This page provides general educational positioning information for radiography students. Each exam includes typical concepts such as patient position, part alignment, central ray (CR), IR orientation, breathing instructions, and evaluation considerations. Content is for learning and review only and is not medical advice or a substitute for clinical judgment.
Patient Position
Seated at the table with the elbow flexed about 90°, forearm resting on the tabletop at shoulder height if possible.
Part Position
PA: Palm flat on the IR, fingers slightly separated, wrist and forearm in the same plane.
Oblique: From PA, rotate hand laterally 45°; support with a sponge to keep fingers parallel to IR.
Lateral: Hand in true lateral (ulnar side down), fingers superimposed or fanned as requested.
CR
Perpendicular to the 3rd MCP joint.
IR Size / Orientation
8×10 in (18×24 cm) or similar, tabletop, portrait.
Breathing Instructions
No breathing instructions required; instruct patient to hold still.
Evaluation Considerations
PA: Equal concavity of phalanges and metacarpals, open IP and MCP joints, entire hand and distal radius/ulna included.
Oblique: 45° rotation demonstrated by slight overlap of metacarpal heads, open IP and MCP joints, soft tissue and bony detail visible.
Lateral: Superimposed metacarpals, digits in true lateral, distal radius/ulna included.
Notes
Remove rings and jewelry. Use small focal spot and tight collimation for detail.
Patient Position
Seated at the table with the forearm resting on the tabletop.
Part Position
PA: Hand pronated, wrist in contact with IR, fingers flexed slightly to bring wrist closer to IR.
Oblique: From PA, rotate wrist 45° laterally; support with sponge.
Lateral: Elbow flexed 90°, wrist in true lateral with thumb up and radius/ulna superimposed.
CR
Perpendicular to mid‑carpal area.
IR Size / Orientation
8×10 in (18×24 cm), tabletop, portrait.
Breathing Instructions
No breathing instructions; emphasize no motion.
Evaluation Considerations
PA: Distal radius/ulna, carpals, and proximal metacarpals included; no rotation.
Oblique: Trapezium and scaphoid well demonstrated, carpals partially superimposed as expected.
Lateral: Distal radius/ulna superimposed, carpals visible, true lateral demonstrated.
Notes
For scaphoid, special views may be added (e.g., ulnar deviation). Collimate tightly to wrist.
Patient Position
Seated with arm fully extended, shoulder, elbow, and wrist in the same plane if possible.
Part Position
AP: Hand supinated, forearm centered to IR, epicondyles parallel to IR.
Lateral: Elbow flexed 90°, thumb up, wrist and elbow in true lateral.
CR
Perpendicular to mid‑forearm.
IR Size / Orientation
14×17 in (35×43 cm) or 11×14 in (30×35 cm) depending on patient size, portrait or diagonal to include both joints.
Breathing Instructions
No breathing instructions; instruct patient to hold still.
Evaluation Considerations
AP: Entire radius and ulna including wrist and elbow joints, slight superimposition at proximal radius/ulna as expected.
Lateral: Distal radius/ulna superimposed, elbow flexed 90°, entire forearm included.
Notes
Ensure both joints are included; use two images if necessary for large patients.
Patient Position
Seated at the table with arm extended as much as possible.
Part Position
AP: Hand supinated, elbow fully extended, epicondyles parallel to IR.
Oblique: 45° internal (medial) and 45° external (lateral) obliques as requested.
Lateral: Elbow flexed 90°, thumb up, humerus and forearm in same plane.
CR
Perpendicular to mid‑elbow joint.
IR Size / Orientation
8×10 or 10×12 in (18×24 or 24×30 cm), portrait.
Breathing Instructions
No breathing instructions; emphasize no motion.
Evaluation Considerations
AP: Open elbow joint, epicondyles in profile, proximal radius/ulna and distal humerus included.
Oblique: Medial oblique shows coronoid process; lateral oblique shows radial head and neck free of superimposition.
Lateral: Olecranon process in profile, humeral epicondyles superimposed.
Notes
If patient cannot fully extend, perform partial flexion views per department protocol.
Patient Position
Standing or seated upright, back to IR if possible.
Part Position
AP: Arm slightly abducted, hand supinated, epicondyles parallel to IR.
Lateral: Arm internally rotated or flexed and placed across abdomen, epicondyles perpendicular to IR.
CR
Perpendicular to mid‑humerus.
IR Size / Orientation
14×17 in (35×43 cm), portrait, shoulder and elbow included if possible.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
AP: Greater tubercle in profile laterally, humeral head and neck visible, elbow and shoulder included if possible.
Lateral: Lesser tubercle in profile medially, superimposed epicondyles.
Notes
Use upright Bucky when possible; for trauma, consider horizontal beam lateral.
Patient Position
Upright or supine, affected shoulder against IR for AP views; oblique for Y‑view.
Part Position
AP External: Hand supinated, epicondyles parallel to IR (anatomic position).
AP Internal: Hand rotated internally, back of hand on thigh, epicondyles perpendicular to IR.
Scapular Y: Patient rotated 45–60° toward affected side, scapula in lateral profile.
CR
AP: 1 inch inferior to coracoid process.
Y‑view: Perpendicular to scapulohumeral joint.
IR Size / Orientation
10×12 in (24×30 cm), portrait.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
AP External: Greater tubercle in profile laterally.
AP Internal: Lesser tubercle in profile medially.
Y‑view: Humeral head projected over glenoid fossa; useful for assessing dislocation.
Notes
For trauma, avoid rotating the arm; use neutral rotation and horizontal beam views as appropriate.
Patient Position
Upright or supine, arms at sides.
Part Position
Center clavicle to IR, chin raised slightly to avoid superimposition.
CR
AP: Perpendicular to mid‑clavicle.
AP Axial: 15–30° cephalic angle to mid‑clavicle (less angle for larger patients).
IR Size / Orientation
10×12 in (24×30 cm), landscape.
Breathing Instructions
Often performed on inspiration for AP and inspiration or expiration per department protocol for axial.
Evaluation Considerations
Entire clavicle including AC and SC joints, axial view projects clavicle above ribs and scapula.
Notes
Use upright position when possible to reduce thyroid dose and improve comfort.
Patient Position
Upright or supine for AP; upright oblique for lateral.
Part Position
AP: Affected arm abducted 90° if tolerated, hand supinated, scapula centered to IR.
Lateral: Patient rotated 45–60° toward affected side, arm positioned to demonstrate body or acromion as requested.
CR
AP: 2 inches inferior to coracoid process.
Lateral: Medial border of scapula.
IR Size / Orientation
10×12 in (24×30 cm), portrait.
Breathing Instructions
AP may use slow breathing technique; lateral usually suspended respiration.
Evaluation Considerations
AP: Entire scapula visible with lateral border free of superimposition.
Lateral: Scapula in true lateral, body of scapula free of rib superimposition as much as possible.
Notes
Adjust rotation to separate scapula from ribs; use shielding appropriately.
Patient Position
Upright, back to IR, arms at sides.
Part Position
Center AC joints to IR; perform one exposure without weights and one with equal weights attached to wrists (if ordered).
CR
Perpendicular to midpoint between AC joints (for bilateral view).
IR Size / Orientation
14×17 in (35×43 cm), landscape, or two 8×10 in (18×24 cm) for separate sides.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Both AC joints included, no rotation, comparison of joint spaces with and without weights.
Notes
Upright position is essential; follow facility protocol regarding use of weights.
Patient Position
Supine or seated with knee flexed, plantar surface of foot on IR for AP and oblique.
Part Position
AP: Foot flat on IR, 10° posterior (cephalic) angle often used to open joint spaces.
Oblique: From AP, rotate foot medially 30–40°.
Lateral: Foot in true lateral, plantar surface perpendicular to IR.
CR
Base of 3rd metatarsal.
IR Size / Orientation
10×12 in (24×30 cm), portrait.
Breathing Instructions
No breathing instructions; emphasize no motion.
Evaluation Considerations
AP: Entire foot including phalanges and tarsals, open joint spaces as much as possible.
Oblique: Sinus tarsi visible, 3rd–5th metatarsals free of superimposition.
Lateral: Metatarsals nearly superimposed, distal tibia/fibula included.
Notes
Use sponges for support; adjust angle per department protocol.
Patient Position
Supine or seated with knee flexed, plantar surface on IR.
Part Position
AP: Toes flat, 10–15° posterior angle to open joint spaces.
Oblique: Medial rotation 30–45° for most toes.
Lateral: Individual toe placed in true lateral as requested.
CR
MTP joint of interest or 3rd MTP for all toes.
IR Size / Orientation
8×10 in (18×24 cm), portrait.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
Entire toe and distal metatarsal included, open IP and MTP joints where possible.
Notes
Use tape or gauze to separate toes for lateral views.
Patient Position
Supine for axial; lateral recumbent for lateral view.
Part Position
Axial: Leg extended, ankle dorsiflexed so plantar surface is near 90° to IR; support as needed.
Lateral: Foot in true lateral, calcaneus centered to IR.
CR
Axial: 40° cephalic angle to base of 3rd metatarsal.
Lateral: Perpendicular to 1 inch inferior to medial malleolus.
IR Size / Orientation
8×10 in (18×24 cm), portrait.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
Axial: Calcaneus visualized from tuberosity through subtalar joint.
Lateral: Calcaneus in profile, subtalar joint open as much as possible.
Notes
Ensure strong dorsiflexion for axial view to avoid superimposition of metatarsals.
Patient Position
Supine with leg extended.
Part Position
AP: Foot dorsiflexed, ankle centered to IR.
Mortise: From AP, rotate leg internally 15–20° until intermalleolar line is parallel to IR.
Lateral: Foot dorsiflexed, ankle in true lateral with fibula superimposed over posterior half of tibia.
CR
Perpendicular to mid‑ankle joint (between malleoli).
IR Size / Orientation
8×10 in (18×24 cm), portrait.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
AP: Distal tibia/fibula and talus included, slight overlap of distal tibia/fibula.
Mortise: Uniform joint space around talus, distal tibia/fibula not superimposed over joint.
Lateral: Tibiotalar joint open, distal fibula superimposed over posterior tibia.
Notes
Check rotation carefully for mortise view; use sponges for support.
Patient Position
Supine with leg extended.
Part Position
AP: Leg centered to IR, foot dorsiflexed, femoral condyles parallel to IR.
Lateral: Leg in true lateral, knee slightly flexed.
CR
Perpendicular to mid‑shaft of tibia/fibula.
IR Size / Orientation
14×17 in (35×43 cm) or 11×14 in (30×35 cm), diagonal if needed to include both joints.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
Entire tibia and fibula including knee and ankle joints; slight overlap at proximal and distal tibia/fibula as expected.
Notes
Use two images if one IR cannot include both joints adequately.
Patient Position
Supine or seated with knee extended for AP and oblique; lateral recumbent for lateral.
Part Position
AP: Leg extended, femoral condyles parallel to IR.
Oblique: Rotate leg 45° medially or laterally as requested.
Lateral: Knee flexed 20–30°, femoral condyles superimposed.
CR
AP/Oblique: 1/2 inch inferior to patellar apex; angle may vary slightly based on body habitus per protocol.
Lateral: 5–7° cephalic angle to knee joint.
IR Size / Orientation
10×12 in (24×30 cm), portrait.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
AP: Open femorotibial joint, patella centered over femur.
Oblique: Appropriate condyles and tibial plateau demonstrated depending on rotation.
Lateral: Patellofemoral joint open, femoral condyles superimposed.
Notes
Adjust CR angle per department protocol; support ankle for true lateral.
Patient Position
Prone for PA; seated or supine with knee flexed for tangential views.
Part Position
PA: Patella centered to IR, heel rotated slightly to place patella closer to IR.
Tangential (Sunrise/Merchant/etc.): Knee flexed per protocol, patella centered to IR, femur and tibia positioned to open patellofemoral joint.
CR
PA: Perpendicular to mid‑patella.
Tangential: Directed to patellofemoral joint with angle per method used.
IR Size / Orientation
8×10 in (18×24 cm), portrait.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
PA: Patella in profile, no rotation.
Tangential: Patellofemoral joint space open, patella in profile.
Notes
Follow facility protocol for flexion limits, especially in trauma or post‑operative patients.
Patient Position
Supine for both AP and lateral.
Part Position
AP Proximal: Leg extended, foot internally rotated 10–15° to place femoral neck in profile.
AP Distal: Leg extended, femoral condyles parallel to IR.
Lateral: Patient rolled toward affected side, femur in true lateral; may require two images (proximal and distal).
CR
Perpendicular to mid‑femur for each segment.
IR Size / Orientation
14×17 in (35×43 cm) or 11×14 in (30×35 cm), portrait; two images often required.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Entire femur including hip and knee joints on combined images; proximal view shows femoral neck without excessive foreshortening.
Notes
For suspected fracture, avoid rotating leg; follow trauma protocol.
Patient Position
Supine, pelvis not rotated.
Part Position
AP: Leg internally rotated 15–20° to place femoral neck parallel to IR.
Frog‑Leg (Modified Cleaves): Hip and knee flexed, thigh abducted 40–45° from vertical.
CR
AP: 1–2 inches distal to mid‑femoral neck (often midway between ASIS and pubic symphysis).
Frog‑Leg: Perpendicular to femoral neck.
IR Size / Orientation
10×12 in (24×30 cm), portrait.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
AP: Entire hip joint and proximal femur, femoral neck in profile.
Frog‑Leg: Femoral neck and head demonstrated, lesser trochanter in profile medially.
Notes
Do not attempt frog‑leg in acute trauma; use cross‑table lateral instead.
Patient Position
Supine, midsagittal plane aligned to table center.
Part Position
Legs extended and internally rotated 15–20° if not contraindicated to place femoral necks parallel to IR.
CR
Perpendicular to midpoint between ASIS and pubic symphysis (approximately 2 inches inferior to ASIS).
IR Size / Orientation
14×17 in (35×43 cm), landscape.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Entire pelvis and proximal femora, iliac wings symmetric, obturator foramina symmetric (no rotation).
Notes
For trauma, do not rotate legs; keep them in neutral position.
Patient Position
Upright preferred; supine if trauma. Chin slightly elevated for AP and obliques; lateral performed with shoulder relaxed.
Part Position
AP Axial: Chin raised so occlusal plane is perpendicular to IR; MSP aligned.
Odontoid (Open Mouth): Lower edge of upper incisors aligned with base of skull; mouth open wide.
Lateral: Shoulder relaxed, chin slightly elevated, C1–C7 visible if possible.
Obliques: Body rotated 45°, head aligned with torso.
CR
AP Axial: 15–20° cephalic to C4.
Odontoid: Perpendicular through open mouth.
Lateral: Perpendicular to C4.
Obliques: 15–20° cephalic (posterior oblique) or caudal (anterior oblique) to C4.
IR Size / Orientation
10×12 in (24×30 cm), portrait.
Breathing Instructions
Lateral: Expiration to lower shoulders.
Others: Suspended respiration.
Evaluation Considerations
AP: C3–T2 visible, open intervertebral spaces.
Odontoid: Dens and lateral masses symmetric.
Lateral: C1–C7 visible, zygapophyseal joints open.
Obliques: Intervertebral foramina open.
Notes
For trauma, use cross‑table lateral first; do not move head or neck.
Patient Position
Upright or supine for AP; lateral recumbent for lateral; swimmer’s for cervicothoracic junction.
Part Position
AP: MSP aligned, arms at sides.
Lateral: Arms raised, spine parallel to IR.
Swimmer’s: One arm raised, opposite arm depressed.
CR
AP/Lateral: Perpendicular to T7.
Swimmer’s: Perpendicular or slight caudal angle to C7–T1.
IR Size / Orientation
14×17 in (35×43 cm), portrait.
Breathing Instructions
AP: Suspended respiration.
Lateral: Breathing technique may be used to blur ribs/lungs.
Evaluation Considerations
AP: T1–T12 visible, symmetric vertebrae.
Lateral: Intervertebral spaces open.
Swimmer’s: C7–T1 clearly demonstrated.
Notes
Use lead blocker behind patient for lateral to reduce scatter.
Patient Position
Supine for AP/obliques; lateral recumbent for lateral and spot.
Part Position
AP: Knees flexed to reduce lordosis.
Obliques: Rotate body 45°.
Lateral: Spine parallel to IR, knees flexed.
L5–S1: Center to lumbosacral junction.
CR
AP: Perpendicular to L3.
Obliques: 1–2 inches medial to elevated ASIS.
Lateral: L3.
L5–S1: 5–8° caudal angle to 1.5 inches below iliac crest.
IR Size / Orientation
14×17 in (35×43 cm) for AP/lateral; 8×10 in (18×24 cm) for L5–S1.
Breathing Instructions
Suspended expiration.
Evaluation Considerations
AP: Open intervertebral spaces.
Obliques: “Scotty dogs” visualized.
Lateral: Intervertebral foramina open.
Spot: L5–S1 joint space open.
Notes
Use lead blocker behind patient for lateral to reduce scatter.
Patient Position
Supine for AP; lateral recumbent for lateral.
Part Position
MSP aligned; legs extended.
CR
AP Axial: 15° cephalic to 2 inches superior to pubic symphysis.
Lateral: Perpendicular to 3–4 inches posterior to ASIS.
IR Size / Orientation
10×12 in (24×30 cm), portrait.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
AP: Sacrum free of foreshortening.
Lateral: Sacral canal and foramina visible.
Notes
Use support under waist for lateral to keep spine parallel.
Patient Position
Supine for AP; lateral recumbent for lateral.
Part Position
MSP aligned; legs extended.
CR
AP Axial: 10° caudal to 2 inches superior to pubic symphysis.
Lateral: 3–4 inches posterior to ASIS.
IR Size / Orientation
8×10 in (18×24 cm), portrait.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
AP: Coccyx free of superimposition.
Lateral: Coccyx in profile.
Notes
Angle direction differs from sacrum; confirm before exposure.
Patient Position
Supine for AP; oblique for SI joint views.
Part Position
AP Axial: MSP aligned.
Obliques: Rotate body 25–30°.
CR
AP Axial: 30–35° cephalic to 2 inches below ASIS.
Obliques: 1 inch medial to elevated ASIS.
IR Size / Orientation
10×12 in (24×30 cm), portrait.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Open SI joint on elevated side; symmetric pelvic structures.
Notes
Angle varies slightly by gender; follow protocol.
Patient Position
Upright preferred; MSP aligned.
Part Position
Arms at sides or holding support bar; include entire spine.
CR
Perpendicular to midpoint of IR.
IR Size / Orientation
Long 14×36 in (35×90 cm) or stitched images.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Entire spine from C1 to sacrum; pelvis included for alignment.
Notes
PA reduces breast dose; use shielding appropriately.
Patient Position
Supine on backboard; do not move head or neck.
Part Position
IR placed vertically at shoulder; shoulders depressed if possible.
CR
Horizontal beam to C4.
IR Size / Orientation
10×12 in (24×30 cm), portrait.
Breathing Instructions
Expiration to lower shoulders.
Evaluation Considerations
C1–C7 visible if possible; soft tissue and vertebral alignment assessed.
Notes
Do not remove collar; obtain physician clearance before additional views.
Patient Position
Upright preferred; MSP aligned.
Part Position
PA: Forehead and nose on IR, OML perpendicular.
AP Towne: OML or IOML perpendicular; chin tucked.
Lateral: MSP parallel, IPL perpendicular.
CR
PA: Perpendicular to nasion.
Towne: 30° caudal (OML) or 37° (IOML) to 2.5 inches above glabella.
Lateral: 2 inches superior to EAM.
IR Size / Orientation
10×12 in (24×30 cm), portrait.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
PA: Petrous ridges fill orbits.
Towne: Dorsum sellae within foramen magnum.
Lateral: Superimposed orbital roofs and mandibular rami.
Notes
Remove dentures, earrings, and hairpins.
Patient Position
Upright to demonstrate air‑fluid levels.
Part Position
Waters: Chin extended, MML perpendicular.
Caldwell: Nose and forehead on IR, OML perpendicular.
Lateral: MSP parallel, IPL perpendicular.
CR
Waters: Perpendicular to exit at acanthion.
Caldwell: 15° caudal to nasion.
Lateral: 1 inch posterior to outer canthus.
IR Size / Orientation
8×10 in (18×24 cm), portrait.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Waters: Maxillary sinuses unobscured.
Caldwell: Frontal and ethmoid sinuses visible.
Lateral: All sinus groups visible.
Notes
Upright is essential for fluid levels.
Patient Position
Upright preferred.
Part Position
Same as sinus positions but centered to facial bones.
CR
Waters: Acanthion.
Caldwell: Nasion.
Lateral: Zygoma.
IR Size / Orientation
8×10 in (18×24 cm), portrait.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Waters: Orbits and maxillae demonstrated.
Caldwell: Orbital rims and nasal structures.
Lateral: Superimposed facial bones.
Notes
Remove glasses and jewelry.
Patient Position
Upright preferred.
Part Position
Same as facial bones but centered to orbits.
CR
Waters: Acanthion.
Caldwell: Nasion.
Lateral: Outer canthus.
IR Size / Orientation
8×10 in (18×24 cm), portrait.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Waters: Orbital floors visible.
Caldwell: Orbital rims and ethmoid sinuses.
Lateral: Superimposed orbital roofs.
Notes
Shield eyes from bright light; instruct patient to look straight ahead.
Patient Position
Upright preferred.
Part Position
Waters: Chin extended, MML perpendicular.
Lateral: MSP parallel, IPL perpendicular.
CR
Waters: Acanthion.
Lateral: 1/2 inch inferior to nasion.
IR Size / Orientation
8×10 in (18×24 cm), portrait.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Lateral: Nasal bones in profile, soft tissue visible.
Notes
Use small focal spot for detail.
Patient Position
Upright preferred; MSP aligned. For SMV, patient extends neck to place vertex of skull near IR.
Part Position
SMV: IOML parallel to IR, vertex against IR.
Oblique SMV: Rotate head 15° toward side of interest.
Waters: Chin extended, MML perpendicular.
CR
SMV: Perpendicular to IOML, centered midway between arches.
Oblique SMV: Same CR, but head rotated.
Waters: Acanthion.
IR Size / Orientation
8×10 in (18×24 cm), landscape or portrait depending on method.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
SMV: Bilateral arches free of superimposition.
Oblique SMV: Arch of interest free of superimposition.
Waters: Zygomatic arches and maxillae demonstrated.
Notes
Use small focal spot for detail; avoid excessive neck extension in elderly patients.
Patient Position
Upright preferred; MSP aligned.
Part Position
Modified Towne: OML perpendicular; chin tucked.
Axiolateral (Schuller or Law): Head in true lateral or rotated 15° depending on method; both open and closed mouth exposures performed.
CR
Modified Towne: 35° caudal to TMJ level.
Axiolateral: 25–30° caudal angle to TMJ closest to IR.
IR Size / Orientation
8×10 in (18×24 cm), portrait.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Open and closed mouth views demonstrate condyle movement; joint spaces visible without excessive superimposition.
Notes
Instruct patient not to protrude mandible; simply open mouth naturally.
Patient Position
Upright preferred; chest against IR; chin raised; hands on hips with shoulders rolled forward to move scapulae laterally.
Part Position
MSP perpendicular to IR; weight evenly distributed; top of IR 1.5–2 inches above shoulders.
CR
Perpendicular to T7 (inferior angle of scapula).
IR Size / Orientation
14×17 in (35×43 cm), portrait or landscape depending on body habitus.
Breathing Instructions
Second full inspiration.
Evaluation Considerations
Entire lungs visible; 10 posterior ribs above diaphragm; scapulae out of lung fields; no rotation.
Notes
Upright reduces pulmonary vessel engorgement and demonstrates air‑fluid levels.
Patient Position
Left side against IR; arms raised; elbows flexed; chin elevated.
Part Position
MSP parallel to IR; midcoronal plane perpendicular.
CR
Perpendicular to T7.
IR Size / Orientation
14×17 in (35×43 cm), portrait.
Breathing Instructions
Second full inspiration.
Evaluation Considerations
Posterior ribs superimposed; costophrenic angles included; open thoracic intervertebral spaces.
Notes
Left lateral reduces magnification of the heart.
Patient Position
Side‑lying on radiolucent pad; arms raised; chin elevated.
Part Position
MSP perpendicular to IR; allow patient to settle for 5 minutes for fluid/air levels.
CR
Horizontal beam to T7.
IR Size / Orientation
14×17 in (35×43 cm), portrait.
Breathing Instructions
Second full inspiration.
Evaluation Considerations
Demonstrates air‑fluid levels; side of interest up for pneumothorax, down for effusion.
Notes
Mark side up; use horizontal beam only.
Patient Position
Supine, MSP aligned, arms away from body.
Part Position
Center IR to iliac crests; include pubic symphysis.
CR
Perpendicular to iliac crests.
IR Size / Orientation
14×17 in (35×43 cm), portrait.
Breathing Instructions
Expiration.
Evaluation Considerations
Kidneys, ureters, bladder included; psoas muscles and lower ribs visible.
Notes
Use grid; remove artifacts.
Patient Position
Upright for at least 5 minutes; arms away from abdomen.
Part Position
Center IR 2 inches above iliac crests to include diaphragm.
CR
Perpendicular to 2 inches above iliac crests.
IR Size / Orientation
14×17 in (35×43 cm), portrait.
Breathing Instructions
Expiration.
Evaluation Considerations
Diaphragm included; air‑fluid levels visible.
Notes
Mark “upright.”
Patient Position
Left side down; arms raised; knees slightly flexed.
Part Position
IR centered 2 inches above iliac crests.
CR
Horizontal beam to 2 inches above iliac crests.
IR Size / Orientation
14×17 in (35×43 cm), portrait.
Breathing Instructions
Expiration.
Evaluation Considerations
Demonstrates free air under right hemidiaphragm.
Notes
Left side down prevents stomach gas from mimicking free air.
Patient Position
Upright or supine; multiple positions used.
Part Position
Center esophagus to IR; patient drinks contrast during exposures.
CR
Perpendicular to T5–T6.
IR Size / Orientation
14×17 in (35×43 cm).
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Entire esophagus visualized with contrast.
Notes
Use thick and thin barium per protocol.
Patient Position
Upright and supine; multiple obliques.
Part Position
Center stomach and duodenum to IR; patient drinks contrast.
CR
Varies by position; typically L1–L2.
IR Size / Orientation
11×14 or 14×17 in.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Stomach, duodenal bulb, and C‑loop demonstrated.
Notes
Use compression and spot images as needed.
Patient Position
Upright or supine; serial images.
Part Position
Center abdomen to IR; follow contrast progression.
CR
Perpendicular to iliac crests.
IR Size / Orientation
14×17 in.
Breathing Instructions
Expiration.
Evaluation Considerations
Entire small bowel demonstrated over time.
Notes
Time intervals vary by protocol.
Patient Position
Supine, prone, and oblique positions used.
Part Position
Colon centered to IR; contrast administered rectally.
CR
Varies by projection; typically iliac crests.
IR Size / Orientation
14×17 in.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Entire colon demonstrated; flexures open on obliques.
Notes
Follow safety protocols for contrast administration.
Patient Position
Seated lateral to IR.
Part Position
Center oropharynx; patient swallows various consistencies.
CR
Perpendicular to oropharynx.
IR Size / Orientation
8×10 in.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
Demonstrates swallowing mechanism.
Notes
Performed with speech pathology.
Patient Position
Supine; multiple timed images.
Part Position
Center kidneys and bladder as needed.
CR
Varies by image; typically iliac crests.
IR Size / Orientation
14×17 in.
Breathing Instructions
Expiration.
Evaluation Considerations
Kidneys, ureters, and bladder demonstrated with contrast.
Notes
Follow contrast safety protocols.
Patient Position
Supine oblique.
Part Position
Penile urethra centered; contrast injected retrograde.
CR
Perpendicular to urethra.
IR Size / Orientation
10×12 in.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
Entire urethra demonstrated.
Notes
Performed under sterile technique.
Patient Position
Supine; bladder catheterized.
Part Position
Bladder centered; images during filling and voiding.
CR
Perpendicular to bladder.
IR Size / Orientation
10×12 or 14×17 in.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
Bladder and urethra demonstrated during voiding.
Notes
Follow pediatric safety protocols when applicable.
Patient Position
Supine.
Part Position
Stoma catheterized; contrast instilled.
CR
Perpendicular to stoma region.
IR Size / Orientation
10×12 or 14×17 in.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
Loop and anastomosis demonstrated.
Notes
Use sterile technique.
Patient Position
Supine or upright.
Part Position
Joint centered; contrast injected under sterile technique.
CR
Perpendicular to shoulder joint.
IR Size / Orientation
10×12 in.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Joint capsule and contrast distribution demonstrated.
Notes
Often followed by CT or MRI.
Patient Position
Supine.
Part Position
Hip centered; contrast injected.
CR
Perpendicular to hip joint.
IR Size / Orientation
10×12 in.
Breathing Instructions
Suspended respiration.
Evaluation Considerations
Joint space and capsule demonstrated.
Notes
Use sterile technique.
Patient Position
Supine.
Part Position
Knee slightly flexed; contrast injected.
CR
Perpendicular to knee joint.
IR Size / Orientation
10×12 in.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
Menisci, joint capsule, and contrast distribution demonstrated.
Notes
Often followed by MRI for detailed soft‑tissue evaluation.
Patient Position
Supine; limb elevated slightly depending on vein of interest.
Part Position
Contrast injected into peripheral vein; tourniquet placement varies by protocol.
CR
Perpendicular to area of interest.
IR Size / Orientation
Varies by anatomy; typically 14×17 in.
Breathing Instructions
No breathing instructions unless chest included.
Evaluation Considerations
Contrast‑filled veins demonstrated without excessive overlap.
Notes
Follow contrast safety and sterile technique protocols.
Patient Position
Upright preferred; supine if needed.
Part Position
Chest centered; include device and lead pathways.
CR
Perpendicular to mid‑thorax.
IR Size / Orientation
14×17 in.
Breathing Instructions
Second full inspiration.
Evaluation Considerations
Device position and lead course visible; lungs and mediastinum included.
Notes
Do not raise arm on pacemaker side unless cleared.
Patient Position
Supine; legs extended and aligned.
Part Position
Three exposures: hips, knees, ankles.
CR
Perpendicular to each joint center.
IR Size / Orientation
Long IR or stitched digital images.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
Accurate measurement of femur and tibia lengths.
Notes
Ensure no rotation of legs.
Patient Position
Seated at table.
Part Position
Left hand and wrist placed flat on IR.
CR
Perpendicular to 3rd MCP joint.
IR Size / Orientation
8×10 in.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
Entire hand and wrist visualized for comparison to standards.
Notes
Left hand used universally for consistency.
Patient Position
Supine; legs extended.
Part Position
Include hip, knee, and ankle joints.
CR
Perpendicular to mid‑shaft or joint centers depending on protocol.
IR Size / Orientation
Long IR or stitched images.
Breathing Instructions
No breathing instructions.
Evaluation Considerations
Accurate visualization of long bone alignment and length.
Notes
Ensure no rotation of limbs.
Patient Position
Varies by projection; typically supine or upright.
Part Position
Multiple images including skull, spine, pelvis, ribs, and long bones.
CR
Perpendicular to each region.
IR Size / Orientation
Varies by anatomy.
Breathing Instructions
Varies by region.
Evaluation Considerations
Complete skeletal survey with consistent technique.
Notes
Use identical exposure factors for comparable regions.
Patient Position
Supine or upright depending on region.
Part Position
Includes long bones of upper and lower extremities.
CR
Perpendicular to mid‑shaft or joint centers.
IR Size / Orientation
Long IR or stitched images.
Breathing Instructions
Varies by region.
Evaluation Considerations
Entire long bones visualized with joints included.
Notes
Used for systemic conditions requiring full skeletal evaluation.