during suspended expiration, Central Ray + Direct pery ficular to midpoint of IR at level of T5-T6. Reference: 11th edition ATLAS pp, 2138139. eect) Bt Patient Position + Position patient p Part Position = Center IR ate stsiominal cavity for 24-> 30hem IR or (2) mids ted level of L 1-12. betwen midline and left lateral border of tal plane for 35. 43-cm IR. Respiration: ‘Otain radiograph during suspended expiration Central Ray + Direet perpendicular to IR at level oF 112. Reference: Ph edition ATHAS pp. 2:046:145 kVp: 100Brecabeucleie PA oblique (RAO) Patient Position Part Position *Ble ces. (Hypersthenic patients require the greatest rotation) + Center IR at evel of LL + Position patient so a sagittal plane passing midway between er elevated side is centered Respiration: Obtain radiograph during sis Central Ray + Direct perpendicular to center of IR midway between vertebral column and lateral border of abdomen at level of L and support patient to obliquity of 40 t0 brae and lateral bo ded expiration. Reference: Ith edition ATLAS pp, 2:148:149, Patient Position Part Position ide, and support patient 10 obliquity of 30 to Hypersthenie patients require the greatest rotation; for asthenie patients.) n patient so sagittal plane passing midway between vertebrae and Teft margin of abdomen is centered to IR + Center IR at level of L112. Respiration: ‘Obtain radiograph during suspended expiration Central Ray + Direct perpendicular to center of IR midway beweeen vertebral cofuinn and left lateral border of abdomen at level of L1-L2. Reference: Ih ein ATLAS pp. 2:150.4SL kVp: 100Patient Position + Position patient ercet (let Part Position + Adjust body so plane abdominal surface is centered \ + Center IR at level of L1-L2 + Adjust to tre late Respiration: Obtain radiog Central Ray + Direct perpendicular to center of IR midway between mideoronal plane and anterior surfa at evel of L1-L2 for recumbent or L3 for ph during suspended expiration, ‘of abdom Fight position, Reference: 11th edition ATIAS pp. 2: 152-133. kVp: 110 Patient Position on patient supine. CT be placed in partial Trendelen: Part Position + Adjust patient so midline of 1 coincides (1) halfway bet 11 border of abdomen for 24- x 30-cm IR or (2) at iidsagital plane for 35-* 43-cma IR. + Cemter IR at level of LI-L2. midline and I Respiration: Obtain radiog Central Ray + Direct perpendicular to IR at level of pylorus (LI aph during suspended expiration. Reference: Lah edition ATLAS pp. 2:154-155,pT lael Melon ese) AP Patient Position + Position patient supine, (Table may be placed in partial Trendelen- burg position to better d Part Position + Adjust patient so midline of grid coincides (1) halfway between nd lateral border of abdomen for 24- % 30-em IR oF (2) at sl plane for 35- X43-em IR. + Cemter IR-at level of L1-L2. midline Respiration: Obiain radiograph du Central Ray * Direct perpendicular to TR at level of pylorus (L.1-L2). suspended expiration, Aeference: 11th ection ATLAS pp, 2:134- 188. ea rea Patient Position «Position patient supine oF prone Part Pos Center midst *Cemter IR at level of iliac crests (m ne exposures). Respiration: Obtain radiograph during suypended expiration. Central Roy + Direct perpendicular to IR-entering fevel of iliac crests (or slightly above). to grid iy be stighily higher for early Reference: 1h edition ATLAS pp, 2: 160.161,Peele T MSU iN Potient Position Respiration: suspended expiration, Central Ray + Direct perpendicular to IR entering level of iliac crests Koference: Lith edition ATIAS pp. 2:176177. Large Intestine GAL Patient Position + Positi patient pro Part Position + Center midsagitta! plane to grid with center of IR at level of Respiration: « raph dor Central Ray + Direct 30 to 40 degrees caudad, For demonstration of reuosigmoid area using smaller IR, direct central ray so it enters midline at level of ASIS. 1g Suspended expiration. Reference: 11th edition ATLAS p, 2/178eee a AC A ique (LAO and RAO) Patient Position + Position patient PA obi Part Position » Rotate patient 35 to + Flex knoe for stability + Center body: to midline of or left side up, + Adjust center of IR at level of iliac crests Respiration: Obtain Central Ray « Direct perpendicular to IR entering elevated side 1 102 inches 2.5 0 5 cm lateral to midline of body on elevated side and at level eraph during suspended expiration References 1th éltion ATLAS pp, 2179-180: eee} fee Pationt Position + Position patient late Part Position * Adjust body to true fater (right oF left side down). * Center mideoronal p in {0 center Of grid, * Center IR to ASS. = Have patient flex knees anc hips slight! Respiration: Obtain radiograph di Central Ray + Direct perpendicular to IR entering midcoronal plane at le of ASIS. andl bring arms forward, suspended expiration Reference: 11h editon ATLAS p. 2:18.Large Intestine ag Patient Position * Center IR at level of iliac crests Respiration: (Obtain rad Central Ray + Direct perpendicular to IR. entering midsagital plane at level of iliae crests Reference: Mth edion ATIAS p.2:182. Large Intestine AP axial Patient Position Part Position + Center midsagittal plane to eri Center IR at level of 2 inches (5 cm) above iliac eres Respiration: Obtain radiograp Central Ray = Direct 30 0.40 degrees cephalad, em below level of ASI. (When retrosien ‘central ray enters inferior margin of pubic sym ing suspended expiration Reference: 1th editon ATLAS p. 2:183.Patient Position Part Position + Rovate patie * Center abdomet AP obl 35 t0 45 degrees from AP position either right or left + Adjust center of IR to level of iliac crest, Respiration: Obtain radiograph dui Central Ray suspended expiration + Direct perpendicular entering elevated side 1 t@ 2 inches (2.5.10 Scm) la Reference: 11th edtion ATLAS pp, 2184-185, I 10 midline of body at level of iliac crests. Pationt Position Part Position + Place arms above head with knees slightly Mexed. + Center IR to midsagital plane at level of iliac erests Respiration: CObiain radiograph during suspended expiration. Central Roy Direct horizont ‘References Eth edition ATLAS pp. 2187-188. FR at level of iliae crests and perpendicular tPeer Mar eicmiamone Patient Position Part Position = Adjist arms to remove from area of interest, and distribute weight ually on fee * Center IR at PA projection, (2) midway between midsag aspect of side of interest for oblique Ane for lateral position. plane for AP or © and Lateral Respiration: Obrisin radi raphy during suspended expiration, Central Ray + Direct perpendicular to IR at le of ila crests Referee: 11° edition ATLAS p. 22190. Patient Position + Position patient supin Part Position + Rotate patient 30 degree + Place support unser ele r + Adjust hips and shoulders planes. + Genter spine to grid + Genter IR at level of iliac crests Respiration: Obtain radiograph during suspended expiration. Central Ray + Direct perpendic ‘erests entering ele approximately 2 sidetlle f lets moni Patient Position + Position patient supine Parl Position + Center midsagittal plane (0 grid (4 (Sto 7.5m) above pubic symphysis to demonstrate the or (2) at pubic Symphysis for vosding studies e Rajust shoulders and hips to be equidistant from TR { htane patient place arms across upper chest of al Sid + Have patient extend legs Respiration: Obtain radiograph du Central Ray = Direct 10 10 15 degrees eaudad (1) at level 2 t© 3 inches (3 ‘above pubic symphysis fo demonstrate bladder oF (2) at ened expiration 75m) pubic symphysis for voiding studies. Reference: 11h enon ATLAS pp. 2:252233:. Pe AP oblique (RPO or LPO) Patient Position + Position patient supine Part Position te patient 40 to 60 degroes from supine TR 2 to 3 inches (5 10 7.5-em) above upper border of pubic ysis and 2 inches (S cm) medial to ASIS. + Have patient abcluct uppermost thigh to peevent its fon bladder area Respiration: ‘Obitin radiograph d Central Roy + Direct perpen " hes (S em) medial to midsagittal plane (1) at level 2 10 3 inches (5 to 7.5 em) superior to pubic symphysis or (2) at pubic symphysis for voiding studies. NOTE: RPO position is also used for male cystourethrography. pended expiration Reference: th eltion ATIAS pp. 2.234.235.Bladder eel Patient Position = Adjust patient's arms = Center IR 2 inches (S em) ab Respiration’ Obtain radi Central Ray + Direct perpendicular to IR. enter; symphysis. ion ATEAS p.2:236, Reference: 1 during suspended expiration. nches (5 em) above pubie Kvp: 95 ee ee ceed pee we sons\bbreviations Used in This Section one AML focal ine FAM TOM OL: Orbitomeatad line onsereantius Fovaorita margin ference: [1th edition ATEAS p.2:300. LLL" N attachment External acoustic ‘ meatus vee aa (g2nion)Cranium Piven hoster iene Ualaiiccd Patient Position + Position patient seated erect or prone. Part Position + Have patient rest head on forehead and nose midline of grid device + Position midsagittal plane perpenilic + OMIL is perpendicular to IR. Respiration: Obiain radiograph d Central Ray Direct perpendicul + Caldwell method: D + Center IR to centeal ray. NOTE: If patient is obese o hypersthenic, a small radiolucent sponge ‘may be needed under forehead. 1g suspended respiration. to IR exitin ject 15 degrees caudad exiting Reference: Ith edition APIAS pp. 2:3106313. Part Position Contrai Roy * AR: + AP axial: < ad ns. ‘kVp: 80Patient Position + Position patient Patt Position + Position midsagittal plane parallel 10 IR. “TOML is perpendicular to front edge of IR ‘+ Intexpopillary line is perpendicular to IR. Respiration: ‘Obtain radi Central Ray + Direct perpendicular entering 2 in + Center IR to central ray suspended respiration. ph durin yes (5 em) superior to EAM, Reference: 1th edition ATLAS pp. 2306-307, corel) keoMcnn suse Patient Position Position patient seated erect Or supe Part Position Center midsacgittal plane to midline of gril devie, and adjust to ake perpendictiar «Have patient flex neck, aid adjust OML perpendicular to IR. When patient cannot flex neck, place IOML perpendicular. + Plage top of IR at level of eran Respiration: ‘Obtain radiograph du Central Ray Direct through foramen magnum with caudal angle of 40 degrees to OML 6 37 degrees to JOML., Central ray enters approxintatel Ys inches (6.4 ei) superior to glabella and passes through Tevel of EAM. pended respiration, efereice: 11th eon ATEAS pp. 2:316321.Cranium Pee nC aise) Patient Position + Position patient seated erect or prone. Part Position + Have patient rest head on forehead and nose, + Place arms in comfortable position ‘Adjust shoulders to lie in same transverse plane. + Adjust head so that mids wo, Respiration: Obiain radiograph during Central Ray + Direct 25 degrees cephalad enteri to extemal occipital protuberance ( (38-em) superior to nasion. iypended respiration. Reference: 1th edition ATEAS pp. 2:322-323. SCHULLER METHOD. jttal plane and OME are perpendicular n) and exiting 114 inches Patient Position + Position patient seated erect at head unit or supine on elevated table support Part Position + Have patient extend neck and rest head! on vertex. * Center and adjust midsa + Adjust JOML. parallel to plane of IR if possible. + Immobilize head. suspended respiration, Central Ray + Direct through sella tureica perpendicular to 1OM angles of mi + Central ray passes throu of EAM. point % inch (1.9 em) Reference: [1th ection ATLAS pp. 2:324-325, tal plane perpendicular to TR. centering between rior 0 level xfey eerie ole R celia) fester sieikes eis aia Patient Position Part Position * Center affected orbit vo IR. + Have patient rest head on 7ygoma, move, and chin, + Adjust AML perpendicular to 1R. + Rotate midsagital plane 53 degrees from IR. Respirction: Obtain radi Central Ray + Direct perpendicular entering approximately Li superior and 1 inch (2.5 cm) posterior to elevated top of car attachment exiting orbit closest to IR + Ensure that collimation iy extremely close nter IR to central ray. raph during suspended respiration Reference: [10h edition ATUAS pp, 2396-337. Facial Bones freee) Patient Position Part Position + Postion zygomatic bor + Adjust midsagittal plane parallel (0 IR. + 1OML is parallel with transverse axis of IR. * Interpupillary line is perpendicular to IR Respiration: Obiain radiograph during suspended respiration. Central Ray + Direst perpendicular entering lateral surface of zygomatic bone halfway between outer canthus and EAM. + Center IR to central ray to center of grid. Reference: 110h edition ATLAS pp. 2389-351.Patient Position Part Position * Center and adjust il plane perpendicular to IR, and have patient res wed ch + Hyperextend neck and adjust OML to form 37-degree IR plane + Mentomeatal line is approximately perpendicular to 1R. * Usually patient’s nose is about % inch (1.9 em) from + Center IR to acanthion. Respiration: ‘Obiain radiograph during suspended respiration Central Ray ion. + Direct perpendicular exiting & Reference: [th edition ATIAS pp. 2:352°353. Facial Acanthoparietol REVERSE WATERS METHOD Patient Position * Position patients Part Position + Ceinter and adjust midsagittal plane perpendicular to IR. + Adjust extension of neeK so th degree angle with plane of IR. If necessary, place a support under patient's shoulders to help extend neck + Mentomeatal line is approximately perpendicular to plane of IR + Adjust head so-that midsagittl plane is perpendicular to plane of IR Respiration: ‘Obiain radiograph during suspended respiration ‘Central Ray + Direct perpendicular (o enter acanthion ter IR to central ray. Reference: 11th edition ATLAS pp, 2:386-357.IN ferol tel feria Patient Position + Position patient seated erect or semipron Part Position on w IR. ital plane parallel to IR. nsverse axis of IR. = Center i = Adjust mids = JOML is parallel with ti += Interpupillary line is perpendicular to TR. Respiration: ‘Obtain radiograph during suspended respiration. ‘Central Ray + Direct perpendicula + Ensure that collimation is extreme] entering 4 inch (1.3 em) distal to nasion, close. Reference: 11th edition ATLAS pp 28004361. Pure Rise ae uicol Patient Position + Positign patient “ot or supine on elevated table support Part Position + Hyperextend neck, and have patient rest head on vertex: * Conter and adjust midsagittal plane perpendicular to ER + Adjust IML parallel with IR if possible Respiration: ‘Obtain radiograph during suspended respiration Central Ray + Direct perpendicular TOML entering midway betw rehes. ters approximately I inch (2.5 em) poster + Central ray € amt Reference: 11th etion ATEAS pp. 2:362-363.Paella eleealcill civ eaice Patient Position + Position patient seated erect or supine Part Position + Hyperextend neck. Ee ad adjust midsagittal plane perpendicular 0 IR. + Adjust IOML as parallel as possible with IR, + Rotate mids tal plane 15 degrees toward side then tilt top of head approximately 15 degrees av ‘examined So that central + Center zygomatic arch to IR. examined, Respiration: Obtain radiograph during suspended respiration Central Ray += Direct perpendicular to [OML enter point 1 inch (2.5 em) posterior fo eoter canthus. Reference: 11th edition ATEAS pp. 2:564-365. arerdurle ici} el ce Mesh ad ince Patient Position P Part Position + Center inidsagittal plane to grid device, and (just to perpendicular « Flex neek, and adjust OML perpendicular 0 IR. Respiration: ‘Obiain radiograph during suspended respiration. ‘Central Ray = Direct 30 de cos caudad entering glabella approximately 1 inch (2.3 em) superior (o nasion. (Direct 37 degrees caudad if 1OML is perpendicular to IR.) + Center IR to central ray. Reference: 11th eltion ATLAS pp. 2:566°367.Central Ray ielatelen ela selal Patient Position + Position patient Part Position + Position midsapittal plane perpendicular to IR + OMIL is perpendicular to IR + Have patient rest foreliead and nose on ER holder Respiration: Obiain radiog Central Ray + Direct 20 10 25 degrees cephalad exiting + Cemer IR to central ray ph during suspended respiration. Reference: [sh edition ATLAS p, 2:369.Mandible Teewekessitc Patient Position + Position patient se: Part Position + Place head in lateral position with interpupillary line perpendicular fo IR. Have patient close mouth and keep teeth t + Extend neck enough that long axis of mandibular body is parallel with transverse axis of IR, preventing superimposition of cervieal spine. + If projection is being performed on tabletop, position IR so that complete body of mandible is positioned on IR. + Adjust rotation of head so that area of interest is parallel to IR as follows: (1) ramus: Keep head in true lateral position; (2) body rotate head 30 degrees toward IR; (3) symphysis: rotate head ed erect, semisupine, or semiprone. radiograph during suspended respi Central Ray + Direct 25 degrees cephalad to pass directly through mandibular region of interest Reference: 1 Ith edition ATLAS pp. 2:372-374. kvp: 75 BCT Soleil ie =. oleae bd Gio Patient Position + Position patient seated erect or supine Part Position + Adjust head s tal plane is perpendicular to TR. + lex neck to place OML perpendicular to IR. © After first exposure with patient’s mouth closed, do not permit patient to move. Change IR, and make second exposure with mouth fully open, Respiration: ‘Obiain radiograph during suspended respiration, Central Ray + Direct 35 degrees caudal centered (0 entering approximately 3 inches (76 * Center IR to central smporomandibular joints ) superior to nasion. Reference: [1th edition ATLAS pp 2:376:577.Temporomandibular Articulation Axiolateral oblique Patient Position + Position patient seated erect or semiprone Patt Position + Center a point ¥ inch (1 i ale! with transvers 3 em) anterior to EAM to IR + Rotate midsag c 15 degrees toward IR. + Adjust AML pi axis of IR, + Interpupi tary line is perpendicular IR. e with patient's mouth closed, do not permit id exposure with + After first exposu patient to move. Change IR, and make sec patient's mouth fully open. Respiration: Obtain radi Central Ray + Direct 15 degrees caudad exi tok + Ceateal ray will enter about 14 inches (3.8 em) superior to upside EAM. Ieerence 10h ein ATLAS pp. 2380-381 ph during suspended respiration. ‘emporomandibular joint closer Paranasal eis Lis Patient Position ssition patient seated erect Part Position + Adjust head to teve lateral position, + Midsagittal plane is parallel, and interpupilla toIR « Adjust |OML horizontal and parallel with transverse axis of IR Aine is penpendicular Respiration: Obiain radiograph during suspended respiration Central Ray + Direct horizontal and perpendicular entering Y4t0 1 inch (1.3 10 2:5 em) posterior to outer canthus. enter IR to geniral ray ‘Reference: Nth ediion ATIAS pp. 2:394:395Frontal and Anterior Ethmoidal Sinuses PMoelmes a Gua Patient Position + Position patient seated Part Position + Tilt vertical + Have p + Position mids rid device down 15 d ent rest head on Forehead and « perpendicular to midline of IR. + OML is perpe + This positioni Respiratio Obiain radio Central Ray + Direct horizontal (0 center of IR exiting masion, NOTE: If grid device cannot be tilted, place a radiolucent sponge between forehead and grid so that OML remains 15 degrees from horizontal x-ray beam -es from horizontal central suspended respiration. Reference: 1th edition ATLAS pp, 2:396-397- Peta ae Rou Rac pare ete) Pationt Position * Position p Patt Position + Cenier and adjust micsagittal plane perpendicular to TR, and have patient nest head on extended chin + Adjost OML to form 37-degree a “approximately perpendi = Center IR to acanthion + Open mouth option: Have pats fully open mouth to demonstrate the sphenoid and maxillary sinuses. Respiration: Obtain radiograph during suspended respiration, Central Ray = Direct horizontal and perpendicular to IR ex ng acanthion Reference: [1th etion ATEAS pp. 2:398-399.Ethmoidal and Sphenoidal Sinuses ieateienicel Patient Position Part Position + Center a 1 midsigittal plane perpendicular to IR. + Adjust JOML paral} with IR Respiration: Obuin Central Ray + Direct horizontal und perpendicular to TOME * Central ray enters approwimately % inch (19 emi) of EAM dlr nded respiration Reference: Ith eton ATLAS pp. 2:402-403 us Reruns cut edds Revere scl a as kau Patient Position + Posi Part Position + Position head in | te midsagittal plane (face) 15 d + From true lateral position, 10 toward IR, sTOML is parallel with transverse axis of IR. Inierpupillary line is perpendicular 0 TR. Respiration: Obtain radiograph during suspended respiration Central Ray «Direct 15 degrees eaudad entering approxitnately 2 inches (Sem) posterior and 2 inches (5 cm) superior to EAM farthest from IR «+ Central ray exits 1 inch (2.5 cm) posterior to EAM of affected side, + Center IR to central ray. kvp: 75 Reference: [Lv edition ATLAS pp, 2528-329.Petromasstoid Portion Axiolateral oblique (posterior profile) _STENVERS METHOD Patient Position + Posi Part Position + Have patient rest + Adjust IOML parallel to IR imidsagital plane at 45 Respiration Obiain radiograph during suspended respiration Central Ray + Direct 12 degrees cephalad emtering 3 to 4 inches (7.6 10 10.

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