Successfully reported this slideshow.
Activate your 14 day free trial to unlock unlimited reading.
Water's - best for maxillary sinus
(Ethmoids and frontals too far from film)
Basic Patient Position
The patient sits erect facing the bucky, midsagittal plane
in the midline of the film, coronal plane parallel to the
film interpupillary line parallel to the floor. The chin is
raised to bring the orbital meatal line at 45 degrees to the
In some centers the patient is imaged mouth open to
demonstrate the sphenoid sinuses.
best for ethmoids and frontal sinus
(Temporal bones overlie maxillary)
enlargement of the adenoids (red arrow)
The white arrow points toenlarged lingual tonsils at
the base of the tongue.
Neck lateral veiw
1. Cervical vertebrae
• Erosion of vertebral bodies- No.
• Loss of cervical Lordosis – due to prevertebral muscle
2. Pre-vertebral soft tissue shadow
• Should be < 2/3 of AP diameter of cervical vertebral
body (c2-6mm, c6-22 mm)
• If > suspect Retropharyngeal abscess
• Look for FB / Air fluid level / Gas shadow
3. Air collumn in trachea
4. Hyoid bone & Laryngeal cartilage ossifications
Chronic Retropharyngeal abscess
•Secondary to TB spine(Pott’s spine)
•Erosion of cervical vertebra
•Treatment with ATT
FB Cricopharynx with Acute
Foreign Body Aspiration
PA & lateral views of chest & neck
Inspiration & expiration
Lateral decubitus views
25% have normal radiography
• Radiopaque FB easily seen with xray
• Radiolucent FB (the majority) may have
obliterated bronchial air
column, atelectasis, mediastinal shifts, or air-
trapping in the affected lung
• Inspiratory hypoinflation and expiratory
hyperinflation in hallmark of bronchial FB
• Decubitus films – dependent lung should collapse
but will remain inflated if FB
X ray neck AP view
•Round radio opaque
object ( Coin)
esophagus is an AP
•A coin would
•Can be confirmed
by lateral view
Foreign Body Ingestion
Common locations in esophagus
Aorta/left mainstem bronchus
Radiologic examination of the salivary glands
The submandibular and parotid glands are
investigated by this method
The sublingual gland is usually not evaluated this
Difficulty in cannulation
1. Obtain preliminary radiographs
• Any condition that is visibe w/o contrast
• Optimum technique obtained
2. 2-3 min before procedure give lemon
3. Contrast media (iohexol) injected into main duct
4. After procedure suck on lemon to clear contrast
5. 10 min after procedure take radiograph
Radiographic examination of the tracheobronchial
tree by radiopaque iodinated compound
(dianosil,iohexaol) in a low viscous suspension.
rarely performed today, having been superseded by
high resolution computed tomography HRCT
procedure used to examine upper gastrointestinal
tract,which include the pharynx, esophagus, cardia of
The contrast used is barium sulfate.
TYPES OF CONTRAST STUDY
(i) SINGLE CONTRAST STUDY
(ii) DOUBLE CONTRAST STUDY
Suspected esophageal perforation.
If strong clincal suspicion of aspiration or TEF,then
omnipaque swallow (iohexol) advised.
SOFT TISSUE NECK,CHEST – AP & LAT –
NECK-AP & LATERAL
-One mouthful contrast bolus with high
-Patient is asked to swallow once and stop
swallowing there after.
-This is to get optimum mucosal coating.
-frontal and lateral view x-ray taken.
-Multiple mouthful barium suspension given.
-prone swallow to assess esophageal contraction.
-useful in esophageal compression, displacement
or disordered motility.
Partially obstructing cervical
Frontal view shows a
circumferential, radiolucent ring
(straight white arrows) in the proximal
cervical esophagus. Partial obstruction
is suggested by a jet phenomenon
(black arrows), with barium spurting
through the ring, and by mild
dilatation of the proximal cervical
A Zenker's diverticulum is a pulsion hypopharyngeal
false diverticulum with only mucosa and submucosa
protruding through triangular posterior wall weak site
(Killian's dehiscence) between horizontal and oblique
components of cricopharyngeus muscle
Preferably high viscosity
with normal density barium
Classical finding in
carcinoma –rat tail
CA ESOPHAGUSWith shouldering
The stenotic segment is long giving a “" *rat-tail” appearance
Barium swallow shows mild dilatation of the esophagus with irregular
stenotic lesion in the lower end of the esophagus “moth eaten appearance
Patient seated or standing
facing the Bucky.
Nose and forehead touching
the Bucky to get the
perpendicular to film.
P-A Skull Film
.There should be no rotation.
The petrous ridges will be
superimposed with the orbits.
To clear the ridges, the
Caldwell view can be taken.
Patient is seated facing the
tube.The chin is tucked into the
chest until the canthomeatal line
is perpendicular to film. A chair
the allows some reclining will
make this easier for the patient.
The entire skull and especially
the occipital region of the skull
must be on the film.
Structure seen include the
foramen magnum, petrous
ridges, IAC’s and TM Joints
No rotation of skull
Patient seated of standing
facing the Bucky. Rotate the
body into an oblique position.
Turn skull so the affected side
is next to the Bucky.
The interpupillary line must be
perpendicular to film and tube.
Mid sagittal plane parallel to
Skull Lateral Film
Entire skull must be on the
There should be no rotation of
the skull, orbits and mandible
The facial bones are sinuses
will be dark (over exposed).
Usually both lateral views are