Ace PDF

Prepared by: Mohammad Mohsen G.
Malik, RRT
Radiography
-process of taking a radiograph to assist in medical
examinations.
Radiograph
-is a film containing a manifest image of an anatomical
part.
IDENTIFICATION OF RADIOGRAPH
-NAME OF THE PATIENT

-PATIENT`S AGE OR BIRTHDATE OF THE PATIENT
-DATE
-GENDER
-secondary marker
-Patient position
-Name of the Institution
* PATHOLOGIC CONDITION THAT REQUIRE DECREASE OF
TECHNICAL FACTORS.
* PneumoThorax
* Old Age
* Emaciation
* Degenerative Arthritis
* Atrophy
Normal CXR vs. Pneumothorax
* PATHOLOGIC CONDITION THAT REQUIRE INCREASE OF
TECHNICAL FACTORS.
* PLEURAL EFFUSION
* HYROCEPHALUS
* EDEMA
* ASCITES
* PRE- EXPOSURE INSTRUCTIONS
1. Inspiration (inhalation)
- Depress diaphragm and abdominal viscera
- Lengthens and expands the lung field
- Elevates the rib and reduces their angle near spine
- Elevate the sternum and push it anteriorly.
2. Expiration (exhalation)
- Elevates the diaphragm and abdominal viscera
- Shortens the lung field
- Depress the sternum
- Lowers the rib and increase angle near spine
* Anatomical Position
* Different planes
* Sagittal
* Mid-sagittal
* Coronal
* Mid- coronal
* Horizontal
* Fundamental planes of
the body:
* MID- SAGITTAL PLANE

* MID CORONAL PLANE
* HORIZONTAL PLANE
* SPECIAL PLANES
*INTERILLIAC
- plane that transects
the pelvis at the top of
the iliac crest at the
level of the fourth
lumbar spinuous process.
Occlusal
- a plane formed by the biting
surfaces of the upper and lower
teeth with the jaws closed.
DIVISIONS OF THE ABDOMEN
* AXIAL SKELETON
* APPENDICULAR SKELETON
SKULL CRANIUM 8
FACIAL BONES 14
HYOID 1
AUDITORY OSSICLES 3
VERTEBRAL COLUMN CERVICAL 7

THORACIC 12
LUMBAR 5
SACRAL 1
COCCYX 1
THORAX STERNUM 1
RIBS 24
TOTAL BONES: 80
*
SHOULDER GIRDLES CLAVICLES 2
SCAPULA 2
UPPER LIMBS HUMERUS 2
ULNA 2
RADIUS 2
CARPALS 16
METACARPALS 10
PHALANGES 28
PELVIC GIRDLES HIP BONES 2
LOWER LIMBS FEMUR 2

TIBIA 2
FIBULA 2
PATELLA 2
TARSALS 14
METATARSALS 10
PHALANGES 28
TOTAL BONES 126

* Long bones
* Short bones
* Irregular bones
* Flat bones
*
* LONG BONES
- consist of a shaft and 2 articular extremities.
* The SHAFT OF A LONG

BONE IS REFERRED AS
DIAPHYSIS.
* And the articular

ends as
EPIPHYSIS.
* SHORT BONES
- consist mainly of cancellous tissue and have only a thin outer
layer.
* FLAT BONES
- consists of largely of compact tissue
* IRREGULAR BONES
-cannot be classified in any of the foregoing groups
* RADIOGRAPHIC POSITIONING ??
* ANTERIOR/ VENTRAL
* forward or front part of the body or to forward part of an organ;
* POSTERIOR/ DORSAL
* Back part of the body
* CAUDAL/CAUDAD/INFERIOR
* Towards the foot
* CRANIAL/ CEPHALIC/ SUPERIOR
* towards the head
* PROXIMAL
* part closest to the center, midline or trunk
* DISTAL
* part farthest to the center, midline or trunk
*
* Posterior/ Dorsal
* back half of the patient
* Anterior/ Ventral
* front half of the patient
Hands and feet

Plantar
-refers to the sole or posterior surface of the foot
Dorsal
DORSUM PEDIS-refers to the top or anterior surface of the foot
DORSUM MANUS- -refers to the back or posterior surface of the
hand
* Projection vs. Position vs. View vs. method vs. tangential vs. axial
* Projection
* describes the direction or path of the CR or x-ray beam as it passes
through the patient projecting an image onto IR.
* Position
* term used to indicate the patient’s general physical position.
* View
* describes the radiographic image as seen from the vantage of the image
receptor.
* Method
* some radiologic procedures that are named after individual in
recognition of their having developed a method to demonstrate a
specific anatomical part.
* TANGENTIAL
-central ray skims between body parts to profile a bony structure and
project it free of superimposition.
* AXIAL
* a longitudinal angulation of the central ray with the long axis of the
bony part
* All images obtained when the central ray is angled.
PROJECTION GENERAL BODY POSITION SPECIFIC BODY POSITION
Posteroanterior (PA) Anatomic R and L lateral

Anteroposterior (AP) Supine Obliques
Mediolateral Prone LPO
Lateromedial erect RPO
AP or PA oblique Recumbent LAO
AP or PA axial Trendelenburg LPO
Tangential Sim’s Decubitus
Transthoracic Fowlers Left Lateral
Dorsoplantar (DP) Lithotomy Right Lateral
Plantodorsal (PD) Ventral
Inferosuperior axial Dorsal
Superoinferior axial Lordotic
Axiolateral
Submentovetex (SMV)
Verticosubmental (VSM)
Parietoacanthial
Acantioparietal
Cranicaudal
* Posteroanterior (PA) projection
* Anteroposterior (AP) projection
* AP Oblique
* PA Oblique
* Mediolateral
* Lateromedial projection
*
* SUPINE
* lying on back with face facing upward
* PRONE
* lying in abdomen
* ERECT
* upright position
* RECUMBENT
* Lying down in any position
* DORSAL RECUMBENT (lying on the back)
* VENTRAL RECUMBENT(lying face down)
* LATERAL RECUMBENT(lying on side)
*
* TRENDELENBURG
* a recumbent position with the head lower than the feet
* FOWLER’S
* a recumbent position with the head higher than the feet
* SIM’S
* a recumbent oblique position with patient lying on the left
anterior side with the right knee and thigh flexed and the left
arm extended down behind the back
* LITHOTOMY
* a recumbent position with knees and hip flexed and thigh
abducted and rotated externally, supported by ankle support.
* LATERAL- refers to side of or side view
* A right lateral will always be 90° or perpendicular, or at the right
angle, to a true PA and AP projection
* OBLIQUE- an angled position neither the sagittal nor the coronal

body plane is perpendicular to the IR.
* LEFT AND RIGHT ANTERIOR OBLIQUE (LAO and RAO)

* Oblique body position in which the left and right anterior aspect is
closest to the IR
* LEFT AND RIGHT POSTERIOR OBLIQUE (LPO and RPO)

* Oblique body position in which the left and right posterior aspect is
closest to the IR
*
* ABDUCTION
* movement a part away from the central axis of the body
* ADDUCTION
* movement a part toward the central axis of the body
* EXTENSION
* straightening of the joint, stretching a part, backward bending
movement
* HYPEREXTENSION
* FLEXION
* bending movement where angle between contiguous bones is
diminished.
* HYPERFLEX
*
* EVERT/ EVERSION
* movement of the foot when turned outward at the ankle joint
* INVERT/INVERSION
* movement of the foot when turned inward at the ankle joint
* PRONATE
* turn the forearm so that the palm of the hand faces downward
* SUPINATION
* Turn the forearm so that the palm of the hand faces upward
* Surface Landmarks
*
* STHENIC (50%)
Characteristics:
* modification of predominant type
Build: Moderately heavy
* Predominant type
Abdomen: moderately
* Average or ordinary long
Heart: Moderately transverse * Thorax: moderately
Lungs: Moderate length short
Diaphragm: moderately high * Pelvis: relatively small

Stomach: high, upper left
Colon: spread evenly; slight dip
in transverse colon
Gallbladder: centered on right
side. Upper abdomen
* HYPOSTHENIC-(35%)
* modification type of extreme asthenic type, that is, more
toward the sthenic type
* The organs and characteristics for this habitus are
intermediate between the sthenic and asthenic
* It is the most difficult to classify
HYPERSTHENIC-(5%) Characteristics:
* one of the massive build Build: massive
Abdomen: long
* Thorax:short, board
Heart: axis nearly transverse deep
Lungs: short apices at or near * Pelvis: narrow
clavicles
Diaphragm: high
Stomach: high, transverse and in
the middle
Colon: around the periphery of
the abdomen
Gallbladder: high, outside, lies
more parallel
ASTHENIC-(10%) Characteristics:
* extremely slender build Build: frail
Abdomen: moderately
Heart: nearly vertical and at long
midline
Lungs: long, apices, above
clavicles, may be boarder above * Thorax: long and
base shallow
Diaphragm: low * Pelvis: wide
Stomach: low and medial, in the
pelvis when standing
Colon: low and folds itself
Gallbladder: low and nearer the
midline
* Source-to-Image Receptor Distance
* The greater the SID, the less the body part is magnified and
greater the recorded detail
* SID of 40 inches (102 cm) is the most conventional examinations
* In chest Radiography a 72 inch SID is the minimum distance.

* Procedures:
*AP
*PA
*Lateral
*Oblique
*Robert Method
*Burman Method
*Folio method
*
AP PROJECTION
Part position: hand in extreme internal rotation.
PA PROJECTION
hand in the lateral position, rest the elevated
Part position:
phalanges and abducted thumb on a transparent
support .
Central ray: ⊥ MCP jt.

* LATERAL PROJECTION
Position of part:
-hand in its natural position/ pronation with the palmar
pushes inward.
* PA OBLIQUE
Position of part:
-hand in its natural position/ pronation
Central ray: ⊥ MCP jt.
* Evaluation criteria:
*Area from the distal tip of the

thumb to the trapezium should be
included
AP Projection (Robert Method)
Position of part:
* Extend the limb
* Rotate the arm internally to place the posterior aspect of the thumb
on the IR with the thumbnail down.
DEMONSTRATE:
-ARTHRITIC CHANGES
-FX, DISPLACEMENTS AT THE 1ST CMC JT AND BENNETTE FX.
-1ST METACARPAL BASE
-TPZ
-1ST CMC JT FREE FROM SUPERIMPOSITION
* Robert Method
* Perpendicular entering at the first CMC joint
* Long and Rafert Modification:
* Angled 15 degrees cephalad to CMC joint.
* Lewis Modification:
* Angled 10- 15 degrees cephalad entering to MCP joint.
AP AXIAL (Burman Method)
( Radial Shift of the Carpal Canal position )
* When the dorsifelxion of the wrist is not contraindicated,
* Burman gives a clearer of the image of the first CMC joint
than does the standard AP projection
Position of the part:
* Hyperextend the hand
* Rotate the hand to place the first digit in the horizontal position
or internally
Central Ray:
-Direct the central ray about 1 inch
distal to the first CMC joint at
an angle of 45° towards the elbow
Structures shown:
* Magnified Concavo-convex outline of the first metacarpal
* Trapezium on concave profile
* Base of the metacarpal in convex profile
trapezium
1st metacarpal
Carpometacarpal joint
Position of part:
* both hands on the cassette
* Wrap a rubber band around the distal portion of both thumbs
* Ensure that the thumbs remain in the PA plane by keeping the
thumbnails parallel to the cassette
* Instruct the patient to pull their thumbs apart and hold
Structures Shown:
for diagnosis of Ulnar Collateral ligament (UCL)
tear
*
* PA Projection
* PA oblique
* Lateral in Flexion And Extension
* AP projection
Routine:
1. Bony injuries
- PA, PA Oblique, Lateral
2. Bony Pathology
- PA, PA Oblique
3. FB Localization
- PA and Lateral
*
Position of Part:
- Elbow form 90 degrees
- palmar surface down.
Central Ray:
Perpendicular to the third MCPjoint
Structures shown:
Frontal image of carpals, metacarpals
and phalanges (except the thumb),
articulations of the hand and the
distal radius and ulna
*
* hand in the lateral position, ulnar side
down.
- IP jt, a 45° foam wedge to support

fingers.
- metacarpals are the area of interest,

rotate the patient’s hand medially from
the lateral position, touching the
cassette by fingertips
*Structures shown:
*Oblique position of the bones and soft
tissues
*This is used in the investigation of
fractures and pathologic conditions.
*Central Ray:
*Perpendicular to the third MCP joint
*
Position of the part:
* Extend the digits with the first digit at the right angles inrelation to the
palm
* Can be:
* ULNAR SURFACE TO FILM
* Lateromedial
* RADIAL SURFACE TO FILM
* Mediolateral
*This position shows a lateral image of the hand
in extension
localize foreign bodies and metacarpal fracture

displacement
*Central Ray:
* Perpendicular to the 2ND MCP joints
FAN LATERAL
*Eliminates the
superimposition of the
phalanges for all except the
proximal phalanges.
*
* Structures shown:
* This position demonstrate anterior
and posterior displacement I
fractures of the metacarpals
* Central Ray:
* Perpendicular to the MCP joints.
Entering MCP joint of the second
digit.
*
* Sometimes referred to as “ ball-catcher’s position”

* Useful for early detection of Rheumatoid Arthritis
*Position:
- Both hands in half-supinate
position
- 45° from the posterior aspect of
the each hand
Central Ray:
*Perpendicular midway between
both hands at the level of MCP
joints
*
*
* PA and AP Projections
* Lateral Position
* PA and AP Oblique position
* Flexion positions
* Scaphoid Series position PA axial (Stecher and Rafert- Long
Method)
* Trapezium PA axial Oblique position (Clemens- Nakayama
Method)
*
Central Ray:
* Perpendicular to the midcarpal area

* Perpendicular in between of two styloid processes
* This position gives a slightly oblique projection of the ulna

*
CR:
*Perpendicular to the midcarpal
area
Demonstrate:
Better illustration of carpal
interspaces
*
Central Ray:
Perpendicular to the wrist joint/ midcarpal area
Demonstrate:
-colles and smith fracture
Fiolle- carpe bossu
*
From the lateral position, rotate the wrist medially
CR:
* Perpendicular to midcarpal area
Structures shown:
* Carpals on the lateral side particularly the scaphoid and trapezium
*
* Position the part:

* From AP, Rotate the wrist medially
until it forms 45 degrees to the
film (semisupinated)
* Central Ray:
* Perpendicular to the midcarpal
area
* Structures shown:
* separates the pisiform from the
adjacent carpal bones
* gives a distinct image of the

triquetrum and hamate
Hamate
Pisiform
Triquetrium
Lunate
*
From PA projection, Turn the patient’s

hand outward until the hand is in
extreme ulnar flexion
* CR:
* Perpendicular at the level of scaphoid
* This projection corrects foreshortening of the
scaphoid, which occurs with a perpendicular central
ray.
* It also opens the spaces between the adjacent carpals
*
* Fron PA projection, Turn the
patient’s hand inward until the hand
is in extreme radial flexion
* CR;
* Perpendicular to midcarpal area
Demonstrate:
interspaces between the carpals
on the medial side of the wrist.
*
* Elevate the IR 20 degrees
CR:
* Perpendicular directed to enter the
scaphoid
* Bridgman suggested that the wrist in
ulnar flexion for this radiograph
Demonstrate:
Scaphoid inprofile
* The 20 degree angulation of the wrist places the
scaphoid at the right angles to the central ray so that
it is projected without self-superimposition
(Rafert-Long Method)
- extreme ulnar flexion.
CR:
*Perpendicular and multiple cephalad
angles
*Four separated exposures are made
(0,10,20 and 30 degrees)
*Directly enter the scaphoid bone
* Demonstrate:
* This projections are used for
diagnosing scaphoid fractures
using a four-image multi-angle
central rays series
*
*CR:
45 degrees distally enter
to anatomical snuff box
Demonstrate:
Trapezium inprofile
*
*
INFEROSUPERIOR PROJECTION
-Hyperextended the wrist
- Rotate the hand towards the

radial side to prevent
superimposition of the shadows
of the hamate and pisiform.
CR:
- 25 to 30 degrees to the long axis of the hand,
approximately 1 inch distal to the base of the 3rd mcp.
Demosntrate:
Carpal Canal inprofile
“this method also known as

Modified LENTINO METHOD”
TEMPLETON AND ZIM METHOD
* SUPEROINFERIOR PROJECTION
CR:
*Tangential to the
carpal canal 20 to 35
degrees from the long
axis of the forearm.
TANGENTIAL PROJECTION (CARPAL BRIDGE)
* Shows tangential image of the carpals
* Fx of the scaphoid
* Lunate dislocation
* Chip fx in dorsal aspect of the carpal bone
* CR:
45 degrees to the
Long axis of the forearm
*
* AP and Lateral
*
* Supinate the hand
* Long axis of the forearm parallel
to the IR
* Patient laterally until the forearm
is in true supinated position.
CR:
perpendicular in midpoint of the
forearm
* Structures shown:
elbow joint
radius and ulna
proximal row of slightly distorted carpal bones
*
-elbow 90 degrees
CR: Perpendicular to the midpoint of the forearm

* Structures shown:
- bones of the forearm
- the elbow joint
- proximal row of the carpals bones
Evaluation Criteria:
-wrist and distal humerus must seen on
the radiograph
-superimposed radius and ulna at their
distal end
-superimposed of the radial head over
the coronoid process
*
* AP
* Lateral
* AP Oblique (Medial and Lateral Rotation)
* AP partial and acute flexion position (distal
Humerus)
* AP partial flexion (proximal forearm)
* PA acute flexion (proximal forearm)
* Lateral (Radial Head)
* PA axial (distal humerus and olecranon
process)
*
* Extend the elbow, supinate the hand and center the
elbow joint to the IR
* CR:
* Perpendicular to the elbow joint
Structures shown:
AP projection of the elbow joint, distal arm and
proximal forearm
* Evaluation Criteria:
* Radial head, neck and tuberosity slightly
superimposed over the proximal ulna.
*
- elbow 90 degrees, Adjust the hand in
lateral position and, humeral
epicondyles are perpendicular to the
plane of the IR.
CR:
*Perpendicular to the elbow joint
* Structures shown:
* Demonstrates the elbow joint , distal arm and
proximal forearm
* fat pods (A or P)
*
* Extend the limb, pronate the hand
* CR:
*The image shows an oblique projection of
elbow with the coronoid process
projected free of superimposition.
*
*From AP projection, rotate the hand
laterally
* A proper lateral rotation is achieved
when the patient’s first and second digits
should touch the table.
* CR:
* Structures shown:
* radial head and neck free of superimposition
of the ulna
* Open elbow joint

* Position the patient at the level of the table to
place the distal humerus in the IR
* Supinate the hand
CR:
* Perpendicular to the humerus, transversing the
elbow joint
* Depending on the degree of flexion, angle the CR
distally into the joint.
* Structures shown:
* This projection shows the distal
humerus when the elbow
cannot be fully extended.
*
* Rest the dorsal surface/ proximal forearm on the IR.
* CR:
* Perpendicular to the long axis of the forearm
Traversing elbow joint.
* Demonstrates
- proximal forearm when the
elbow cannot be fully extended.
*
* Patient position
* Seated, arm at the level of the
table
* Flex the elbow 90 degrees, 80
degrees
ELBOW IN 90 DEGREES
CR 45 DEGREES TOWARDS THE ELBOW
ELBOW IN 80 DEGREES
CR 45 DEGREES AWAY
FROM THE ELBOW
* ELBOW FLEX 90 DEGREES DEMONSTRATE:
* RADIAL HEAD IN PROFILE
* ELBOW FLEX 80 DEGREES DEMONSTRATE:

* CORONOID PROCESS IN PROFILE
* Greenspan and Norman reported that the radial
head can be projected more clearly with reduced
superimposition by directing the CR 45 degrees
medially or towards the elbow
* ARM at the level of the table with the
elbow fully flexed.
* Epicondyles are parallel
* The long axis of the arm and the

forearm should be parallel with the
long axis of the IR.
*CR:
*Perpendicular to the distal
humerus approx. 2 inches (5
cm) superior to the olecranon
process.
* Demonstrate:
* Olecranon inprofile
*
* Position of the part:

* Flex the elbow 90 degrees
* Place the joint in the lateral position
*Make the first
exposure with the
hand supinated.
Radial Tuberosity facing

anteriorly.
* Make the second exposure
with the hand lateral
position.
Radial Tuberosity facing

anteriorly.
* Make the third exposure
with the hand pronated.
Radial Tuberosity
facing posteriorly.
* Make the fourth exposure
with the hand in extreme
internal rotation.
Radial Tuberosity
facing posteriorly.
* Demonstrate:
* Radial head partially superimposed the coronoid

process as well as the radial tuberosity.
* CR:
*
* arm in vertical position.
* Forearm is parallel to the long axis of the
table
* Flex the elbow to form 75 degrees.
* Supinate the hand to prevent rotation of
humerus and ulna
*CR:
*Perpendicular to the
ulnar sulcus
*Structures shown:
*Demonstrates the
epicondyles, trochlea,
ulnar sulcus and olecranon
fossa.
This Projection is useful for detection of

Radiohumeral bursitis or obscured
calcifications located in the ulnar sulcus.
*
* Adjust the arm at an angle of 45-50
degrees.
* Supinate the hand
* CR:
* Direct the CR to the Olecranon process
* 1. Perpendicular to demonstrate the
dorsum of the olecranon process
* 2. At a 20-degree angle toward the OP to
demonstrate the curved extremity and
articular margin of the olecranon
process
*
* UPRIGHT
* AP Projection
* Lateral
* RECUMBENT
* AP
* Lateral
*
* Abduct the arm and slightly and

supinate the hand
* CR:
* Perpendicular to the midshaft of the
humerus or midway between the elbow
and shoulder joints
* Structures shown:
* Entire length of the humerus.
* Humeral head and greater tubercle
* Epicondyles are parallel
*
* Internally rotate the arm, abduct the

arm and place the patient’s anterior
hand on the hip
* CR:
* Perpendicular to midshaft of the
humerus or midway between the elbow
and shoulder joints
* Demonstrate:
* Entire length of the humerus.
* A true lateral position of humerus
* Lesser tubercle
* Epicondyles are perpendicular
*
* Supine position
* Elevate theopposite shoulder to place

the affected in contact with the IR.
* Abduct the arm slightly and supinate

the hand
*
* Supine
* Medially rotate the arm, to place the

epicondyles perpendicular with the
IR.
* Rest the posterior aspect of the hand

against the patient’s side.
*
- Flex the elbow, turn the thumb surface

of the hand up
* Adjust the body to place the lateral

surface of the humerus perpendicular
to CR.
* CR
* Recumbent:
* Horizontal and perpendicular to
the midportion of the humerus
and center of the IR
* Lateral Recumbent:
* Center of the IR, which exposes
only the distal humerus.
*
* PRE-patient instruction:
* Full inspiration to improve contrast
CR
* Perpendicular to the level of the
SURGICAL NECK
* Patient position:
- patient into lateral position,
affected humerus is incontact with
the IR, unaffected arm is raise upward
and the hands touching the head.
* Structure shown:
* Lateral image of the shoulder
and humerus is projected
through the thorax
* Demonstrate
* Proximal humerus
* S-SHAPED
* LAST BONE TO COMPLETELY OSSIFY AT AGE 21
* LOCATED OVER THE UPPER ANTERIOR RIB CAGE
*
* Shaped like an inverted triangle
* Upper margin of the scapula – 2nd thoracic
vertebra
* Lower margin of scapula – 7th thoracic vertebra
*
* PROCEDURES:
- AP (EXTERNAL, INTERNAL, NEUTRAL)
- TRANSTHORACIC LATERAL PROJECTION (LAWRENCE METHOD)
- INFEROSUPERIOR AXIAL PROJECTION
- INFEROSUPERIOR AXIAL PROJECTION (RAFERT MODIFICATION)
- INFEROSUPERIOR AXIAL PROJECTION (WEST POINT)
- INFEROSUPERIOR AXIAL PROJECTION (CLEMENTS MODIFICATION)
- SUPEROINFERIOR AXIAL PROJECTION
- AP AXIAL PROJECTION
- TANGENTIAL PROJECTION
- PA OBLIQUE PROJECTION (RAO, LAO) (SCAPULAR Y)
- AP APICAL OBLIQUE AXIAL PROJECTION (RPO, LPO) (GARTH METHOD)
- AP OBLIQUE PROJECTION (GRASHEY)
- AP AXIAL PROJECTION (STRYKER NOTCH METHOD)
- APPLE METHOD
*
AP (EXTERNAL)
- ERECT
- HAND IS ABDUCTED AND SUPINATED
- EPICONDYLES ARE ||
DEMONSTRATE:
-GREATER TUBERCLE
-SUPRASPINATUS
AP (INTERNAL)
-DORSAL ASPECT OF THE HAND AGAINST THE HIP
-EPICONDYLES ARE PERPENDICULAR
DEMONSTRATE:
-LESSER TUBERCLE
-SUBSCAPULARIS
AP (NEUTRAL) (TRAUMA)
- PALMAR/ ANTERIOR ASPECT OF THE HAND AGAINST THE HIP
- EPICONDYLES ARE 45 DEGREES TO IR.
TRANSTHORACIC LATERAL PROJECTION (LAWRENCE METHOD)
- SAME AS HUMERUS
-USE IF ARM CAN`T ABDUCT OR ROTATE
- ACCURATE LATERAL VIEW OF SHOUDLER JT.
CR: HORIZONTAL AT THE LEVEL OF SURGICAL NECK
*10-15 DEGREES CEPHALAD (CANNOT FULLY ELEVATE THE

UNAFFECTED SHOULDER)
INFEROSUPERIOR AXIAL PROJECTION (LAWRENCE METHOD)
-SUPINE
-AXILLARY VIEW
-ABDUCT THE HAND 90 DEGREES
-HUMERUS ROTATE EXTERNALLY
CR: 15-30 MEDIALLY TOWARDS

THE AXILLA
(THE GREATER THE ABDUCTION
THE GREATER THE ANGLE)
INFEROSUPERIOR AXIAL PROJECTION (CLEMENTS MODIFICATION)
-LATERAL RECUMBENT, UNAFFECTED SIDE DOWN
-ABDUCT THE AFFECTED ARM 90 DEGREES POINTING TO
THE CEILING
CR:
-HORIZONTAL IF THE PATIENT CANT ABDUCT
THE ARM 90 DEGREES
-5-15 MEDIALLY TOWARDS THE AXILLA
IF PATIENT CAN ABDUCT THE ARM 90
INFEROSUPERIOR AXIAL PROJECTION (RAFERT MODIFICATION)
-SUPINE
-ABDUCT THE ARM 90 DEGREES
-EXAGERATED EXTERNAL ROTATION OF THE
CR: 15 MEDIALLY
DEMO:
- HILL SACH`S DEFECT
INFEROSUPERIOR AXIAL PROJECTION (WEST POINT)
- PRONE
- ABDUCT THE ARM 90 DEGREES, FOREARM RESTED OVER THE
EDGE OF THE TABLE
CR: 25 ANTERIORLY,
25 MEDIALLY
DEMO
- POSTERIOR AND ANTERIOR
GLENOID RIM
- BONY ABNORMALITIES
SUPEROINFERIOR AXIAL PROJECTION
-SEATED, PX LEAN LATERALLY
-ELBOW 90 DEGREES, HANDS PRONATED
CR:
5-15 TOWARDS THE ELBOW
DEMO
- POINT OF INSERTION OF
SUBSCAPULARIS
AND TERESMINOR
SUPEROINFERIOR PA TRANSAXILLARY (HOBBS METHOD)
-ERECT or PRONE
-AFFECTED ARM IS FULLY RAISED
CR:
HORIZONTAL TO SHOULDER JOINT
AP OBLIQUE PROJECTION (GRASHEY METHOD)
-ERECT, BODY 35-45 TOWARDS AFFECTED SIDE
-ARM SLIGHTLY ABDUCT, PALMAR RESTING AT
THE ABDOMEN
CR: HORIZONTAL
TO SCAPULOHUMERAL JT
DEMO
GLENOID CAVITY
BANKARTS LESION
AP AXIAL PROJECTION
-UPRIGHT/ SUPINE
-SCAPULOHUMERAL JOINT CENTERED TO THE IR
CR:
35 DEGREES CEPHALAD
TO SCAPULOHUMERAL
JOINT
AP AXIAL (STRYKER NOTCH METHOD)
-SUPINE
-ARM FLEX BEYOND 90, PALM OF HAND RESTING ON THE HEAD
CR:
10 DEGREES CEPHALAD
TO THE CORACOID PROCESS
DEMO
-IDENTIFY THE CAUSE OF
SHOULDER DISLOCATION
AP OBLIQUE (GLENOID CAVITY) (APPLE METHOD)
-ERECT
-RPO/LPO, ROTATE THE BODY 35-45 TOWARD THE AFFECTED
SIDE
-PATIENT HOLD 1POUND WT. ABDUCT THE AFFECTED ARM 90
DEGREES.
CR:
HORIZONTAL TO THE CORACOID
PROCESS
DEMO:
LOSS OF ARTICULATION CARTILAGE
IN SCAPULOHUMERAL JOINT
TANGENTIAL PROJECTION (BICIPITAL GROOVE) (FISK METHOD)
-ERECT OR SUPINE
-PLACE THE IR REST ON THE FOREARM, SLIGHTLY LEAN
FORWARD
CR:
PERPENDICULAR
IF THE PATIENT CAN LEAN
FORWARD 10-15 DEGREES
(SUPINE)
10-15 POSTERIORLY
TO THE LONG AXIS OF
THE HUMERUS
PA (TERESMINOR INSERTION) (BLACKETT-HEALY)
-PRONE
-FOREARM OF THE AFFECTED SIDE AT THE BACK
-IR CENTER 1” INFERIOR TO CORACOID PROCESS
CR:
PERPENDICULAR TO
HUMERAL HEAD
DEMO:
TANGENTIAL IMAGE OF
TERESMINOR INSERTION
AP (SUBSCAPULARIS INSERTION) (BLACKETT-HEALY)
-SUPINE
-ABDUCT THE AFFECTED ARM, FLEX THE ELBOW
-DORSAL ASPECT OF THE HAND RESTING ON HIP
CR:
PERPENDICULAR
SHOULDER JOINT
DEMO
TANGENTIAL IMAGE
OF SUBSCAPULARIS
INSERTION
AP AXIAL (INFRASPINATUS INSERTION)
(INTERNAL, EXTERNAL, NEUTRAL ROTATION)-
FULL EVALUATION OF HUMERAL HEAD
CR:
25 CAUDAD TO CORACOID PROCESS
BEST DEMO:
SUBACROMIAL SCPACE, INFRASPINATUS
INSERTION
PA OBLIQUE PROJECTION (SCAPULAR Y)
-DESCRIBED BY RUBIN-GRAY-GREEN
-ERECT
-RAO/LAO, BODY ROTATION 45-60
CR
HORIZONTAL TO
GLENOHUMERAL JOINT
DEMO
CORACOID AND SCAPULAR SPINE
TANGENTIAL (SUPRASPINATUS) (NEER METHOD)
-SEATED/UPRIGHT
-RPO/LPO, ROTATE THE UNAFFECTED SIDE 45-60 DEGREES
AWAY FROM THE IR.
CR:
10-15 CAUDAD TO THE
SUPERIOR ASPECT OF
HUMERAL HEAD
DEMO:
CORACOACROMIAL ARCH, ROTATOR CUFF
SYNDROME, DX SHOULDER IMPEGMENTATION
AP APICAL OBLIQUE AXIAL (GARTH METHOD)
-ERECT
-RPO/LPO
-HAND PLACED ACROSS THE CHEST
CR:
45 CAUDAD
SCAPULOHUMERAL JOINT
BEST DEMO:
POSTERIOR DISLOCATION OF
SHOULDER JOINT, HILL-SACH
GLENOID FX.
VELPEAU AXILLARY LATERAL VIEW
-STANDING AT THE EDGE OF THE TABLE
-IR PLACED AT THE TABLE, ASK THE PATIENT TO LEAN
BACKWARD 20-30 DEGREES
CR
PERPENDICULAR
TRAVERSING TO THE
SHOULDER JOINT.
DEMO:
MAGNIFIED GLENOHUMERAL
JOINT
ACROMIOCLAVICULAR JOINT
AP BILAT (PEARSON METHOD)
-UPRIGHT
-2 EXPOSURES (WITH AND WITHOUT WEIGHT BEARING)
-5-8 POUNDS OF WEIGHT
CR
MIDWAY BETWEEN 2 A.C JOINT
DEMO:
-DISLOCATION, SEPARATION AND
FUNCTION OF JOINTS.
-DEGREE OF SEPARATION OF AC JT
-HEMORRHAGE AND SWELLING OF
JOINTS
AP AXIAL (ALEXANDER METHOD)
-ERECT
-CORACOID PROCESS CENTER IN IR
CR:
15 CEPHALAD TO AC JOINT
OR CORACOID PROCESS
DEMO:
ACJ SUPERIOR TO ACROMION,
SUBLAXATION
PA AXIAL OBLIQUE (ALEXANDER METHOD)
- ERECT
-LAO/RAO, PLACE THE AFFECTED HAND ACROSS THE
UNAFFECTED AXILLA.
-BODY ROTATED 45-60 DEGREES
CR
15 CAUDAD TO THE AC JOINT
DEMO:
AC ARTICULATION INPROFILE
AP PROJECTION
-ERECT
-SUPINE- TO PREVENT ADDITIONAL INJURY
-CLAVICLE CENTER TO IR
CR:
HORIZONTAL
MIDSHAFT OF CLAVICLE
-SUSPENDED RESPIRATION
PA PROJECTION
-PREFERRED TO REDUCE MAGNIFICATION AND
IMPROVE
RECORDED DETAIL.
CR:
HORIZONTAL/PERPENDICULAR
TO THE MIDSHAFT OF CLAVICLE
DEMO:
ENTIRE SHAFT OF CLAVICLE
AP AXIAL PROJECTION
-LORDOTIC POSITION
CR:
•0-15 UPRIGHT
•15-30 SUPINE
DEMO:
ANTERIOR DISPLACEMENT OF FRAGMENTS
OF FX.
PA AXIAL PROJECTION
-PRONE
-HANDS ARE IN SUPINATION
CR:
15-30 CAUDAD TO
SUPRACLAVICULAR REGION
DEMO:
DISPLACEMENT FX OF CLAVICLE
TANGENTIAL PROJECTION (TARRANT METHOD)(COBBS METHOD)
-SEATED
-PX SLIGHTLY LEAN FORWARD
-FORTRAUMA PX HAVING MULTIPLE CLAVICULAR INJURIES
AND CANNOT ASSUME
LORDOTIC AND RECUMBENT
POSITION
-USE LONG SID TO
DECREASE MAGNIFICATION
CR:
25-35 TRAVERSING TO THE
LONG AXIS OF CLAVICLE
OR ANTEROINFERIORLY
THE MIDSHAFT OF
THE CLAVICLE
AP PROJECTION
-ERECT/SUPINE
-ABDUCT THE ARM AND PLACE THE DORSAL SURFACE
OF THE AFFECTED HAND ABOVE THE HEAD.
CR:
HORIZONTAL/PERPENDICULAR
TO THE MIDSCAPULAR AREA
LATERAL PROJECTION
-ERECT
-RAO/LAO
2 POSITION
•ABDUCT THE ARM AND PLACE

THE DORSAL SURFACE OF THE
HAND AT THE BACK (SCAPULAR Y)
-DEMO
ACROMION AND CORACOID
CR: horizontal
•ARM EXTENDED UPWARD medial border of scapula
AND FOREARM RESTED ON THE HEAD
-DEMO
SCAPULAR BODY
PA OBLIQUE (LORENZ AND LILIENFELD) (RAO/LAO)
•LORENZ
-SUPINE
-ARM FORM 90 DEGREES INRELATION TO THE BODY
HAND RESTED AGAISNT THE HEAD.
•LILIENFELD
-SUPINE
-ARM IS FULLY RAISED
CR: PERPENDICULAR TO THE

MID AREA OF SCAPULA
TANGENTIAL PROJECTION (LAQUERRIERE-PIERQUIN METHOD)
- SUPINE
-HEAD TURN AWAY FORM THE SIDE OF INTEREST
CR:
45 CAUDAD POSTEROSUPERIOR
OF SHOULDER
35 CAUDAD (OBESE)
BEST DEMO:
SCAPULAR SPINE INPROFILE
TANGENTIAL (PRONE)
-ALTERNATIVE FOR LQPM
- HAND IN SUPINATION
CR:
45 CEPHALAD
POSTERROINFERIOR
OF SHOULDER
BEST DEMO:
SCAPULAR SPINE INPROFILE
Pathology:
• Congenital Clubfoot
-talipes equinovarus
-abnormal twisting of the foot usually inward or downward
•Pott`s Fx
-avulsion Fx of the medial malleolus with loss of ankle mortise
•Jones Fx
-avulsion Fx of the base of the 5th metatarsal
•Gout
-Hereditary form of arthritis which uric acid is deposited in
joints.
•Osgood-Schlatter Disease
-incomplete separation or avulsion of the tibial tuberosity
•Giant Cell Tumor
-Osteoclastoma
-Lucent lesion in the metaphysic usually at the distal femur
•Chondromalacia Patella
-Runner`s knee
-softening of the cartilage under the patella
•Joint Effusion
-Accumulation of fluid in joint cavity
•Lisfranc Injury
-Abnormal Separation in the base of 1st and 2nd metatarsal
and cunieform
•Reiter Syndrome
-Erosion of S.I jt and lower limbs
•Hallux Valgus
- Congenital Abnormality of hallux
-Lateral deviation of the great toe
Routine Procedures:
1.Bony Injury- AP, APO, Lateral

2.Bony Pathology- AP, APO
3.Localization of F.B- AP, LATERAL
DIVISIONS OF FOOT:
•HINDFOOT- CALCANEUS AND TALUS
•MIDFOOT- CUBOID, NAVICULAR AND

CUNIEFORMS
•FOREFOOT- METATARSAL AND PHALANGES

MEDIAL LONGITUDINAL ARCH
-CALCANEUS
-TALUS
-NAVICULAR
-CUNIEFORM
LATERAL LONGITUDINAL ARCH

-METATARSAL
-CUBOID
-CUNIEFORM
LOWER LIMB/ LOWER
EXTREMITY
1. FOOT
2. LEG
3. FEMUR
4. HIP
TOES:
1. AP (DORSOPLANTAR)
2. AP OBLIQUE
3. LATERAL
AP (DORSOPLANTAR)
-8X10
-SUPINE OR SEATED AT THE TABLE
-KNEE FLEXED
-PLACE 15 DEGREES FOAM WEDGE UNDER THE FOOT
CR:
PERPENDICULAR TO 2ND MTP OR
15 POSTERIORLY
AP AXIAL (15) – OPEN IP JOINTS

AND REDUCES FORSHORTENING
PA (PLANTODORSAL)
ALTERNATIVE FOR AP
-PRONE
CR:
PERPENDICULAR TO THE 2ND MTP JOINT
DEMO:
ARTHRITIS
GOUT
IP INTERSPACES
AP OBLIQUE
•MEDIAL ROTATION – FOR 1ST, 2ND AND 3RD DIGIT

•LATERAL ROTATION- FOR 4TH AND 5TH DIGIT
-30-45 ROTATION
CR:
PERPENDICULAR 3RD MTP JOINT
LATERAL
-LATERAL RECUMBENT, UNAFFECTED SIDE
CR:
PERPENDICULAR IP JT
SESAMOID
•Tangential projection (LEWIS METHOD)
•TANGENTIAL PROJECTION (HOLLY METHOD)
•TANGENTIAL PROJECTION (CAUSTON METHOD)

Tangential projection (LEWIS METHOD)
-PRONE
-DORSIFLEX GREAT TOE
-BALL OF FOOT PERPENDICULAR TO THE IR
CR:
PERPENDICULAR TO THE 1ST
MTP JOINT
DEMO:
SESAMOID INPROFILE
TANGENTIAL PROJECTION (HOLLY METHOD)
-SEATED
-PLANTAR FORM 75 DEGREES TO IR
-TOES FLEXED AND HOLD WITH STRIP GAUZE BANDAGE
-MEDIAL BORDER OF THE FOOT PERPENDICULAR TO THE IR
CR: PERPENDICULAR TO THE 1ST MTP HEAD
DEMO:
SESAMOID INPROFILE
TANGENTIAL PROJECTION (CAUSTON METHOD)
-LATERAL RECUMBENT, UNAFFECTED SIDE
-LIMB PARTIALLY EXTENDED, FOOT IN LATERAL POSITION
CR: 40 TOWARDS THE HEEL

AT THE LEVEL OF
PROMINENCE
OF THE 1ST MTP JOINT
FOOT
-AP (DORSOPLANTAR)
-AP OBLIQUE (MEDIAL AND LATERAL ROTATION)
-PA OBLIQUE (GRASHEY)
-LATERAL (MEDIO, LATERO)
-PA OBLIQUE)
-LATERAL WT. BEARING
-AP WT BEARING
-AP AXIAL (COMPOSITE)
AP (DORSOPLANTAR)
-SUPINE
-KNEE FLEXED
-PLANTAR SURFACE AGAINST THE IR
CR:
PERPENDICULAR OR
10 DEGREES POSTERIORLY
TOWARDS THE 3RD MT BASE
DEMO:
GENERAL SURVEY OF THE FOOT
AP OBLIQUE (MEDIAL AND LATERAL ROTATION)
-SUPINE
-KNEE FLEXED
-LEG ROTATED MEDIALLY
-PLANTAR SURFACE OF THE FOOT FORM 30 DEGREES TO THE IR
CR:
PERPENDICULAR TO THE 3RD MTP BASE
DEMO:
-CUBOID INPROFILE
-SINUS TARSI
-INTERSPACES ON LATERAL SIDE OF FOOT
-LATERAL CUNIEFORM
-3RD TO 5TH MTP BASE
AP OBLIQUE (LATERAL ROTATION)
-SUPINE
-KNEE FLEXED
-LEG ROTATED LATERALLY
-PLANTAR SURFACE OF THE FOOT FORM 30 DEGREES TO IR
CR:
PERPENDICULAR
TO THE 3RD MTP BASE
DEMO:
-NAVICULAR
-INTERSPACES IN THE MEDIAL SIDE
-MEDIAL AND INTERMEDIATE CUNIEFORM
-1ST AND 2ND MTP BASE
LATERAL (MEDIOLATERAL PROJECTION)
-SEATED
-FOOT TURN AWAY FROM THE MIDLINE UNTIL THE LEG AND
FOOT FORM LATERAL POSITION
CR:
PERPENDICULAR
TO THE 3RD MTP BASE
DEMO:
-LOCALIZATION OF FOREIGN BODIES
-DEGREE OF ANTERIOR AND POSTERIOR
DISPLACEMENT OF FX
LATERAL (LATEROMEDIAL PROJECTION)
-SEMI SUPINATED (LPO/RPO)
-MEDIAL SURFACE OF THE FOOT AGAINST THE IR
-FOOT TURN TOWARDS FROM THE MIDLINE UNTIL THE LEG
-FOR PATIENT COMFORT
CR:
PERPENDICULAR
TO THE 3RD MTP BASE
DEMO:
TRUE LATERAL IMAGE OF
FOOT
PA OBLIQUE PRORJECTION (GRASHEY METHOD)
-PRONE
-FOOT IS ELEVATED
-FOOT TURN 30 MEDIALLY OR 20 LATERALLY
CR:
PERPENDICULAR TO THE 3RD MTP BASE
30 MEDIALLY (NAVICULAR INPROFILE,

INTERSPACES BET. 1ST AND 2ND MT
20 LATERALLY (INTERSPACES BET. 2ND 3RD

4TH 5TH MT
LATERAL PROJECTION (WT. BEARING)
-UPRIGHT
-FEET ELEVATED
-IR BETWEEN FEET
-WT EQUALLY DISTRIBUTED ON EACH FOOT
CR:
HORIZONTAL POINT ABOVE
3RD MTP BASE
DEMO:
-STATUS OF LONGITUDINAL ARCH
(PES PLANUS)
-LISFRANC INJURY
-BOHLER`S CRITICAL ANGLE
AP AXIAL (WT BEARING)
-UPRIGHT
-BOTH FEET AGAINST THE IR
-WT EQUALLY DISTRIBUTED
CR: 10-15 POSTERIORLY BETWEEN

FEET AT THE LEVEL OF 3RD MTP BASE
DEMO:
- ACCURATE COMPARISON OF MT
AND TARSAL
- HALLUX VALGUS
AP AXIAL PROJECTION WT. BEARING (COMPOSITE METHOD)
-UPRIGHT, 2 EXPOSURES
1ST EXPO- OPPOSITE FOOT STEP BACKWARD TUBE IN FRONT
2ND EXPO- OPPOSITE FOOT STEP FORWARD TUBE AT BACK
CR:
1ST EXPO 15 POSTERIORLY
2ND EXPO 25 ANTERIORLY
RP:
3RD MTP BASE- 1ST EXPO
LEVEL OF LATERAL MALLEOLUS – 2ND EXPO
BEST DEMO- ENTIRE FOOT

* EQUINOS – PLANTAR FLEX W/ INVERSION Of
CALCANEUS
* ADDUCTION- MEDIAL DISPLACEMENT OF

FOREFOOT
* SUPINATION- ELEVATION OF MEDIAL BORDER OF

FOOT
AP PROJECTION (KITE METHOD)
-SUPINE/SEATED
-HIP AND KNEE FLEX
-FOOT AGAINST THE IR
CR: 15 DEGREES POSTERIORLY AT THE LEVEL OF TARSALS
DEMO:
-DEGREE OF FOREFOOT ADDUCTION AND CALCANEAL INVERSION
-TRUE RELATIONSHIP OF BONES AND OSSIFICATION CENTERS OF
TARSALS
LATERAL PROJECTION (KITE METHOD)
-LATERAL RECUMBENT
-UPPERMOST LIMB
CR: PERPENDICULAR TO MIDTARSAL AREA
DEMO:
ANTERIOR TALAR SUBLAXATION
DEGREE OF PLANTAR FLEXION (EQUINOS)
MARIQUE- X-RAY OF ANKLE LATERAL PRE AND POST TX.

DORSOPLANTAR AXIAL PROJECTION (KANDEL METHOD)
-UPRIGHT
-BENDING FORWARD POSITION
-PLANTAR AGINST THE IR
CR: 40 DEGREES ANTERIORLY AT THE LEVEL OF LOWER LEG
DEMO: CALCANEUS
FREIGBERGER- 35, 45, 55 ANGULATION FOR SUSTENTACULUM TALAR

*
AXIAL PROJECTION (PLANTODORSAL)
-SUPINE/SAETED
-LEG FULLY EXTENDED, DORSIFLEX FOOT WITH STRIP
-FOOT PERPENDICULAR TO THE IR
CR:
40 CEPHALAD TO 3RD MT BASE
DEMO:
CALCANEUS AND SUBTALAR JOINT
Or the talocalcaneal joint AND
SUSTENTACULUM TALI
AXIAL PROJECTION (DORSOPLANTAR)
-PRONE
-ANKLE ELEVATED
-FOOT PEREPENDICULAR TO THE IR
-IR VERTICAL, AGAINST THE SOLE OF THE FOOT
CR:
40 CAUDAD
TOWARDS LONG AXIS OF FOOT
DEMO:
CALCANEUS, SUBTALAR
SUSTENTACULUM TALI
LATERAL PROJECTION (MEDIOLATERAL)
-SUPINE, PX TURN TOWARDS AFFECTED SIDE
-LATERAL SURFACE OF THE FOOT AGAINST THE IR
CR:
PERPENDICULAR
1” DISTAL TO THE
MEDIAL MALLEOLUS
DEMO:
CALCANEUS AND
ANKLE JOINT
BRODEN METHOD
-AP AXIAL OBLIQUE PROJECTION (MEDIAL ROTATION)
- AP AXIAL OBLIQUE PROJECTION (LATERAL ROTATION)
ISHERWOOD METHOD
-LATEROMEDIAL OBL. PROJECTION (MEDIAL ROTATION FOOT)
-AP AXIAL OBL PROJECTION (MEDIAL ROTATION ANKLE)
-AP AXIAL OBL PROKECTION (LATERAL ROTATION ANKLE)
AP AXIAL OBLIQUE PROJECTION (MEDIAL ROTATION)
-SUPINE
-LEG AND FOOT ROTATED 45 MEDIALLY, DORSIFLEX FOOT
-4 CENTRAL RAY ANGULATIONS
CR:
10, 20, 30, 40
CEPHALAD 2-3CM TO
LATERAL MALLEOLUS
DEMO:
-DETERMINE PRESENCE OF JOINT -40 DEGREES (ANTERIOR PORTION)
INVOLVEMENT IN CASES OF -10 DEGREES (POSTERIOR PORTION)
COMMINUTED FX -20-30 ( TALUS AND SUSTENTACULUM
TALI ARTICULATION)
AP AXIAL OBLIQUE PROJECTION (LATERAL ROTATION)
-SUPINE, DORSIFLEX FOOT
-LEG AND FOOT ROTATE 45 DEGREES LATERALLY
CR:
15 CEPHALAD 2CM DISTAL AND ANTERIOR TO MEDIAL MALLEOLUS
DEMO:
-POSTERIOR ARTICULATION
ISHERWOOD METHOD (LATEROMEDIAL OBL. PROJECTION)
-MEDIAL OBL PROJECTION OF FOOT
-LEG FOOT ROTATE 45 DEGREES
CR:
PERPENDICULAR
1” DISTAL, ANTERIOR
TO LATERAL MALLEOLUS
DEMO:
ANTERIOR SUBTALAR ARTICULATION
AP AXIAL OBLIQUE PROJECTION (MEDIAL ROTATION ANKLE)
-SUPINE/ SEATED
-LEG, FOOT AND ANKLE ROTATE 30 MEDIALLY, DORSIFLEX FOOT
CR:
10 CEPHALAD
1” DISTAL AND ANTERIOR TO
LATERAL MALLEOLUS
DEMO:
MIDDLE ARTICULATION OF
THE SUBTALAR JOINT
AP AXIAL OBLIQUE PROJECTION (LATERAL ROTATION ANKLE)
-SUPINE/ SEATED
-LEG, FOOT AND ANKLE ROTATE 30 LATERALLY, DORSIFLEX FOOT
CR:
10 CEPHALAD
1” DISTAL MEDIAL MALLEOLUS
DEMO:
POSTERIOR SUBTALAR
ARTICULATION
AP PROJECTION
-SUPINE
-DORSIFLEX FOOT
-ROTATE 5 MEDIALLY( PLACE MALLEOLI EQUIDISTANT)
CR:
PERPENDICULAR
BET. MALLEOLI
DEMO:
ANKLE JOINT AND
TIBIOTALAR JOINT
-SEMI SUPINE
-LATERAL SURFACE OF FOOT AGAINST IR
CR:
PERPENDICULAR
MEDIAL MALLEOLUS
DEMO:
TRUE LATERAL PROJECTION
OF LOWER 3RD OF LEG, ANKLE
AND TARSALS
AP OBL PROJECTION (MEDIAL ROTATION)
-SUPINE
-LEG AND FOOT ROTATE 45 MEDIALLY –DEMO BONY STRUCTURE
-LEG AND FOOT ROTATE 15-20 MEDIALLY –DEMO INTERMALLEOLAR
PARALLEL TO IR, MORTISE
CR:
PERPENDICULAR ANKLE JOINT
RP
MIDWAY BET. MALLEOLI
AP PROJECTION (STRESS METHOD) (FORCE INVERSION AND EVERSION)
-SEATED
-FOOT FORCIBLY TURNED TOWARD THE OPPOSITE SIDE
-INVERSION AND EVERSION STRESS TO JOINT
CR:
PERPENDICULAR
ANKLE JOINT
DEMO:
EVALUATE THE PRESENCE OF
LIGAMENTOUS TEAR
AND JOINT SEPARATION
TIBIA
-SHIN BONE
-WEIGHTED BEARING OF THE Lower LEG
FIBULA
-CALF BONE
-NONE-WEIGHTED BEARING BONE
AP PROJECTION
-SUPINE, FEMORAL CONDYLES || TO IR
-LEG CENTER TO THE IR, FOOT IN VERTICAL POSITION
CR:
PERPENDICULAR TO THE
MIDSHAFT OF THE LEG
Demo:
TIBIA, FIBULA, KNEE JOINT
LEG JOINT
-SEMI-SUPINE (RPO/LPO), FEMORAL CONDYLES PERPENDICULAR
-LATERAL SURFACE OF THE LEG AGAINST THE IR
CR:
PERPENDICULAR MIDSHAFT
Demo:
TIBIA, FIBULA, KNEE JOINT
LEG JOINT
AP PROJECTION
-SUPINE
-LEG Rotate medially approx. 5 degrees to place
interepicondylar line parallel to film
CR: (DEPENDS ON THE MEASUREMENT BET. ASIS AND TABLE TOP

3-5 CAUDAD (THIN PELVIS <19CM)
PERPENDICULAR (19-24CM)
3-5 CEPHALAD (LARGE PELVIS >24 CM)
RP: ½” BELOW PATELLAR APEX
Demo:
KNEE JOINT
PA PROJECTION
-PRONE
-LEG Rotate medially approx. 5 degrees to place
interepicondylar line parallel to film
CR:
5-7 CAUDAD
Demo:
KNEE JOINT
-lateral recumbent, femoral condyles perpendicular to the IR
-knee flex 20-30 degrees or <10 degrees for new or unhealled
patellar fx.
CR:
5-7 CEPHALAD
RP:
1” DISTAL TO MEDIAL
EPICONDYLE
AP OBL. MEDIAL ROTATION
SUPINE
-ROTATE THE LEG 45 DEGREES MEDIALLY
CR: (DEPENDS ON THE MEASUREMENT BET. ASIS AND TABLE TOP

Demo:
PROXIMAL TIBIOFIBULAR JT
FIBULAR HEAD
AP OBL. LATERAL ROTATION
SUPINE
-ROTATE THE LEG 45 DEGREES LATERALLY
CR: (DEPENDS ON THE MEASUREMENT BET. ASIS AND

TABLE TOP
Demo:
TIBIAL PLATEU, MEDIAL
FEMORAL, TIBIAL CONDYLES
AP BILAT/UNILAT PROJECTION WEIGHT-BEARING
-ERECT
-KNEE FULLY EXTEND, WEIGHT EQUALLY DISTRIBUTED
-IR VERTICAL
LEACH-GREGG-SIBER
CR:
HORIZONTAL
DEMO:
-Reveal NARROWING OF KNEE JOINT
-EVALUATE VARUS AND VALGUS
DEFORMITY AND DJD
PA WEIGHT BEARING (STANDING FLEXION) (ROSENBERG METHOD)
-upright, facing vertical IR
-ANTERIOR SURFACE OF FLEXED KNEE AGAINST IR
-FEMUR 45 DEGREES INRELATION TO IR
CR
Horizontal or 10 caudad
Demo:
Useful for evaluating joint space
narrowing & demonstrating
articular cartilage disease
PA AXIAL PROJECTION (TUNNEL VIEW) (HOLMBLAD METHOD)
-KNEELING, femur is 70 degrees inrelation to the table top
-lean forward 20 degrees
-ANTERIOR SURFACE OF THE KNEE AGAINST IR
3 POSITIONS:
CR: -Standing; knee flexed &
PERPENDICULAR TO rested on a stool
POPLITEAL DEPRESSION
-Standing at side of table;
knee flexed & rested over the
IR
DEMO:
INTERCONDYLAR FOSSA -Kneeling on table; knee over
the IR (Holmblad Method)
AP AXIAL PROJECTION (BECRLERE METHOD)
-supine
-knee flexed 60 degrees to the long axis of tibia
-use curved cassette
CR:
LONG AXIS OF LOWER LEG
RP:
½” INFERIOR TO PATELLAR APEX
DEMO:
INTERCONDYLAR FOSSA,
INTERCONDYLAR EMINENCE
KNEE JOINT AND TIBIAL PLATEU
PA AXIAL PROJECTION (CAMP-COVENTRY METHOD)
-PRONE
-FEMUR CLOSE INCONTACT
-FLEX KNEE 40-50, SUPPORT UNDER THE FOOT
CR: (DEPENDS HOW MUCH knee flex)

40 (knee flex 40)
50 (knee flex 50)
CAUDAD TOWARDS THE
POPLITEAL DEPRESSION
DEMO:
-ICF
-LOOSE BODIES (JOINT MICE)
-Evaluate split and displaced cartilage in osteochondritis
-Evaluate flattening or underdevelopment of lateral femoral condyles in
congenital slipped patella
PA PROJECTION
-PRONE
-ROTATE HEEL 5-10 DEGREES LATERALLY TO PLACE
PATELLA || TO IR
CR:
PERPENDICULAR
MID-POPLITEAL
AREA
DEMO:
SHARPER IMAGE OF PATELLA
-LATERAL RECUMBENT
-AFFECTED KNEE FLEXED 5-10 DEGREES, NOT >10 FOR
NEW AND UNHEALED PATELLAR FX
-FEMORAL EPICONDYLES AND PATELLA PERPENDICULAR TO IR
CR:
PERPENDICULAR TO
MID-PATELLOFEMORAL
JOINT
DEMO:
PATELLA, PF JOINT SPACE
PA OBL PROJECTION (MEDIAL, LATERAL ROTATION)
-PRONE, KNEE FLEX 5-10 DEGREES, KNEE ROTATE 45-55 MEDIALLY
PRONE, KNEE FLEX 5-10 DEGREES, KNEE ROTATE 45-55 LATERALLY
CR:
PERPENDICULAR TO PATELLA
DEMO:
MEDIAL ROTATION (MEDIAL PORTION OF PATELLA FREE OF FEMUR)
LATERAL ROTATION (LATERAL PORTION OF PATELLA FREE OF FEMUR)
PA AXIAL PROJECTION (KUCHENDORF METHOD) (LATERAL ROTATION)
-PRONE
-HIP ELEVATED 2-3”, KNEE FLEX 10 DEGREES (RELAX THE
MUSCLE)
-KNEE ROTATED 35-40 LATERALLY
CR:
25-30 CAUDAD
RP:
JOINT SPACE BET. PATELLA
AND FEMORAL CONDYLES
DEMO:
OBL PATELLA FREE OF SUPERIMPOSITION OF FEMUR
TANGENTIAL PROJECTION (HUGHSTON METHOD)(JAROSCHY METHOD)
-PRONE
-ANTERIOR SURFACE OF KNEE AGAINST IR
-KNEE FLEX 50-60, FOOT RESTED AGAINST COLLIMATOR
FOR SUPPORT
CR:
45 CEPHALAD PATELLOFEMORAL
JOINT
DEMO:
-PATELLA, PFJ
-SUBLAXATION OF PATELLA AND PATELLAR FX
-ALLOWS ASSESMENT OF FEMORAL CONDYLES
TANGENTIAL PROJECTION (SETTEGAST METHOD)
-DISADVANTAGE: EXTREME FLEXION OF KNEE
-SUPINE OR PRONE(PREFERRED)
-KNEE ACUTELY FLEXED UNTIL PATELLA PERPENDICULAR IR
CR:
PERPENDICULAR IF JOINT
IS PERPENDICULAR TO IR
•15-20 CEPHALAD IF PFJ
IS NOT PERPENDICULAR
DEMO:
-VERTICAL AND TRANSVERSE FX OF PATELLA
-USEFUL FOR INVESTIGATING ARTICULATING SURFACES OF PF
ARTICULATION
TANGENTIAL PROJECTION (MERCHANT METHOD)
-SUPINE
-BOTH KNEE FLEX 40 DEGREES OR BET. 30-90 TO
DEMONSTRATE THE VARIOUS PATELLAR DISORDERS)
-IR RESTING ON PX SHIN, USES IR HOLDING DEVICE AND
AXIAL VIEWER
CR:
30 CAUDAD PFJ
DEMO:
-FEMORAL CONDYLE
-IC SULCUS
-MAGNIFIED NON DISTORTED PATELLAE
TANGENTIAL PROJECTION (SUNRISE METHOD) (MOUNTAIN/SKYLINE)
VIEW
-SUPINE OR SITTING
-KNEE FLEX 40-45 DEGREES
CR:
30 DEGREES
HORIZONTALLY TO PFJ
DEMO:
JOINT SPACE BET. PATELLA AND
FEMORAL CONDYLES
AP PROJECTION
-SUPINE
-MIDSHAFT OF FEMUR CENTER TO IR
-ROTATE LEG 5 INTERNALLY (KNEE ICLUDED)(DISTAL FEMUR)
-ROTATE LEG 10-15 INWARD (HIP INCLUDED)(PROXIMAL FEMUR)
CR:
MIDSHAFT OF FEMUR
DEMO:
FEMUR
HIP JOINT
KNEE JOINT
LATERAL PROJECTION MEDIOLATERAL
-Patient is in lateral recumbent position
-separate the unaffected thigh
-FEMORAL EPICONDLYES PERPENDICULAR IR
(DISTAL FEMUR,KNEE INCLUDED)-UNAFFECTED LIMB DRAW
FORWARD, PELVIS IN TRUE LATERAL POSITION, KNEE FLEX 45 DEG
(PROXIMAL FEMUR, HIP INCLUDED)-UNAFFECTED LIMB
DRAW POSTERIORLY , PELVIS ROLLED 10-15 POSTERIORLY
CR:
PERPENDICULAR MID-FEMUR
DEMO:
LATERAL IMAGE OF FEMUR
TRANSLATERAL PROJECTION (CROSS TABLE LATERAL)
-DORSAL DECUBITUS
-IR PLACED AGAINST THE MEDIAL OR LATERAL SURFACE OF
FEMUR
-ELEVATE THE HIP and femur approx. 2-3 inches
CR:
HORIZONTAL medial side
Of mid-femur
Demo:
ENTIRE FEMUR AND KNEE
JOINT
AP PROJECTION
-supine
-lower limbs are extended
-rotate the feet 15-20 degrees medially or internally
CR:
Perpendicular to the midpoint
Of the film approx.
2” superior to S.P or midway
Between ASIS and S.P
DEMO:
Entire pelvis along
With the proximal femora
LATERAL PROJECTION
-patient in left lateral recumbent
-Dorsal decubitus / upright position
-center the M.A.P to the midline of table
-use Grided cassette or bucky Tray
CR:
Perpendicular at the
level of the soft
Tissue depression just
above the G.T
Demo:
Gullwing sign
Legg-calve Pethres
Chassard Lapine Axial (jackknife)
-seated on the end of Radiographic table
-Posterior surface of the knees is in contact with the edge
of the table
-Patient leaning forward grasping the ankle joint
CR:
Perpendicular through the
lumbo sacral region
level of the
greater trochanters
Demo
-measuring the horizontal
Biischial diameter in
Pelvimetry
- the relationship b/w femoral heads
and acetabulum
-Rectosigmoid
AP AXIAL (MODIFIED CLEAVES METHOD)
-BILATERAL PROJECTION OF FEMORAL NECK
-SUPINE
-BEND THE KNEES AND ABDUCT THE FEMUR FOR APPROX 45
DEGREES, SOLES OF THE FOOT INCONTACT TO EACH OTHER
CR:
PERPENDICULAR
1” SUPERIOR TO S.P
DEMO:
OBLIQUE IMAGE OF FEMORAL
HEAD, NECK AND TROCHANTER
AxioLATERAL PROJECTION (ORIGINAL CLEAVES METHOD)
-UNILATERAL PROJECTION OF THE FEMORAL NECK
-Bend the knees and hip of the affected side and draw the
sole of the foot against the opposite knee and lean the thigh
laterally for approx. 40 degrees
Cr:
PERPENDICULAR 1” SUPERIOR
TO SYMPHYSIS PUBIS OR
40 CEPHALAD
1” SUPERIOR TO S.P
ANDREN AND VON ROSEN
-BILATERAL HIP
-45 DEGREES ABDUCTION OF LEG WITH INWARD ROTATION
OF FEMORA
Cr:
Perpendicular between 2 hip joint
Or at the level of S.P
DEMO:
DESCRIBES THE LONGITUDINAL
RELATIONSHIP BETWEEN
LONG AXIS OF FEMUR AND
ACETABULUM
MARZ AND TAYLOR
- 2 AP projection
CR:
1ST EXPOSURE- PERPENDICULAR TO S.P
2ND EXPOSURE- 45 CEPHALAD TO S.P (DEMO ANTERIOR
DISPLACEMENT OF FEMORAL HEAD)
DEMO
LATERAL AND SUPERIOR DISLOCATION OF FEMORAL HEAD
AP PROJECTION
-SUPINE
-15 DEGREES INWARD ROTATION OF FEET
CR:
PERPENDICULAR 2.5 inches
below midline of the ASIS
and Symphysis pubis line
LATERAL- MEDIOLATERAL PROJECTION (LAUENSTEIN AND HICKEY)
-SUPINE, PX SLIGHTLYY ROTATED TO AFFECTED SIDE
-CENTER THE HIP IN THE CASSETTE
-FLEX THE KNEE AND HIP AFFECTED SIDE 90 DEGREES
CR:
PERPENDICULAR MIDWAY BET
ASIS AND PUBIC SYMPHYSIS- LAUENSTEIN METHOD
20-25 DEGREES CEPHALAD

MIDWAY BET ASIS AND PUBIC
SYMPHYSIS –HICKEY METHOD (FOR SEPARATION OF GREATER
TROCHANTER AND FEMORA NECK)
AXIOLATERAL PROJECTION (DANELLIUS- MILLER METHOD), LORENZ,
SURGICAL CROSSTABLE LATERAL
-SUPINE
-UNAFFECTED HIP MOVE UPWARD
-INFEROSUPERIOR
CR:
PERPENDICULAR TO THE LONG
AXIS OF THE FEMORAL NECK
DEMO
-Lateral view of the Acetabulum
-Femoral head and Neck
-Trochanteric area for hip trauma
AXIOLATERAL PROJECTION CLEMENTS – NAKAYAMA METHOD
-SUPINE
-ALTERNATIVE FOR DANELLIUS MILLER
-ANGUALTED IR AT THE LATERAL SIDE OF THE AFFECTED HIP
CR:
15 DEGREES POSTERIORLY
DEMO:
LATERAL IMAGE OF ACETABULUM
AXIOLATERAL PROJECTION (FRIEDMAN METHOD)
-LATERAL RECUMBENT, UNAFFECTED SIDE UP 10 DEGREES
POSTERIORLY
CR:
35 DEGREES CEPHALAD
AT THE LEVEL OF FEMORAL
NECK
DEMO:
-Demonstrate elongated view of the femoral neck
-Legg – calve perthes
PA OBLIQUE PROJECTION (RAO – LAO) (HSIEH METHOD)
-SEMI PRONE
-elevate the unaffected side forming a 40 – 45 degrees RAO
position
CR:
Perpendicular to the level of
the intertrochanteric line
DEMO:
posterior dislocation of
the femoral head

POSTEROLATERAL OBLIQUE (LILIENFIELD METHOD)
-AFFECTED SIDE DOWN
-LAT. RECUMBENT, SLIGHTLY MOVE FORWARD APPROX 15
DEGREES OF UNAFFECTED SIDE
CR:
PERPENDICULAR AT THE MIDPOINT
OF THE FILM TRAVERSING
AT THE HIP JOINT.
COLONNA METHOD
-UNAFFECTED SIDE
-AFFECTED SIDE ROTATE 17 DEGREES FORWARD
CR:
PERPENDICULAR AT THE MIDPOINT
OF THE FILM TRAVERSING
AT THE HIP JOINT.
DEMO:
SEPARATE THE SHADOW OF THE HIP
AND GIVE OPTIMUM POSITION OF THE
SLOPE OF ACETABULAR ROOF AND THE
DEPTH OF THE SOCKET
*
PA AXIAL OBL. (TEUFEL METHOD)
-LAO/RAO
-AFFECTED SIDE DOWN
-38 DEGREES BODY ROTATION FROM THE TABLE
CR:
12 DEGREES CEPHALAD
AT THE LEVEL OF ACETABULUM
DEMO:
FOVEA CAPITIS
SUPEROPOSTERIOR WALL OF
ACETABULUM
AP OBLIQUE PROJECTION (JUDET METHOD)
- 2 OBLIQUE POSITIONS, 45 DEGREES BODY ROTATION
INTERNAL OBLIQUE- AFFECTED SIDE UP, FOR ILIOPUBIC FX,

POSTERIOR RIM OF ACETABULUM (OBTURATOR VIEW)
EXTERNAL OBLIQUE- AFFECTED SIDE DOWN, FOR ILIOISCHIAL
COLUMN FX RIM OF THE ACETABULUM (ALAR VIEW)
DEMONSTRATE:
DX FX OF ACETABULUM
CR:
PERPENDICULAR AT THE LEVEL
OF 2” BELOW ASIS
PA
-PRONE
CR:
PERPENDICULAR AT THE LEVEL
OF DISTAL COCCYX
AP AXIAL (TAYLOR) (OUTLET VIEW)
-SUPINE
CR:
MALE- 20-35 CEPHALAD 2” DISTAL TO UPPER BORDER OF S.P
FEMALE- 30-45 CEPHALAD 2” DISTAL TO UPPER BORDER OF S.P
DEMO:
UNDISTORTED IMAGE OF RAMI
SUPERIOR INFERIOR AXIAL “INLET” PROJECTION (LILIENFELD
METHOD)
-SEATED/ SEMI-SEATED
- lean the patient 40 – 45 degrees backward
- Knee is flexed
CR:
Perpendicular to the IR
At the trochanter level
2 inches above the
symphysis pubis
PA AXIAL “INLET” PROJECTION (STAUNIG METHOD)
- prone
CR:
35 CEPHALAD AT THE LEVEL
OF GREATEER TROCHANTER
DEMO:
INLET
AP OBLIQUE PROJECTION (RPO – LPO POSITION)
-Elevate the unaffected side 40 degrees to placing the
broad surface of the wing of the affected ilium parallel with the
plane of IR
CR:
Perpendicular to the midpoint
of the IR level of the ASIS
DEMO:
shows unobstructed projection
of the ala and sciatic notches
PA OBLIQUE (RAO-LAO POSITION)
-PRONE
-Elevate the unaffected side 40 degrees
CR:
PERPENDICULAR
MIDWAY BETWEEN ASIS AND S.P
DEMO:
-Shows the ilium in profile
-Femoral head within the acetabulum
TOPOGRAPHIC LANDMARKS
- CERVICAL REGION
- C1- MASTOID TIP
- C2-C3- GONION
- C5- THYROID CARTILAGE
- C7 VERTEBRAL PROMINENCE
- THORACIC REGION
- T1- 2” SUPERIOR TO STERNAL NOTCH
- T2-T3- MANUBRIAL NOTCH/ SUPERIOR MARGIN OF SCAPULA/ SUPRA
STERNAL NOTCH
- T4-T5- STERNAL ANGLE
- T7 INFERIOR ANGLE OF SCAPULA
- T9-T10- XIPHOID PROCESS
- T10- XIPHOID TIP
- LUMBAR REGION
- L3- LOWER COSTAL MARGIN
- L3-L4- LEVEL OF UMBILICUS
- L4- MOST SUPERIOR ASPECT OF ILIAC CREST
- SACRUM AND PELVIC REGION

- S1- AS1S
- COCCYX- S.P AND G.T
VERTEBREA
- consist of 33 bones that compose of
spinal column
1. Cervical - 7
2. Thoracic - 12
3. Lumbar - 5
4. Sacral - 5
5. Coccygeal - 4
SPINAL CURVATURES
1. CONCAVE CURVES (HALLOW)

- CERVICAL
- LUMBAR
(SECONDARY OR COMPENSATORY CURVE)
-DEVELOP AFTER BIRTH
CERVICAL: WHEN BABY START HOLDING THE HEAD

LUMBAR: WHEN BABY LEARNS TO WALK
2. CONVEX CURVES (ARCHED)

- THORACIC
- SACRAL
(PRIMARY CURVE)
-PRESENT AT BIRTH
ABNORMAL CURVATURES
1. LORDOSIS
-EXAGERATED LUMBAR CURVATURE
-SWAY BACK
-INCREASE IN ANTERIOR CONVEXITY OR POSTERIOR
CONCAVITY
2. KYPHOSIS
-EXAGERATED THORACIC CURVATURE
-HUMPBACK OR HUNCHBACK
-INCREASE IN ANTERIOR CONCAVITY OR POSTERIOR
CONVEXITY
3. SCOLIOSIS
-EITHER LEFT OR LATERAL CURVATURE
-S-SHAPED
2 TYPES:
DEXTROSCOLIOSIS- RIGHT LATERAL CURVATURE
LEVOSCOLIOSIS- LEFT LATERAL CURVATURE
4. GIBBUS
-POSTERIOR ANGULATION OF SPINE
PATHOLOGY
1. CLAY-SHOVELERS- AVULSION FX OF THE SPINOUS PROCESS IN
LOWER CERVICAL AND UPPER THORACIC (C6-T1)
2. COMPRESSION FX- FX COZ COMPACTION OF BONES AND DECREASE
IN LENGTH OR WITH
3. HANGMAN`S FX- FX OF THE ANTERIOR ARCH OF C2 DUE TO
HYPEREXTENSION OF THE NECK
4. JEFFERSON`S- COMMINUTED FX OF THE RING OF C1
5. HERNIATED NUCEUS PULPOSUS- RAPTURE OR PROLAPSED OF THE
NUCLEUS PULPOSUS INTO SPINAL CANAL.
6. OSTEOPOROSIS- LOSS OF BONE DENSITY
7. OSTEOPETROSIS- INCREASED DENSITY OF ATYPICALLY SOFT BONE
8. SHEUERMANN`S DISEASE- ADOLESCENT KYPHOSIS, KYPHOSIS WITH
ONSET IN ADOLESCENCE
10. SPINA BIFIDA- FAILURE OF THE POSTERIOR ENCASEMENT OF
SPINAL CORD TO CLOSE
11. SPONDYLOLISTHESIS- FORWARD DISPLACEMENT OF VERTEBRA
OVER LOWER VERTEBRA, USUALLY L5-S1
12. SPONDYLOSIS- SEPARATION OF PARS INTERARTICULARIS
13. ANKYLOSING SPONDYLITIS- TYPE OR ARTHRITIS THAT AFFECT
THE SPINE.
14. ODONTOID FX. –DISRUPTION OF THE ARCHES OF C1.
15. TEARDROP BURST FX.- COMMINUTED VERTEBRAL BODY WITH
TRIANGULAR FRAGMENTS AVULSED FROM AP BORDER
CAUSED BY COMPRESSION WITH HYPERFLEX IN C-SPINE,
16. TRANSITIONAL VERTEBRA- OCCURS WHEN THE VERTEBRA
TAKES ON A CHARACTERISTICS OF ADJACENT REGION OF
SPINE.
17. CHANCE FX.- FX THROUGH THE VERTEBRAL BODY CAUSED BY
HYPERFLEXION FORCE.
18. WHIPLASH INJURY- DAMAGE TO THE LIGAMENTS, VERTEBRAE
OR SPINAL CORD CAUSED BY SUDDEN JERKING BACK OF THE
HEAD AND NECK.
19. SACRALISATION- CAN BE SEMI-FUSED ON ONE OR BOTH SIDE
THAT RUB AGAINST THE ILIAC BONE OF THE PELVIS.
20. LUMBARIZATION- CONGENITAL ANOMALY, IN WHICH THE SACRAL
VERTEBRAE ASSUME THE APPEARANCE OF THE LUMBAR VERTEBRA
LIKE ADDITIONAL LUMBAR VERTEBRA, (APPEARS LIKE L6)
ATLAS (C1)
-ATYPICAL VERTEBRA
-THICK ARCH CALLED ANTERIOR ARCH
-HAS POSTERIOR ARCH
-NO BODY
-NO SPINOUS PROCESS
-CONSIST ANTE., POSTE, ARCH, 2 LATERAL MASSES, 2
TRANSVERSE PROCESS
AXIS (C2)
-STRONG CONICAL PROCESS
-DENS OR ODONTOID PROCESS OR PEG
1. AP Oblique Proj.(R AND L ROTATION)
- Supine
- rotate head 45-600 away
- adjust flexion of neck until IOML is perpendicular
CR: perpendicular
RP: 1” ant. to the EAM
- demons. Dens, Atlanto-Occipital art.

2. PA Projection
- forehead & nose are touching
- OML perpend.
CR: perpend. level of infraorbital margin, RP 1” ant. to

the EAM
demons. Atlanto-Occipital art. AND mandibular condyle

1. AP Projection (Open Mouth)
- SUPINE
- MSP and occlusal perpendicular
CR: PERPENDICULAR MIDPOINT OF OPEN MOUTH
Demons.
-Dens
- vert. body of C2
-lat. Masses of C1
-Zygopophyseal jts. bet C1 & C2
2. AP Projection (Fuchs Method)
-SUPINE, HYPEREXTEND NECK
-MML PARALLEL
CR: PERPENDICULAR CHIN
- done when the upper half of dens not shown in the

open mouth
demons. Dens within the foramen magnum

3. PA Projection (Judd Method)
- PRONE, MML ||
- OML is 37 DEGREES
CR perpendicular
RP distal to the level of the mastoid tips
demons. Dens within the foramen magnum & ant.

& Post. Arches of the atlas.
- Do not attempt
* who has unhealed fx
* who has degenerative disease
* suspected fx in the upper cervical region.
4. AP Axial Oblique Projection (Kasabach
Method) R or L head Rotations
-supine, 40-45 head rotation away
affected side
- entire body is rotated 40-450
- IOML perpendicular
CR: 10–150
RP midway bet. the outer canthus and EAM
Demo: c2 inprofile
Smith & Adel
-supine
- slight extend the neck
- mouth widely open
- head rotated 100 towards affected side
CR: 350 caudally
RP: C3
Demons:
Laminae
-articular facets of the upper cervical vertebrae
Lateral Projection
-supine (x-table lateral)
CR: HORIZONTAL
RP: 1” distal to the tip of mastoid process
DEMO:
JEFFERSON`S FX
HANGMAN`S FX
CLAY-SHOVLERS
1. AP Axial Projection
-SUPINE OR UPRIGHT
- OCCLUSAL plane is perpend to the table top (neck
extended)
CR 15–20 CEPHALAD
Demons:
Lower 5 vert. bodies
interpedicule spaces
intervertebral disks
2. Lateral Projection (Grandy Method)
-UPRIGHT
- 72” SID helps demons. C7
-ADD 5-10 LBS TO DEPRESS THE SHOULDER
CR: HORIZONTAL AT THE LEVEL OF C4
DEMO:
interspaces of cervical bodies,
articular pillars,
lower five zygophophyseal jts.
spinous process
3. Lateral Projection (Hyperflexion / Hypertension)
Hyper Flexion
- drop the head forward
Hyper Extension
- elevate the chin (force extension)
-functional studies of CV
demons. Normal anteroposterior movement, or natural

spinal curvature, absence of movement, range of spinal
motion, ligament stability
AP/PA AXIAL OBLIQUE PROJECTION (RPO,LPO) (RAO,LAO)
ANTERIOR OBLIQUE
-ROTATE BODY 45 DEGREES
CR: 15-20 CAUDAD C4
DEMO: CLOSEST INTERVERTEBRAL FORAMINA
POSTERIOR OBLIQUE
CR: 15-20 CEPHALAD C4
DEMO: FARTHEST IVF AND PEDICLE
PA AXIAL OBLIQUE (DEMONSTRATE BY BARSONY AND KOPPENSTEIN)

AP Projection (Ottonello Method or Chewing or Wagging Jaw)
-SUPINE
- mandible must be in continuous motion
- elevate chin
-occlusal plane perpendicular
-NEED LOW mA and increase S
CR perpendicular
demons. Entire cervical vert. , blurred mandible

6. AP Axial Oblique Projection (Vert. Arch / Pillars) Pillar or Lat.
Mass Proj. (R and L rotation)
- supine,
-head rotation 45-50 towards unaffected side
-head rotation 60-70 towards unaffected side
CR: 35 degrees caudad (30-40 range)

RP: c7
Demons:
45-50 rotation (c2-c7 articular processes)
60-70 rotation (c6-t4 articular processes)
7. PA Axial Proj.
- prone
- neck fully extended
- CR 35-450
-MSP PERPENDICULAR TO IR
CR: 40 CEPHALAD; 35- 45 CEPHALAD RANGE)

RP: C7
DEMO:
VERTEBRAL ARCH STRUCTURES
LATERAL (TWINING METHOD ) (SWIMMER`S)
- UPRIGHT
-DEPRESSED THE SHOULDER
-ARM INCONTACT TO IR RAISED, FOREARM RESTED IN HEAD
ELBOW FLEX
CR: PERPENDICULAR OR 3-5 CAUDAD

RP: 1” ABOVE AT THE LEVEL OF JUGULAR NOTCH OR C7-T1
INTERSPACE
DEMO:
CERVICOTHORACIC REGION
LATERAL PROJECTION (PAWLOW METHOD) (SWIMMER`S)
-LATERAL RECUMBENT
-HEAD ELEVATED AND REST ON THE ARM
-DEPRESSED THE SHOULDER
CR: SAME AS TWINING

5-15 DEGREES CEPHALAD -→ MODIFIED POWLOW
1. AP Projection
-SUPINE OR UPRIGHT
-HIPS AND KNEES FLEXED TO REDUCE KYPHOSIS
-IR PLACED 1½ - 2” above the shoulder
CR: PERPENDICULAR
RP: bet. jugular notch AND Xiphoid process 2.5 cm./1” below the
manubrial notch / T7
FUCHS- SUGGEST HEEL EFFECT (Fat cat)

SHALLOW BREATHING TO BLUR OUT THE LUNGS OR SUSPENDED
RESPIRATION
Demons.:
-Thoracic vertebral bodies

-intervertebral jt. Spaces
-spinous and transveres processes
-costrovertebral articulations and surrounding
structures.
LATERAL PROJECTION (RIGHT OR LEFT PORTION)
-LATERAL RECUMBENT OR UPRIGHT
-USUALLY LEFT LATERAL TO PLACE HEART CLOSER TO IR
-BEND THE KNEES AND HIPS FOR PATIENT COMFORT THEN
PLACE SUPPORT IN LOWER THORACIC.
-ARMS AT RIGHT ANGLE IN RELATION TO THE BODY
CR: PERPENDICULAR OR HORIZONTAL AT THE LEVEL OF T7

OR inferior angle of the scapula
OR
10-15 DEGREES CEPHALAD WITHOUT SUPPORT
(10 DEGREES)- FEMALE
(15 DEGREES)- MALE
Demons:
-thoracic vert. bodies

-Intervertebral jt. Spaces
-IVF
-lower spinous process
-SPONDYLOLISTHESIS
-SPONDYLITIS
3. Oblique (AP or PA) RPO/LPO-RAO/LAO)
-SUPINE OR UPRIGHT
-MCP FORM 70 DEGREES IN RELATION TI IR
RPO/LPO
- excellent demons of cervicothoracic
- AP Oblique by Fuch
- ROTATE BODY 20 DEGREES POSTERIORLY FROM LATERAL
- demons. farthest zygaphophyseal jt.
RAO / LAO
- PA oblique recommended by oppenheimer
-ROTATE BODY 20 DEGREES ANTERIORLY FROM LATERAL
- demons. closest zygaphophyseal jt.
1. AP Projection
-SUPINE OR UPRIGHT
- flex knees
-reduce lumbar lordosis
-place back incontact with table
-reduce distortion of v.bodies
-better delineation of IV disk
CR: perpendicular
RP: for LS = L4 or level of iliac crest
Lumbar only = L3 or 1 ½” above the iliac crest.
DEMO:
DEMO:
-LUMBAR BODIES
-IV DISK SPACES
-INTERPEDICULATE SPACES
-LAMINAE
-SPINOUS AND TRANSVERSE PROCESS
2. Lateral Projection
-LATERAL RECUMBENT OR UPRIGHT
- CR depends on the lumbar column
Male – 50 CAUDAD
Female- 80 CAUDAD
For Scoliosis
-convexity of the spine is closest to the IR to better open the
intervertebral spaces.
DEMO:
Spondylolithesis
IVF of L1-L4
Spinous processes
Vert. bodies
Intervertebral jts.
L5-S1
IVF of L5 (Oblique)
3. Oblique (RPO/LPO-RAO/LAO)
RPO/LPO
- AP Oblique projection
- rotate 450 closest zygapophyseal jts. demonstrated
- for demons. of articular processes of the lumbar region
- and 300 for lumbosacral processes
- pars intercularis (neck of scotty dog)
For Lumbar:
- RP 2” medial to the ASIS and 1 ½” above the iliac
crest (L3)
- rotate 450 closest zygapophyseal jts. demons.
For Zyga.
- RP 2” medial to the ASI
- to a point midway bet. the iliac crest and the ASIS
- Demons. Articular processes closest to the IR and

Scottie dog sign.
Ear = SAP
Eye = Pedicle
Nose = Transverse
Process
Collar = Pars
Interarticularis
Front Leg = IAP
Body = Lamina
AP AXIAL/ PA AXIAL PROJECTION
-SUPINE
-PRONE
CR 30-350 CEPHALAD
RP: 1.5“ superior to the SP
Male -300 CEPHALAD
Female -350 Cephalad
if Prone 30-350 CAUDAD

-LATERAL RECUMBENT
-BEND THE KNEES AND HIPS FOR SUPPORT
RP: bet. the ASIS and the iliac crest

- 50-100
Male - 50
Female - 50-100
3. PA Axial Oblique (Kovacs Method)
RAO and LAO Position

- rotate the pelvis 300 anteriorly from the
lateral
CR: 15-300 caudad

RP: L5
demons.
L5 VF
OBLIQUE LUMBAR (RAO/LAO OR RPO/LPO)
RPO/LPO
-ANTERIOR OBLIQUE PROJECTION
-CR PERPENDICULAR L3 OR LOWER COSTAL MARGIN
-DEMO NEAREST ZYGA. JT.
-PARS INTERARTICULARIS, SCOTTY DOG SIGN
RAO/LAO
-POSTERIOR OBLIQUE PROJECTION
-CR PERPENDICULAR L3 OR LOWER COSTAL MARGIN
-DEMO FARTHEST ZYGA. JT.
-PARS INTERARTICULARIS, SCOTTY DOG SIGN
1. AP Projection
-SUPINE
-LOWER LIMBS EXTENDED, SLIGHTLY ABDUCT THIGH
RP: 5 cm. / 2” superior to the SP
CR: 150 CEPHALAD
DEMO: SACRUM
2. Lateral Projections
-LATERAL RECUMBENT
-PLACE SUPPORT IN LOWER THORACIC
-BEND KNEES AND HIPS FOR COMFORT
CR: PERPENDICULAR AT THE level

of the ASIS
1. AP Projection
-SUPINE
- LOWER LIMBS ARE EXTENDED
CR: 10-150 CAUDAD

RP: 1” above the SP
DEMO: COCCYX
2. Lateral
-LATERAL RECUMBENT
-PLACE SUPPORT IN LOWER THORACIC
-BEND KNEES AND HIPS FOR COMFORT
CR: PERPENDICULAR
Rp: midway between the PSIS and sacroccygeal junction
-
AXIAL POSITION (NOLKE METHOD)
-THIS METHOD IS EXAMINATION OF SACRAL
VERTEBRAL CANAL
-SEATED AT THE END OF TABLE, SLIGHT

LEEAN FORWARD
CR: PERPENDICULAR LONG AXIS OF THE SACRUM

1. AP Axial Projection
-SUPINE, LOWER LIMBS ARE EXTENDED
CR: 30-350 CEPHALAD
RP: 1 ½ - 2“ superior to the pubic symphysis 2”below the level
of the ASIS
Male -300
Female - 350
- PA Axial 30-350 CAUDAD

RP = level of L4
2. AP Oblique Projection (RPO/LPO Position)
-BODY ROTATION 25-30 DEGREES AWAY
- LPO demons. the right sacroiliac jt.
- RPO demons. the left
- rotate the body 25-300 side of interest elevated
- RP 1” medial to the elevated ASIS
- CR perpend.
- demons. the sacroiliac farthest from the IR
3. AP Axial Oblique
- CR 20-250 CEPHALAD
- RP 1” medial to the ASIS & 1 1/2“ distal to
the elevated
ASIS
- rotate the body 25-300 side of interest
elevated ASIS
- RPO Left SI
- LPO right SI
4. PA Oblique Proj. (RAO and LAO Position)
- RAO demons. the right SI
- LAO demons. the left SI
- rotate the body 25-300 towards
- CR perpend.
- RP 1” medial to the ASIS closest to the IR
5. PA Axial Oblique
- RAO demons. the right SI
- LAO demons. the left SI
- rotate the body 25-300 towards
- CR 20-250 CAUDAD
- RP 1.5” distal to the L5 spinous process
PA PROJECTION (CHAMBERLAIN METHOD)
UPRIGHT, STANDING ON TWO BLOCKS
REQUIRED HEIGHT OF BLOCKS- 6 INCHES
1ST EXPOSURE: REMOVE ONE BLOCK, ONE LEG HANGS WITH NO

MUSCULAR RESISTANCE
2ND EXPOSURE: REPLACE SUPPORT UNDER FOOT THAT WAS
HANGING, REMOVE THE OPPOSITE ONE, SECOND LEG HANGING FREE
DEMO: ABNORMAL S.I MOTION

CR: PERPENDICULAR
RP: SYMPHYSIS PUBIS
ASPIRATION (F.B)
-INSPIRATION OF FB INTO THE AIRWAY
ATELECTASIS
-COLLAPSED LUNG
BRONCHIECTASIS
-CHRONIC DILATATION OF BRONCHI AND BRONCHIOLES
BRONCHITIS
-INFLAMATION OF BRONCHI
COPD
-CHRONIC CONDITION OF PERSISTENT OBSTRUCTION OF
BRONCHIAL AIRFLOW
CYSTIC FIBROSIS
-ABNORMAL SECRETION OF SWEAT AND SALIVA AND
ACCUMULATION OF THICK MUCUS IN THE LUNG
EMPHYSEMA
-ENLARGEMENT OF ALVEOLAR WALL, COZ BY ALVEOLAR WALL
DESTRUCTION AND LOSS OF ELASTICITY
EPIGLOTTITIS
-INFLAM ATION OF EPIGLOTTIS
TUBERCOLOSIS
-CHRONIC INFECTION OF THE LUNG DUE TO TUBERCOLOSIS
BACILLUS
PNEUMOCONIOSIS
-INHALATION OF INDUSTRIAL SUBSTANCE
ASBESTOSIS
-INFLAM, COZ BY INHALATION OF ASBESTOS
Pneumonia
-acute infection of the lung parenchyma
PA Projection (AP) Upright
-ERECT
CR: PERPENDICULAR OR HORIZONTAL AT THE MIDPOINT OF THE

FILM
- demons. the amount /degree of curvature
that occurs with the force of gravity acting on the body.
- significantly reduced dose to radiation sensitive areas

PA (FERGUSON METHOD)
2 EXPOSURES
1ST EXPOSURE- FOR CHECKING THE SPINAL CURVATURE

2ND EXPOSURE- USE 4 OR 3” BLOCKS ON THE SIDE SEEING A
ABNORMAL CONVEXITY
CR: HORIZONTAL OR PERPENDICULAR AT THE MIDPOINT OF THE

FILM
AP SPINAL FUSION (R AND L BENDING)
-UPRIGHT OR SUPINE
-RIGHT BENDING, REQUIRES THE LEFT LEG TO BE CROSSED OVER

THE RIGHT (AS WELL AS THE LEFT BENDING)
CR: PERPENDICULAR OR HORIZONTAL AT THE LEVEL OF L3
DEMO:
- DETERMINE THE PRESENCE OF STRUCTURAL CHANGE WHEN
BENDING TO THE LEFT OR RIGHT
- LOCALIZE HERNIATED DISK, SHOW LIMITATION OF MOTION
- THIS PROCEDURE IS DONE 6MONS POST OPERATION.
LATERAL PROJECTION (HYPEREXTENSION, HYPERFLEXION)
-LATERAL RECUMBENT
-LEAN FORWARD WITH THIGH FORCIBLY FLEX
-LEAN THE THORAX BACKWARD AND POSTERIORLY EXTEND
THIGH AND LIMB
CR: PERPENDICULAR
RP: FUSION SITE
DEMO:
IF MOTION IS PRESENT IN THE AREA OF SPINAL FUSION
1ST EXPO: HYPERFLEXION

2ND EXPO: HYPEREXTENSION
LATERAL PROJECTION
-UPRIGHT
- CONVEX SIDE AGAINST THE IR
CR: PERPENDICULAR OR HORIZONTAL MIDPOINT OF THE FILM
SUSPENDED RESPIRATION AT THE END OF EXPIRATION
DEMO:
SPONDYLOLISTHESIS
DEGREE OF KYPHOSIS OR LORDOSIS
*
PA Oblique Proj.
RAO Position
- rotate the body 15-200
- slow or shallow breathing
-for trauma px use LPO or AP Oblique PROJECTION
- CR perpend. to the IR
- RP level of T7
2. Lateral
-ERECT
-PLACE BOTH HAND AT THE BACK THEN PULL DOWNWARD
CR: PERPENDICULAR OR HORIZONTAL

- Sternal angle (R.P.)
- SUSPENDED RESPIRATION AT THE END OF FULL INSPIRATION
- moves the sternum anterior to the ribs
- 72 inches SID
- demons. Entire length of the sternum & sternoclavicular

region
PA OBL. PROJECTION (MOORE METHOD)
-25 DEGREES BODY ROTATION
DEMO:
OBLIQUE IMAGE OF STERNUM
PA Projection
A. Above the diaphragm (1-10)
- deep inspiration
-which depresses diaphragm to its lowest position
DEMO:
-ANTERIOR RIB CAGE
- low kVp
-if injury over the heart – high kVp
*to obtain high scale contrast
- CR perpendICULAR OR HORIZONTAL
- RP 3-4” below the jugular
- SUSPENDED RESPIRATION (Full inspiration)
B. Below the diaphragm (8-12)
-expiration
-to rise to the level of the 7th or 8th posterior ribs
- R8 to R12
- RP midway bet. the xipiod proc. & lower rib cage.
- CR perpend. to the IR
- suspended respiration (full expiration)

2. AP Oblique Projection (RPO or LPO Position)
- side of convexity against the film
- rotate the body 450
- affected side closest to the IR
- demons. axillary ribs
Note: PA Oblique projection

* affected side away from IR
1. PA
- erect
CR: PERPENDICULAR OR HORIZONTAL AT THE LEVEL OF
manubrium sterni
demonstrate subluxation of SCJ or

pathology of the medial end of the Clavicle
PA Oblique Projection RAO / LAO
-SEMI- PRONE
- rotate the body 10-150
CR: PERPENDICULAR OR HORIZONTAL AT THE LEVEL OF T2-T3

AXIOLATERAL (KURZBAUER METHOD)
-LATERAL RECUMBENT, AFFECTED SIDE DOWN
CR: 15 CAUDAD TO SCJ

DEMO: UNOBSTRUCTED LATERAL VIEW OF SCJ ARTICULATION
Parts of Respi
1. Larynx
2. Trachea
3. Right and left bronchi
4. Lungs
Structures located in the
mediastinum:
1. Thymus gland
2. Heart & great vessels
3. Trachea
4. Esophagus
Reasons of Erect CXR
1. To allow the diaphragm to move down

farther:
- causes liver & other abdo. organs to
drop.
- allowing the lungs to fully aerate
2. To show possible air & fluid levels in
the chest.
3. To prevent engorgement AND
hyperemia of pulmonary vessels.
CHEST TELEO
-72 INCHES SID
LUNGS
-3 LOBES R
-2 LOBES L
PARTS of the Lungs
1. Apex
- rounded upper area above the level of the clavicles
2. Carina
- point of bifurcation
- the lowest margin of the separation of the trachea into the
right & left bronchi
3. Base
- lower concave area of each lung that rests on the diaphragm
4. Costophrenic angle
- extreme outermost lower corner of each lung, where the
diaphragm meets the ribs
5. Hilum
- Central area of the lungs
1. PA Projection
-ERECT, SCAPULAR WAY OUT, CHIN UP
- demons. Both lungs, air filled trachea, hilum, heart &
great vessels, bony thorax
CR: PERPENDICULAR AT THE LEVEL OF T7

Reasons of Erect CXR
1. To allow the diaphragm to move
down farther:
- causes liver & other abdo.
organs to drop.
- allowing the lungs to fully
aerate
2. To show possible air & fluid levels in
the chest.
3. To prevent engorgement &
hyperemia of pulmonary vessels.
Engorgement = distended or swollen
with fluid.
Hyperemia = excess of blood
- ERECT, LEFT OR RIGHT, ARMS ARE RAISE

CR: HORIZONTAL OR PERPENDICULAR T7
Left Lateral
- demons. heart, aorta, left sided pulmonary
lesion
Right Lateral
- right sided pulmonary lesions
- demons, interlobar fissures to differentiate the lobes
and to localize pulmonary lesions
3. PA Oblique PROJECTION
RAO
- rotate the body 450 towards
- the side of interest is the farthest side
- demons. Left atrium, anterior portion of the apex of
the left ventricle, right retrocardiac space
-MAXIMUM AREA OF THE LEFT LUNG
CR: PERPENDICULAR T7
LAO
- rotate the body 450
- demons. Trachea, carina, right branch of the
bronchial tree, heart, descending aorta & arch of the aorta
4. AP Oblique
RPO
- corresponds to LAO
LPO
- corresponds to RAO
5. AP Axial Projection (Lindbloom Method) Lordotic Position
- CR perpend to the IR
- RP level of midsternum
- clavicles lying superior to the apices
- demons. Apices & interlobar effusions

PA LORDOTIC POSITION (FLEISCHNER, FERGUSON, FELSON)
-REVERSE OF LORDOTIC POSITION
CR:
PERPENDICULAR OR HORIZONTAL AT THE LEVEL OF T4
IF PX CANT ASSUME LORDOTIC POSITION
PA AXIAL
15-20 CAUDAD
OR
PRONE- 30 DEGREES CAUDAD
AP OR PA PROJECTION
R OR L LATERAL DECUBITUS
-R OR L LATERAL RECUMBENT
DEMO: FLUID LEVEL – LYING AFFECTED SIDE

FREE AIR IN PLEURAL CAVITY- LYING UNAFFECTED SIDE
REMAIN IN THAT POSITION FOR 5 MINS.

TO ALLOW FLUID TO SETTLE AND AIR RISE
ELEVATE THE BODYT 2-3”

AP
-SUPINE OR ERECT
-ADJUST THE NECK SLIGHTLY
RP: MANUBRIUM
DEMO:
AIR FILLED TRACHEA
LATERAL
-UPRIGHT, LATERAL POSITION
-ROTATE THE SHOULDERS POSTERIORLY
CR: HORIZONTAL OR PERPENDICULAR MIDWAY JUGULAR NOTCH AND

ANTERIOR TO HUMERAL HEAD
SUSPENDED RESPIRATION AT THE END OF FULL INSPIRATION
DEMO: AIR FILLED TRAHEA AS WELL AS THYROID AND THYMUS GLAND

TRANSSHOULDER LATERAL
-ERECT,LATERAL POSITION (L)
-ELEVATE THE ARM IN EXTREME ABDUCTION
-FLEX ELBOW AND PLACE FOREARM ACROSS THE HEAD
-DEPRESS THE OTHER SHOULDER
RESPIRATION: FOR TRACHEA- SLOW AND SHALLOW BREATHING

FOR APICES – FULL INHALATION
CR: 15 CAUDAD DIRECTED TO SUPRACLAVICULAR FOSSA
DEMO:
AIR FILLED TRACHEA AND APEX OF THE LUNG
Abdominal aortic aneurysm- dilatation of the abdominal aorta
Billiary stenosis- narrowing of the bile ducts
Bowel obstruction- blockage of the bowel lumen
Cholecystitis- inflamation of gall bladder
Choledocholithiasis- calculus in CBD
Cholelithiasis- gall stones
Ileus- failure of bower peristalsis
Pancreatitis- inflammation of pancreas
Pneumoperitoneum- accumulation of air in peritoneal cavity

AP SUPINE (KUB) (PLAIN FILM ABDOMEN)
-SUPINE
CR: PERPENDICULAR 2-3” ABOVE ASIC
NOTE: ALWAYS INCLUDE SYMPHYSIS PUBIS

AP UPRIGHT
-ERECT
RP: 2” ABOVE ILIAC CREST
NOTE: ALWAYS INCLUDE DIAPHRAGM

Lateral Decubitus
- CR HORIZONTAL
- 2” above the level of the iliac crest
- demons. air fluid levels of abdo.
- px should be on the side a min. of 5 mins / 10-20
mins is preferred
* to allow air to rise or abnormal fluids
to accumulate
- Left Lateral decubitus
* best visualize free intraperitorial air in
the area of the liver in the right upper
abdo.
- Assess abdo. in cases of visceroptosis
Dorsal Decubitus Position (R or L Lat.)
CR: HORIZONTAL
- RP 2” above the level of the iliac crest
- demons.
* Antevertebral space
* Air fluids
* Levels in the abdo.
* Aneurysms
- widening of the wall of the artery
* calcifications of aorta & Umbilical herinas
3 WAYS OR AAS
CXR
ABDOMEN ERECT
-DEMONSTRATE; ILEUS, ASCITES, PERFORATED HOLLOW

VISCUS, INTRA-ABDOMINAL MASS, POST OP.
ABDOMEN SUPINE
Divided into 2 parts:
1. CRANIUM
2. FACIAL BONES
Cranium
8 bones & houses the brain

1 Frontal
1 Ethmoid
2 Parietal
1 Sphenoid
2 Temporal
1 Occipital
Facial bones
14 bones irregular shaped:
2 Nasal
2 Lacrimal
2 Palatine
2 Inferior nasal conchae
2 Maxillae
2 Zygomatic bones
1 Vomer- plowshare
1 Mandible
Average or Normal Cranium
- Oval in shape
- Wider in back than in front
- measures: 6 inches (15 cm.)widest point
from side to side
7 inches(17.8 cm)longest point
from front to back
9 inches(22 cm)deepest point
from vertex to submental
region.
1. MSP MSP
2. Interpupillary IPL
3. Orbitomeatal line OML
4. Infraorbitomeatal IOML
5. Acanthiomeatal line AML
6. Mentomeatal line MML
7. Glabellomeatal line GML
1. Dolicocephalic
- long/ elongated, front, narrow, deep from V to B
- Petrous pyramid & MSP form 400
- less than 75% in length
2. MESOCEPHALIC
- Normal type of the skull
- Petrous pyramid project anteriorly and medially
- MSP forms an angle of 47 degrees
- the length is bet. 75 to 80%
3. Brachycephalic
- broad type of skull / Short
- petrous pyramid & MSP form 540
- greater 80% in length
1. Anterior Fontanel / Bregma
- soft spots
- largest fontanel that closes until 18mos. of age
2. Posterior Fontanel / Lambda
3. Sphenoid fontanel / Pterion
- Right sphenoid
- Left sphenoid
4. Mastoid Fontanel / Asterion

- Right mastoid
- Left mastoid
1. Sagittal
- ÷ 2 PARIETAL BONES
2. Coronal
- ÷ Frontal and parietal bones.
3. Lambdoidal
- ÷ Parietal and occipital
4. Squammosal
- ÷ Temporal & parietal
Skull
- To demons. fracture, bony pathology and intracranial
calcification
1. Fracture
* disruption in the continuity of a bone
A. Linear Fracture
- fracture of the skull that
may appear as jagged or irregular lucent line with
sharp borders
B. Depressed Fracture
- sometimes called pingpong fracture
- fragment of bone that is separated and
depressed into the cranial cavity
2. Gunshot wounds
1. BASAL FX
2. BLOWOUT FX- FX OF THE FLOOR OF THE ORBIT
3. LE FORTE FX- BILATERAL HORIZONTAL FX OF MAXILLAE
4. TRIPOD FX- FX OF THE ZYGOMATIC ARCH, ORBITAL
FLOOR/ RIM, DISLOCATION OF THE FRONTOZYGOMATIC
SUTURE
5. MASTOIDITIS- MASTOID ANTRUM AND AIR CELLS
6. PAGET`S DISEASE- THICK, SOFT BONE MARKED BY
BOWING FXS
7. SINUSITIS- ONE OR MORE PNS
8. TMJ SYNDROME- DYSFXN OF TMJ
1. AP PROJECTION
-CHIN DEPRESSED
-OML PERPENDICULAR
CR: PERPENDICULAR NASION

BEST DEMO:
-CRISTA GALLI
- POSTERIOR PORTION OF CRANIAL VAULT
PA
(SAME AS AP)
demonstrates :
Frontal bone
Ethmoid air cells
Facial bones
Orbital Margin
Mandibular Condyles
Rami
Crista galli
Paget’s Disease
3. LATERAL
- IOML parallel
- MSP parallel to the film
- IPL is perpendicular
CR: PERPENDICULAR AT 5 cm ( 2” ) above the EAM or midway

between inion and the glabella
DEMO:
- Superimposed, orbital roofs & greater wing of the sphenoid
& mastoid regions
BEST DEMO: ALL SINUSES , NASAL BONES

In cases of injury to the frontal bone
- cross table or dorsal decubitus
* to demonstrate the presence of air in
the cranial cavity.
- demons. Of traumatic sphenoid sinus
effusion.
- MSP vertical, IPL perpendicular to the IR.
Cr: horizontal 2 inches superior EAM

4. SMV/ FULL BASAL/ BASILAR PROJ./ inferosuperior
projection
-vertex against the IR
- IOML parallel
- MSP Perpendicular
CR: PERPENDICULAR
Demonstrates: Foramen Magnum
Foramen Ovale and Spinosum
Petrous pyramids
Mastoid Processes
Zygomatic Arches
Sphenoidal and Ethmoidal sinuses
Mandible
Occipital bone and Dens of the Axis
TECHNIQUE: HIGH mAs, LOW kVp

VSM (REVERSE OF SMV)
-menti against the IR
- IOML parallel
- MSP Perpendicular
CR: PERPENDICULAR
BEST DEMO:
ANTERIOR CRANIAL BASE
SPHENOID SINUS
AP Axial/ Townes/ Chamberlaine/GRASHEY/ 35 DEGREES FRONTO
OCCIPITAL/ AP SEMI AXIAL/ HALF AXIAL
- supine
- OML/ IOML- PERPENDICULAR
* 300 caudad to the OML (Sella turcica

Anterior Clinoid processes seen above F.M)
* 370 caudad to the IOML (Dorsum sella,

Posterior Clinoid Processes seen w/in F.M)
RP: 2 ½” above the glabella

TOWNES STRUCTURES:
ENTIRE F.M
OCCIPITAL BONE
MASTOID AIR CELLS
PETROUS PYRAMIDS
DORSUM SELLAE
POST CLINOID PROCESS WITHIN F.MAGNUM
PARIETAL BONES
6. PA Axial/ HAAS/NUCHOFRONTAL PROJECTION
-REVERSE OF TOWNES
- Prone
- Forehead & nose touching the table
- OML ┴
C.R. 250 cephalad 1.5” below the inion & exit 1.5 “ superior
to the nasion
Demons.
-occipital region,
-petrous pyramids,
-dorsum sella and posterior clinoid processes w/in the FM.
- saddle type / horse shoe
Procedure:
1. Lateral
2. Towne’s
1. Lateral
- MSP parallel,
- -IOML parallel
-IPL PERPENDICULAR
CR: PERPENDICULAR
- ¾” anterior & superior EAM
DEMO:
- Superimposed the anterior and posterior clinoid processes
2. Towne’s
- IOML ┴
-MSP ┴
RP: 3” above NASION

CR: PERPENDICULAR
Demons. Pituitary adenomas
- petrous pyramid
OPTIC CANAL (Foramen)
- to demons. size of the optic foramina
- blow out fx. in the floor of the orbit
Procedures:
1. Parieto-orbital Oblique/Rhese/ 3 point
landing
2. Orbito-parietal/Alexander Method
1. Parieto- orbital obl./ Rhese/ 3 points landing/ 3/4TH
POINT LANDING
- semi-prone
- cheek, nose & chin
- MSP is 530
- Acanthiomeatal ┴
C.R ┴
RP: Outer canthus
DEMO:
- Optic foramen, orbital margin
- ethmoidal, sphenoidal & frontal sinuses
2. Orbito - parietal/ Alexander method
- supine
- rotate head away
- MSP 530
- A canthiomeatal ┴
SUPERIOR ORBITAL FISSURES
Procedure:
1. PA Axial/Parieto-Orbital Obl. Pos.
1. PA axial/ parieto - orbital obl. Pos.
- prone
- IOML ┴
- forehead & nose touching
- CR 20-250 caudad
- RP-level of inferior margin of the orbit.
Inferior Orbital Fissures
PROCEDURE:
1. PA axial Proj. (Bertel Method)

1. PA axial Proj. (Bertel Method)
- Prone
- forehead & nose are touching
- MSP ┴
- IOML ┴
- CR 20-250 CEPHALAD exiting the
nasion enters 3” below the INION
Sphenoid Strut
- inferior root of the lesser wing of the
sphenoid bone
Procedures:
1. Parieto-orbital Oblique/Hough
Method
1. Parieto- orbital obl./ Hough method
- prone
- supercillary ridge resting the table
- IOML ┴
- Head rotated toward
- MSP 200
- C.R. 70 CAUDAD
FACIAL BONES
Procedures:
1. Parieto-Acanthial / Waters
2. PA Axial
3. Lateral
1. Parieto- Acanthial/ Waters/MAHONEY
- Best projections for facial bones
- OML 370
- Mentomeatal ┴ tip of the nose is ½ OR
¾ inch from the table top
Demons.
-blowout fx
-orbit, maxillae,
-zygomatic arches,
-Tripod and Le forte fracture
2. PA axial/ CALDWELL
- prone
- forehead and nose touching the table
- MSP ┴
- OML ┴
- Acanthion
* If for Gen survey
modified caldwell- 150 CAUDAD exit at the nasion
- to projects petrous ridges into the
lower 1/3 of the orbits
True caldwell: 23 degrees caudad glabella
CR: PERPENDICULAR
- PETROUS RIDGES FILLED THE ORBIT
- 300 CAUDAD below the inferior margin of orbit (ORBITAL RIM)

(EXAGERATED CALDWELL)
DEMO:
FACIAL FX
ALVEOLAR RIDGES
ORBITAL RIM
NASAL SEPTUM
MANDIBULAR CONDYLES
ZYGOMATIC BONES
3. Lateral
- Prone head true lateral
- MSP parallel
- IPL ┴
- IOML parallel
CR: PERPENDICULAR
RP: between the outer canthus and EAM
Demons.
lateral image of the bones of the face
Demonstrates :
- Depressed fractures of the
frontal sinuses
- Orbital roof
- Sella turcica
- Madible
MODIFIED WATERS
-OML 55 DEGREES
DEMO:
- BLOWOUT FX
- PETROUS RIDGES BELOW INFERIOR BORDER OF ORBITS
REVERSE WATERS/ ACANTHIOPARIETAL

-CHIN UP
-OML 37
-IOML PERPENDICULAR
DEMO:
SUPERIOR FACIAL BONES
PETROUS RIDGES BELOW MAXILLARY SINUS
Tripod Fracture / free floating zygomatic
bone
- fracture caused by a blow to the cheek, resulting
a fracture in the zygoma in three places
* Orbital process
* Maxillary process
* Zygomatic arch
Le Forte fracture
- severe bilateral horizontal fractures of the
maxillae resulting in an unstable detached
fragments
*
NASAL BONES
- demons. fxs. and degree of
displacement of the nasal bones & septum
Procedures:
1. Lateral
2. Tangential/Supero-inferior
3. Parieto-Acanthial (waters)
1. Lateral
- prone, head is true lateral
- IPL ┴
- IOML parallel
- MSP parallel
-CR: PERPENDICULAR
- R.P 1/2 distal to the nasion or bridge of
the nose
DEMO:
DEPRESSED FX. OF FRONTAL SINUS

ORBITAL ROOF
SELLA TRUCICA
MANDIBLE
2. Tangential / superoinferior
- MSP ┴
- Maybe done using occlussal film
*shows medial or lateral displacement
Best for linear fx. of the nasal bone
3. PARIETO-ACANTHIAL (Waters)
- MSP is perpendicular
- OML is 37 degrees angle to the IR
CR: PERPENDICULAR ATH THE LEVEL OF Acanthion
demonstrates:
-displacement of nasal septum and depressed
fractures of the nasal wings.
ZYGOMATIC ARCHES
Procedures:
1. Tangential/SMV/Full Basal
2. Tangential / May Method
3. AP Axial Proj.
(Townes/Grashey)
4. PA Axial / Titterington Method
1. Tangential/ SMV/ Full basal
2. Tangential / May Method
- prone
- nose & chin touching
- MSP 150 away
- C.R ┴ to the IOML
- IOML parallel
- RP ½” posterior to the outer canthus
* demons. zygomatic arch free of
superimposition & those who have
depressed fracture or flat cheek
bone
3. AP Axial Projection(Townes/Grashey)
- Supine
- MSP and OML are perpendicular to IR
30 degrees caudally above the nasion
37 degrees caudally to the IOML
demonstrate:
Zygomatic arches free from
superimposition and fx. of the
zygomatic bone.
4. PA Axial / Titterington Method
- Prone
- Nose and chin resting the table
- MSP perpendicular
- CR 10-15 degrees caudally / 23-38
degrees caudally
demonstrate:
Zygomatic arches
MANDIBLE
Procedures:
1. PA
2. Axio-Lateral oblique proj.
3. PA Axial Projection
1. PA
- forehead & nose touching
- MSP ┴
- OML ┴
* If for Gen. Survey
- C.R ┴
- demons. mandibular body
and rami.
- medial or lateral
displacement of fractures of the rami.
2. Axio-lateral oblique projection
- prone
- MSP parallel
- IPL ┴
- C.R. 250 to 35 degrees cephalad
* If the ramus
- head in true lateral position
- if the body
- rotate the head towards the IR
30deg.
- if the mentum
- rotate the head 45 deg. Towards
the IR
3. PA Axial Projection
- Prone
- MSP and OML are perpendicular
- CR 20-30 degrees cephalad
- demonstrates:
Mandibular rami
Mandibular condyles
TM fossae
Fractures and inflammatory
processes of the mandible
AP AXIAL/ TOWNES METHOD
-Supine
- MSP and OML are perpendicular to IR
*30 degrees caudally above the nasion
*37 degrees caudally to the IOML
DEMONSTRATE
(SAME AS THE OTHER TOWNES)
Panorex / Panoramic Tomo. /
Pantomography Rotational tomo.
- demonstrates fractures of the
mandibles, TMJ pathology and dental
arches
TMJ
Procedures:
1. AP axial/ Townes
2. Lateral Oblique / Axiolateral /
Axial Transcranial
3. Zanelli method
4. Albers-Schonberg (Lateral
transfacial)
1. AP Axial
- supine
- MSP & OML ┴
- C.R. 350 from the
OML or 420 from
IOML
- 3” above the nasion
- demons. Condyloid processes,
mandibular fossae
2. Lateral Oblique /Axio lat. OBL/ SCHULLER`S
- prone, head lateral pos.
- MSP parallel
- IPL┴
- ½ inch anterior and 2 inches superior
to the EAM
- C.R. 25-30 deg. caudad
Open Mouth
- demonstrates the
mandibular fossa & the
inferior & ant. excursion
of the condyle
Close mouth
- demons. fxs. of the neck &
condyle of the ramus
- demons. Disloc. or small fx. of
the cortex
3. Zanelli method / Oblique Transcranial
- rest the cheek against the IR
- rotate the head towards the IR until the
MSP forms 15 degrees angle
- AML is parallel
- CR 15 degrees caudally
- demons. Condyle and mandibular fossa and
the amount of movement dislocation or small fx.
In the cortex of the condyle.
4. Albers-Schonberg (Lateral Transfacial)
- Semi-prone, head in lateral
-rotate the head 20 towards
- MSP and IOML are parallel
- CR 20 degrees cephalad
- IPL perpendicular
- Condyle should lie in the mandibular
fossae in closed mouth exam
- condyle should lie below articular
tubercle in the open mouth exam
Eye
- demonstrates the presence of
radiopaque FB in the orbital cavity.
Procedures:
1. Lateral
2. Modified Waters
3. PA Axial
1. Lateral
- prone, head lat
- 2 exposure are made
* 1 eye raised
* 1 eye down
- C.R. ┴
- R.P. outer canthus
2. Occipito- Mental / Modified Waters
- prone
- nose & chin touching
- OML 500
- MSP ┴ eyes closed
3. PA Axial
- prone
- Forehead and nose to the IR
- OML perpendicular
- CR 30 degrees caudally to project the
petrous portion below the inferior
margin of the orbits.
-
*VOGT- BONE FREE POS*
- used to detect small or low density
foreign particles
2 Movements
1. Vertical movement
2. Horizontal movement
*PARALLAX METHOD*
- deep localization/ fluoroscopic guided
SWEET METHOD
-orbital FB localization using geometric
calculation
Pfeiffer- COMBERG METHOD

- using leaded contact lense placed directly
over the cornea
Function of PNS
- serves as resonating chamber for the
voice
- Decrease the weight of the skull by
containing air
- Help to warm and moisten inhaled air
- act as shock absorber in trauma
1. Maxillary Sinuses
- exhibit a definite cavity at birth
- largest SINUS
2. Frontal Sinuses
- begin to be visible on radiographs @ 6 or 7
y/o
- second largest
- measures 2 to 2.5 cm in the vertical or
lateral dimension
- posterior to the Glabella
3. Ethmoid sinuses
- located within in the lateral masses of the
labyrinths of the ethmoid bone
- develop last
4. Sphenoid Sinuses
- lies in the body of the sphenoid bone
directly below the sella turcica
1. Parieto- acanthial/ waters
- prone
- OML 370
- C.R. horizontally
- R.P acanthion
- MML / MSP ┴
- frontal & ethmoidal cells are
distorted
Demonstrates:
❖ Sinusitis of the maxillary
sinuses
❖Petrous ridges lying
inferior to the floor of the
sinuses.
❖Foramen rotundum
2. PA Axial / Caldwell
- demons. Frontal & ant. Ethmoid
sinuses
- forehead & nose
- MSP & OML ┴
- C.R. 150 to nasion original 230 to
glabella
3. Lateral
- demons. all sinuses
- prone, head in lateral
- MSP parallel
- IPL ┴
- IOML parallel
- R.P. ½ inch. posterior to the outer
canthus of the eye.
4. OM with Open mouth/ Water’s with open
mouth
- demons. Sphenoidal sinuses
- head in prone
- chin resting
- MSP ┴
- OML 370
- C.R.
*
-nose & chin resting on IR
-open mouth
CR: passing sella turcica, exiting mouth

SS: sphenoid sinus through the open
mouth
5. SMV
- basal proj. of sphenoid & ethmoid
sinuses.
- anterior portion of the base of the
skull
- IOML nearly parallel
- MSP ┴
Rhese method
-MSP 40
-OML 30
CR: PERPENDICULAR OUTER CANTUS
DEMONSTRATE
optic canaL
oblique image of ethmoid, frontal, &
sphenoid sinus
(ADDITIONAL)
Pa axial oblique (Law method)
SS: relationship of teeth to maxillary sinus
GRANGER 23
CR: 23 CAUDAD
GRANGER 107
CR: 17 CEPHALAD
*
*A. Lateral
*B. Parietocanthial
*C. PA axial
*D. Upright Lateral
Random question
TOWNES
*Supine
*OML or IOML perpendicular to IR
*C.R.
* 300 to the OML or 370 caudally to the
IOML
*2 ½ inches above the nasion
*petrosas projected above the base of
the skull.
*internal acoustic canals, arcuate
eminences, labyrinths, mastoid
antrums, and middle ears.
AXIOLATERAL/ SCHULLER/ AXIAL
TRANSCRANIAL
*prone, head lateral pos.

*MSP parallel
*IPL┴
*C.R. 25-30 deg. Caudad, ½ inch anterior
and 2 inches superior to the EAM
DEMO:
PNEUMATIC STRUCTURES
LAW/ AXIOLATERAL OBLIQUE
• prone, head lateral
• IOML parallel
• IPL┴
• rotate the head toward
until MSP will forms 150
• CR 150 caudally
(ADDITIONAL)
LOW BEER METHOD/ PARIETO TEMPORAL

-TRUE LATERL AFFECTED SIDE DOWN
CR: 33 ANTERIORLY AND 10

CEPHALAD TO EAM CLOSEST TO TO THE IR
Stenvers / Axiolateral oblique
- Prone
- 3 pt upper landing affected side
- IOML parallel
- MSP is 450 towards the side of interest
- C.R. 120 CEPHALAD
- 3-4” post. & ½” inferior to the EAM.
DEMO:
Petromastoid portion
petrous ridge
mastoid antrum
tympanic cavity
mastoid process
bony labyrinth and carotid canal
Arcelin (reverse of stenvers)
- Supine
- Rotate the head away 450
- IOML ┴
- C.R. 100 CAUDAD
- R.P. 1” ant. & ¾” Superior to the
EAM
demonstrate the Petrous
portion of the temporal bone
Axiolateral projection / Henschen
-TRUE LATERAL POSITION OF HEAD
CR: 150 CAUDAD
RP: EAM closest to IR
Henschen- mastoid air cell & antrum

MEYER METHOD
-OBLIQUE POSITION OF THE HEAD
-45 TOWARDS AFFECTED SIDE
CR: 45 CAUDAD TRAVERSING TEMPORAL

AREA
DEMO:
PETROUS TEMPORAL BONE
AXIOLATERAL/ LYSHOLM/ RUNSTROM 2
-HEAD IN TRUE LATERAL
CR: 35 DEGREES CAUDAD

RP: EAM CLOSES TO THE FILM
DEMO:
CAROTID CANAL
RUNSTROM RECOMMEND TO OPEN MOUTH TO VISUALIZE OF THE

PETROUS APEX BETWEEN THE ANTERIOR WALL OF THE EAM AND
THE MANDIBULAR CONDYLE
*
Rest forehead so that IOML forms 50 deg. to IR. (inion to nasion
line (28 deg to horizontal)
IOML 50- IAC,dorsum sellae, Labyrinths of Ear
OML 50- EAC, tympanic cavities, eustachian

tube
CR: ⊥
Cant be use to pt’s w/ Platybasia
*
*Chin & nose in contact to IR

*MSP ⊥
CR: 23-380 CAUDAD
-enter s vertex, exit lvl of zygo. Arches
DEMO:
BILATERAL ZYGOMATIC ARCH
OML ⊥ to IR rather than IOML
-to project the petrous behind mandibular condyles
CR: 50 anteriorly
CAHOON/ PA AXIAL Projection
- Prone
- OML perpendicular
- C.R. 25 degrees cephalad exiting the nasion
DEMO:
Styloid process of the temporal bone above maxillary
sinuses
*
*MSP ⊥
*AML ⊥
*Pt in open mouth
CR: 130 midway EAM
*
*Pt head in true lateral
*AML parallel to IR bottom
*Pt in open mouth
-to prevent mandibular
condyle from obscurring temporal
styloid
CR: 100 ant. and cephald, exit at
EAM
*
*OML parallel to IR
MSP ⊥
CR: 200 posteriorly midway EAM
Eraso modification
OML- 250 from IR
CR: ⊥
*
Axiolateral oblique- Miller method
-Pt supine
-IOML parallel
-MSP 450 away
-pt in open mouth
CR: 120

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Prepared by: Mohammad Mohsen G.

-NAME OF THE PATIENT

* MID- SAGITTAL PLANE

VERTEBRAL COLUMN CERVICAL 7

PELVIC GIRDLES HIP BONES 2

LOWER LIMBS FEMUR 2

TOTAL BONES 126

* The SHAFT OF A LONG

* And the articular

Hands and feet

Posteroanterior (PA) Anatomic R and L lateral

* OBLIQUE- an angled position neither the sagittal nor the coronal

* LEFT AND RIGHT ANTERIOR OBLIQUE (LAO and RAO)

* LEFT AND RIGHT POSTERIOR OBLIQUE (LPO and RPO)

Diaphragm: moderately high * Pelvis: relatively small

* SID of 40 inches (102 cm) is the most conventional examinations

* In chest Radiography a 72 inch SID is the minimum distance.

Central ray: ⊥ MCP jt.

*Area from the distal tip of the

- IP jt, a 45° foam wedge to support

- metacarpals are the area of interest,

localize foreign bodies and metacarpal fracture

* Sometimes referred to as “ ball-catcher’s position”

* Perpendicular to the midcarpal area

* This position gives a slightly oblique projection of the ulna

* Position the part:

* gives a distinct image of the

From PA projection, Turn the patient’s

* Elevate the IR 20 degrees

- extreme ulnar flexion.

- Rotate the hand towards the

“this method also known as

CR: Perpendicular to the midpoint of the forearm

* Open elbow joint

* Supinate the hand

* Rest the dorsal surface/ proximal forearm on the IR.

* ELBOW FLEX 80 DEGREES DEMONSTRATE:

* Epicondyles are parallel

* The long axis of the arm and the

* Position of the part:

Radial Tuberosity facing

Radial Tuberosity facing

* Radial head partially superimposed the coronoid

This Projection is useful for detection of

* Abduct the arm and slightly and

* Internally rotate the arm, abduct the

* Elevate theopposite shoulder to place

* Abduct the arm slightly and supinate

* Medially rotate the arm, to place the

* Rest the posterior aspect of the hand

- Flex the elbow, turn the thumb surface

* Adjust the body to place the lateral

CR: HORIZONTAL AT THE LEVEL OF SURGICAL NECK

*10-15 DEGREES CEPHALAD (CANNOT FULLY ELEVATE THE

CR: 15-30 MEDIALLY TOWARDS

•ABDUCT THE ARM AND PLACE

CR: PERPENDICULAR TO THE

1.Bony Injury- AP, APO, Lateral

•HINDFOOT- CALCANEUS AND TALUS

•MIDFOOT- CUBOID, NAVICULAR AND

•FOREFOOT- METATARSAL AND PHALANGES

LATERAL LONGITUDINAL ARCH

AP AXIAL (15) – OPEN IP JOINTS