It is a part of the conventional radiography...it is based on clinical anatomical positioning ...

1. CONVENTIONAL
RADIOGRAPHY
(CLINICAL RADIOGRAPHY)
Vanshika
Lecturer
Adesh university Bathinda

2. CONVENTIONAL RADIOGRAPHY:-
It is the use of x-rays to visualize the internal
structures of a patient. X-rays are a form of
electromagnetic radiation,
produced by an x-ray tube. The x-rays are passed
through the body and captured behind the patient
by a detector; film sensitive to x-rays or a digital
detector.

3. RADIOGRAPHY OF
UPPER LIMB

4. HAND:- POSTERO-ANTERIOR:-
Forearm is placed on table in pronation
with palm of hand resting on the film. The
fingers are separated and extended.
:-The vertical central ray is directed to the
head of third metacarpal.

5. ANTERIOR-OBLIQUE (BASIC):-
POSTIONING:-
From the position for pa projection, the
hand is laterally rotated through 45
degree and supported in this position on
a foam pad with fingers slightly fixed.

6. CENTERING OF OBLIQUE VIEW OF
HAND:- Central ray is directed to the
head of the fifth metacarpal bone…

7. LATERAL VIEW:-
POSTIONING:-
Medial aspect of forearm rests on the table with
medial aspect of hand and little finger in contact with
the film with palm of hand at right angle to the film.
The fingers are extended and the thumb is abducted.
The film should be large enough to include styloid
processes.

8. CENTERING OF LATERAL VIEW
OF HAND:- To the head to 2nd
metacarpal bone…

9. SCAPHOID:-
Postero-anterior with hand adducted.
POSITIONING:-Forearm is pronated. Keeping
radial and ulnar styloid processes equidistant
from the film.
Hand is adducted….

10. CENTRING OF SCAPHOID(PA):-
Midway between radial and ulnar
styloid processes..

11. ANTERIOR OBLIQUE(BASIC):-
POSITIONING:-
From pa position hand and wrist are laterally
rotated by 45 degree.
CENTRING:- To ulnar styloid process.

12. POSTERIOR OBLIQUE:-
POSITIONING:-From anterior
oblique the hand and wrist are rotated
by 90 degree. Now the hand is at 45
degree to the cassette.
CENTRING:- Radial styloid process.

13. CARPAL TUNNEL:-
AXIAL:-
POSITIONING:-
Patient stands with back to the table, the
palm of hand pressing on the film
supported on table surface…

14. CENTRING:- Along the line of forearm to a point
midway between hook of hamate immediately and
tubercle of scaphoid laterally (I.E. Between palpable
bony projection)…

15. FINGERS:-
POSTERO-ANTERIOR:-
POSITIONING:-The patient is
positioned seated alongside the table as
for a (pa) projection of the hand.
Forearm is pronated. Finger are
extended and separated. A sandbag is
placed across the dorsal surface of the
wrist for immobilization.

16. CENTRING OF THE PA VIEW:-
The vertical central ray is centred over the
proximal inter phalangeal joint of the affected
finger.

17. #LATERAL- INDEX AND MIDDLE
FINGERS:-
POSITIONING:-
Patient is seated alongside the table with the arm
abducted and medially rotated. Forearm is
supported. Finger is fully extended. The middle finger
is supported on a non-opaque pad..

18. LATERAL VIEW OF FINGER:-
CENTRING:- The vertical central ray is centred over
the proximal inter phalangeal joint of the affected
finger…

19. LATERAL- RING AND LITTLE FINGERS
POSITIONING:-
The patient is seated alongside the table with the palm of
the hand at right-angles to the table and the medial
aspect of the little finger in contact with the film. Finger
is extended. It may be necessary to support the ring
finger on a non-opaque pad to ensure that it is parallel
to the film.

20. LATERAL VIEW OF RING & LITTLE FINGERS:-
CENTRING:- The vertical central ray is centred over
the proximal inter phalangeal joint of the affected
finger…

21. #THUMB:-
LATERAL VIEW OF THUMB:-
POSITIONING:-
The patient is seated along side the table with the arm
abducted, the elbow flexed and the anterior aspect of the
forearm resting on the table. The thumb is flexed slightly and
the palm of the hand is placed on the cassette. The hand is
raised with the fingers partially flexed& supported on a non-
opaque pad, such that lateral aspect of the thumb is in
contact with the cassette..

22. CENTRING OF LATERAL VIEW OF THUMB:-
The vertical central ray is centred over the first
metacarpophalangeal joint.

23. ANTERO-POSTERIOR:-
POSITIONING:-
The patient is seated facing away from the table with the
arm extended backwards and medially rotated at the
shoulder. The hand may be slightly rotated to ensure
that the second, third and fourth metacarpals are not
superimposed on the base of the first metacarpal. The
cassette is placed under the wrist and thumb and
oriented to the long axis of the metacarpal.

24. CENTRING OF (AP) VIEW OF THUMB:-
The vertical central ray is centred over the base of
the first metacarpal..

25. POSTEROANTERIOR- FOREIGN BODY
POSITIONING:-
With the hand in the pa position, the palm of the
hand is rotated through 90 degrees to bring the
medial aspect of the hand in contact with the table
and the palm vertical.
Cassette is placed under the hand and wrist, with
its long axis along the line of the thumb. The
thumb is supported in position on a non-opaque
pad.

26. CENTRING OF PA VIEW OF THUMB:-
The vertical central ray is centred to the first
metacarpo-phalangeal joint…

27. WRIST:-
POSTEROANTERIOR:-
POSITIONING:-
The patient is seated along side the table, with the affected side
nearest to the table. The elbow joint is flexed to 90 degrees and
the arm is abducted, such that the anterior aspect of the forearm
and the palm of the hand rest on the cassette. The fingers are
flexed slightly to bring the anterior aspect of the wrist into
contact with the cassette. The forearm is immobilized using a
sandbag.

28. CENTRING OF PA VIEW OF
WRIST:-
The vertical central ray is centred to a
point midway between the radial and
ulnar styloid processes.

29. LATERAL VIEW OF WRIST:-
POSITIONING:-
From the first method the hand is laterally rotated through 90
degrees to bring the palm of hand at right angle to the table. For
the second method, humerus is laterally rotated by 90 degree
and elbow is extended to bring medial aspect of forearm wrist
and hand in contact with table. Radial and ulnar styloid processes
are made to superimpose by slight backward rotation of hand.

30. CENTRING OF LATERAL VIEW OF
WRIST:-
Ventrical central ray is directed to
the radial styloid process……

31. OBLIQUE:-
POSITIONING :-
Patient is seated with arm partially abducted.
Elbow’ flexed at right angle and forearm pronated. The
film is placed with its centre midway between radial and
ulnar styloid processes.

32. CENTRING OF OBLIQUE
VIEW:-
Midway between the radial and
ulnar styloid.

33. FOREARM:-
ANTERO-POSTERIOR:-
POSITIONING:-
Patient is seated facing the side or end
of table with elbow flexed at right angle
and shoulder lowered to the level of wrist
to bring the inter condylar line of humerus
perpendicular to cassette placed under
forearm. The palm of hand is at right angle
to table.

34. CENTRING OF (AP) VIEW OF
FOREARM:-
Lateral aspect of forearm midway between
wrist and elbow..

35. LATERAL VIEW OF FOREARM:-
POSITIONING:-
Patient is seated at the
side of table with arm abducted.
Elbow flexed at 90 degree and palm
of hand at 90 degree to table. The
shoulder at the same horizontal level
as elbow so that entire medial aspect
of upper limb is in contact with table.

36. CENTRING OF LATERAL VIEW OF
FOREARM:-
Lateral epicondyle of humerus.

37. ELBOW:-
ANTERO-POSTERIOR VIEW:-
POSITIONING:-
From the position of the lateral projection the arm is laterally
rotated and then fully extended until the posterior aspect of the
entire limb is in contact with the tables.
The palm of the hand facing Upwards. the second half of the
film is placed under the elbow with its centre under the joint
and its long axis parallel to the limb. Now adjust the position of
the arm to bring the medial and lateral epicondyles equidistant
from the film.

38. CENTRING:-
Vertical central ray is directed
through the joint space 2.5cm
distal to the mid-point between
the condryles of the humerus.

39. ELBOW
LATERAL VIEW:-
POSITIONING:-
The patient is seated at the side of the table with
the arm abducted, the elbow flexed to 90 degree
and palm of the hand at 90 degree to the table.
The shoulder should be at the same horizontal
level as the Elbow and wrist so that the medial
aspect of the entire limb is the contact with the
table.

40. CENTRING:-
The vertical central ray is directed
to the lateral epicondyle of the
humerus.

41. SHAFT OF HUMERUS:-
ANTEROPOSTERIOR:-
POSITIONING:-
Patient lies supine with the unaffected
shoulder raised. The arm is slightly
abducted but fully extended at the elbow
and supinated to bring the posterior
aspect of upper arm in contact with
cassette which should be large enough to
include shoulder and elbow joint.

42. CENTRING:-
Midway between shoulder
and elbow joints…

43. LATERAL:-
POSITIONING:-
From the antero-posterior position the
elbow is flexed to 90 degree. The arm is
abducted and then medially rotated
through 90 degree bring the medial
aspect of arm, elbow and forearm in
contact with table. The forearm can
assume a more relaxed position with the
palm resting on the table.

44. CENTRING:-
Midway between shoulder
and elbow joints. When rotating
the humerus it is important to
flex the elbow and abduct the
arm to allow forearm to come
into contact with table.

45. SHOULDER:-
ANTERO-POSTERIOR:-
POSITIONING:-
Patient is supine with the
shoulder of the affected side over
the midline of table.

46. CENTRING:-
Coracoid process of scapula(
palpable for general survey of
shoulder region). The film should
also includes clavicle, scapula and
upper 1/3 of humerus.

47. STRYKER’S VIEW:-
POSITIONING:-
Preferably done in supine position with
flexed elbow directed forwards and palm on
top of head.

48. CORACOID :-
Coracoid process with
angulation of tube 10 degree
cephalad.

49. CORACOID PROCESS- AP
POSITIONING:-
Standing position with patient arm over the
head and faces towards the x-ray tube and
rotated so as to bring the plane of scapula
parallel to cassette.
Coracoid:- lateral border of
scapula..

50. CLAVICLE:-
PA VIEW:-
POSITIONING:-
Patient faces the vertical buckey
and midpoint clavicle in the centr
of the cassette. With the head
turned away the shoulder of the
side being examined is brought
closer to the buckey.

51. CENTRING:-
Horizontal beam centred to the
center of the film.

52. SCAPULA:-
BASIC AP VIEW:-
POSITIONING:-The patient lies
supine on the x-ray table or stands/ sits
against the erect buckey. The middle of
the clavicle lies in the middle of the table
and the unaffected side is raised. To
bring coronal plane 20 degree to the
table. The arm of the side bring
examined in partially abducted and
medially rotated and elbow flexed.

53. CENTRING:-
Vertical x-ray beam
centred 5cm inferior to the mid
clavicular point to the middle of the
film. Patient is allowed to breathe
during the exposure.

54. LATERAL VIEW:-
POSITIONING:-
Patient stands facing a
vertical buckey with the arm
abducted and elbow flexed and
hand resting on the hip. The
effected side shoulder is in
contact with the buckey And the
patient is rotated to bring the
scapula at right angle to the film.

55. CENTRING:-
Horizontal ray centred to the mid point of the
medial border of the scapula.

56. THANK YOU..