This document discusses factors that cause geometric distortion in medical imaging. It explains that minimizing magnification improves detail visibility and reduces penumbra effect. Thicker objects and those farther from the image receptor experience more object image distance and distortion. Position distortion occurs when overlapping objects have different distances. Keeping the object and image planes parallel prevents distortion. Anatomy imaged off-center is most distorted due to increased beam angle. Foreshortening results when objects are angled toward the central ray, while elongation occurs when the image receptor or object is angled away. To avoid distortion of inclined anatomy, the beam should be angled halfway to the raised side.