The document discusses various radiographic positioning techniques for imaging different anatomical areas and structures. It provides descriptions of positioning for paranasal sinus views, chest x-rays, spine views, shoulder views including scapula, wrist, hand, elbow, hip, knee and tibia/fibula views. For each area, it specifies the patient positioning, central ray direction, and structures that should be demonstrated in the resulting radiographic image.

1. DR/ABDALLAH NAZEER. MD.
Radiography positions.

31. Para-Nasal Sinuses:
Occipito-mental view with open
mouth(Water View):To show maxillary
antra, frontal, anterior ethmoid and
sphenoid sinuses.
Caldwell view is called occipito-frontal
view or nose-head view.
Lateral view:To show the nasal sinuses
both sides superimposed.
Submento-vertical view:To show
sphenoid and ethmoid sinuses.

34. SINUSES
1. Frontal sinus
2. Ethmoid Sinus
3. Nasal Septum (bony)
4. Zygomatical-Frontal Suture
5. Maxillary Sinus
6. Zygoma
7. Zygomatic Arch
8. Mandible
9. Inferior orbital margin
10. Left orbit
8
1
2
5
7
9
10
3
4
AP WATERS VIEW
6

35. SINUSES
PA view
1. Nasal Septum
2. Frontal Sinus
3. Maxillary Sinus
4. Ethmoid Sinus
5. Inferior Turbinate
6. Odontoid process
7. Superior orbital fissure
2
1
4
3
5
6
7

41. 1. Frontal Sinus
2. Maxillary Sinus
3. Ethmoid Sinus
4. Spenoid Sinus
5. Sella Turcica
6. Occipital Bone
7. Mastoid Air Cells
8. Floor of posterior fossa
9. Anterior arch of C-1
10. Mandible
11.Coronal Suture
10
9
1
2
3
4
5
6
7
8
11
Lateral Sinus & Skull

49. Facial Bones Radiographic Position.
Adult Facial Bones - PA Caldwell

50. Adult Facial Bones - PA 30° (Modified Parietocanthial)

51. Adult Facial Bones - Occipito Mental (OM) (Waters)View

52. Adult Facial Bones - Occipito Mental 30° (OM30)View

53. Adult Facial Bones - Lateral View

54. Adult Facial Bones - Submentovertex (SMV) / Slit Basal / Jughandles View

55. Adult Facial Bones - SlitTownes.

57. SellaTurcica

58. Orbits

63. Temporo-mandibularJoint.
AP axial projection.
Axiolateral oblique projection.

81. 3
2
4
6
1. Lat. & Med. ptyergoid
plate
2. Ethmoid Sinus
3. Odontoid Process
4. Sphenoid Sinus
5. Foramen ovale
6. Maxillary Sinus
7. Mastoid air cells
8. Ant arch of C-1
9. Margin of foramen
magnum
10. Ext. auditory canal
7
9
1
5
8
10
BASE OF SKULL

82. Lateral neck
Sit the patient beside the chest holder as for
lat chest.
Position Cassette to include nasopharynx and
trachea.
Two assistants are necessary - one to hold
child's arms and pull down on shoulders and
one to hold the child's head still in lateral
position with neck slightly extended.
Expose in inspiration.
Alternatively you can lie patient on side

84. Adenoids /Nasopharynx
Patient positioned as above but exposure
centered on and coned to nasopharynx and
more penetrated than lat neck
Cassette should be positioned at side of head
but do not turn the neck to achieve this,
elevate chin instead.
Expose on normal inspiration, if possible
breathing through nose, with mouth closed
NOTVALSALVA
N.B: a lateral chest exposure at 180cm FFD is
appropriate for lat neck.

85. Normal Adult.

89. Cervical spine.
Anter0-posterior view:
Lateral view:
Oblique views:
Lateral view in flexion and
extension:
P-A view with open mouth for
C1 vertebra.

126. ARTICULAR PROCESSES PROJECT SUPERIORLY AND
INFERIORLY FROM EACH LAMINA.
ARTICULAR FACETS ON THESE PROCESSES FACE
POSTERIORLY ON THE SUPERIOR FACET OND ANTERIORLY ON
THE INFERIOR FACET

127. PARS INTERARTICULARIS
IT THE BONY JUNCTION BETWEEN THE
SUPERIOR AND INFERIOR ARTICULAR
PROCESSES

138. Chest x ray positioning.

145. APView.

152. Chest X-ray. PA & AP View.

153. Chest X-ray.
Breath: Inspiration Expiration.

154. Mediastinum and Heart.
Heart size on PA.
With good centering film: 2/3 heart is to left and 1/3
to right of midline.
TV cardiac diameter 14.5 females. 15.5 Males.
Cardiothoracic ratio less than 50%.

175. Position – Patient is supine with
large cassette beneath upper
thorax, shoulders and neck.
X-Ray Beam – Directed anterior to
posterior, angled 40-degrees
cephalad and centered on the
sternum. Voltage should be the
same as for standard AP chest
radiograph.
Demonstrates – Medial clavicle
fractures, SCJ dislocations, SCJ
arthrosis.
Serendipity (40-
Degree CephalicTilt)
SternoclavicularView.

179. Wrist joint:

180. Positioning
PA view should be taken with the wrist and elbow at shoulder height.
This means that the wrist, elbow and shoulder are all in the transverse plane,
perpendicular to the x-ray beam.
Only in this position, the radius and the ulna are parallel.
Lowering the arm makes the radius cross the ulna and become relatively
shorter resulting in improper measurement of the length of the radius.
Lateral view is taken with the elbow adducted to the side.
Shoulder, elbow and wrist are again in one plane, i.e. the sagittal plane.
This positioning will make the lateral view exactly perpendicular to the PA
view.

187. The Hand PA view is part of a two view series
metacarpals, phalanges, carpal bones and distal
radial ulnar joint.
Patient position
patient is seated alongside the table
The affected arm if possible is flexed at 90° so the
arm and hand can rest on the table
The affected hand is placed, palm down on the
image receptor
shoulder, elbow, and wrist should all be in the
transverse plane, perpendicular to the central beam.
The hand series consists of a posteroanterior,
oblique, and a lateral projection.

199. The elbow AP view is part of the two view elbow series, examining
the distal humerus, proximal radius and ulna.
Patient position
Patient is seated alongside the table
The fully extended arm and forearm, in a supinated position, are kept
in contact with the table by lowering the shoulder joint to the level
of the table they all must be in the same plane as the detector.
Technical factors: Anteroposterior, Lateral and obliques projection
Centering point
Mid elbow which is approximately the midpoint between the
epicondyles
collimation
Superior to the distal third of the humerus
Inferior to include one-third of the proximal radius and ulna
orientation
exposure
50-60 kVp
2-5 mAs
Grid: No

200. FrontalView

201. LateralView.

202. Radial headView.

203. ELBOW AP OBLIQUE.

204. ShoulderViews:

217. Clavicle Imaging
Two anteroposterior (AP) radiographs of the clavicle
(with x-ray beam directed at different angles) are
appropriate to assess clavicle mid-shaft fractures acutely
and to follow these fractures during healing. The clavicle
series includes AP in the frontal or thoracic plane and AP
with 20 to 30-degrees cephalic tilt. Technical details of
these radiographs are described below.
AP ClavicleView
Position – Patient erect with arm at side. X-ray cassette
behind patient parallel to thorax.
X-Ray Beam – Directed anterior to posterior,
perpendicular to cassette and centered on mid-clavicle.
Demonstrates – Clavicle shaft fractures, non-unions.

218. AP ClavicleView

219. 30-Degree
CephalicTilt
AP ClavicleView

220. Acromioclavicular
Joint / Distal
Clavicle APView
Position – Patient is erect with arms relaxed and
hanging freely at the side. X-ray cassette is behind
the patient parallel to thorax.
X-Ray Beam – Directed anterior to posterior,
perpendicular to cassette (or angled 10-degrees
cephalad) and centered at the coracoid. Voltage of
the x-ray beam should be reduced by 50% relative to
glenohumeral radiographs to avoid over penetrating
the distal clavicle.
Demonstrates – Distal clavicle fractures, ACJ
dislocations, ACJ arthrosis.

221. Scapula.
Indications
Scapula radiographs are performed for a variety of indications
including:
trauma
suspected primary or metastatic lesions
Projections
Standard projections
AP view
a specialized view that demonstrates the scapula in the
anteroposterior plane
similar position to an AP shoulder, however, limb placement and
breathing technique differ
lateral or scapularY view
orthogonal view to the AP projection
profile 'end on' view of the scapula
ideal projection to assess displacement of scapula fractures

223. ScapularY lateral
with CR perpendicular

238. Basic view for the hip joint.
Antero-posterior view-Both Hips.
Antero-posterior view –Single hip.

258. SACROILIACJOINTS (SI JOINTS)
ROUTINE VIEWS:
AP, RPO, LPO
AP
1. 10 x 12 film
2. Patient supine
3. Bucky
4. 40" SID
5. Central Ray: 15o cephalic angle, enter halfway between A.S.I.S. and
symphysis pubis.
6. Suspended respiration
Obliques (RPO and LPO)
1. 10 x 12 film
2. Patient recumbent
3. Patient rotated 30o from AP position
4. Bucky
5. 40" SID
6. Central Ray: enters 1" medial A.S.I.S. of side up.
7. Suspended respiration

259. AP Axial Sacroiliac joints
Patient's position,
Respiration, Pathology
demonstrate shielding
and shielding.

260. Sacroiliac Joints - Oblique

261. Femur
AP
Cassette Size: 14x17 lengthwise bucky
Position of Patient: supine on the table.
Position of Part: center the injured femur to the
midline of the table, invert the foot 15 degrees to get
the hip in the ap position, place the top of the film
two inches below the iliac crest for upper femur, lower
femur place the bottom of the film two inches below
the knew joint
Central Ray:Vertically to the level of the midcassette
Structures Shown: AP projection of either the upper or
lower femur.

264. KNEE AP
Purpose and Structures ShownTo get clear image of open joint spaces and soft
tissue around the knee joint, and bony detail surrounding patella.
Position of patient Supine. Adjust body so pelvis is not rotated.
Position of part Flex joint slightly, locate apex of patella. Adjust patient’s leg
by placing femoral epicondyles parallel with IR for true AP projection.
Central ray Directed to a point 1.3 cm inferior to patellar apex.

265. KNEE PA.
Purpose and Structures ShownTo demonstrate PA image of knee.To get clear image of open joint
spaces and soft tissue around the knee joint, and bony detail surrounding patella.
Position of patient Prone position with toes resting on radiographic table, or place sandbags
under ankle for support.
Position of part Center a point 1.3 cm below patellar apex to center of IR. Femoral epicondyles
parallel with tabletop.
Central ray Perpendicular to exit a point 1/2 inch (1.3 cm) inferior to patellar apex. Since tibia and
fibula are slightly inclined, the CR will be parallel with the tibial plateau.

266. KNEE LATERAL MEDIOLATERAL.
Purpose and Structures ShownTo get clear image of patella in lateral
profile. Structures shown are the distal end of femur, patella, knee
joint, proximal ends of tibia and fibula, and adjacent soft tissue.
Position of patient lying on affected side. Pelvis not rotated. Affected
knee forward and extend other limb behind it.
Position of part Epicondyles perpendicular to IR. Patella will be
perpendicular to plane of the IR. For new or unhealed patellar fractures;
knee should usually not be flexed more than 10 degrees. Check with
your medical director. Knee flexion of 20 to 30 degrees is usually
preferred – this position relaxes muscles and shows maximum volume
of the joint cavity.
Central ray 5 to 7 degrees cephalad at knee joint 1 inch (2.5 cm) distal to
medial epicondyle. Slight angulation of CR will prevent joint space from
being obscured by magnified image of medial femoral condyle.
In lateral recumbent position, medial condyle will be slightly inferior to
lateral condyle.

268. KNEE APWEIGHT
BEARING STANDING BILATERAL
KNEE PAWEIGHT
BEARING STANDING.

269. KNEE AP OBLIQUE
LATERAL ROTATION.
KNEE AP OBLIQUE
MEDIAL ROTATION.
KNEE PA OBLIQUE
LATERAL ROTATION.
KNEE PA OBLIQUE
MEDIAL ROTATION.

270. KNEE PA AXIAL HOLMBLAD METHOD.
KNEE PA AXIAL CAMP-COVENTRY
METHOD (TUNNEL VIEW). KNEE AXIAL BECLERE METHOD.

271. PATELLATANGENTIAL
PROJECTION HUGHSTON METHOD.
PATELLATANGENTIAL PROJECTION
SETIEGAST METHOD (SUNRISE).

272. TIB FIB AP OBLIQUE MEDIAL OR LATERAL ROTATIONS
Purpose and Structures Shown Oblique view of entire tibia and fibula.
Position of patient Supine on radiographic table.
Position of part Perform oblique projections of leg by alternately rotating limb 45
degrees medially or laterally. For medial rotation, ensure that the whole leg is turned
inward and not just foot. Place support under greater trochanter if needed.
Central ray Perpendicular to IR at midpoint of shin.

273. TIB FIB LATERAL MEDIOLATERAL OR LATEROMEDIAL.
Purpose and Structures Shown Lateral view of entire tibia and fibula.
Position of patient Supine.
Position of part Patient toward affected side with leg on IR. Adjust body’s rotation to
place patella perpendicular to IR. Use supports where needed for patient’s comfort and
to maintain body position. Lift leg enough for assistant to slide rigid support under
patient’s leg. IR may be placed between legs and CR directed from lateral side.
Central ray Perpendicular to IR at midpoint of shin. Include proximal and distal ends of
tibia and fibula. If patient must remain supine, the image may be taken cross-table
using horizontal CR.

300. Thank You.