Rob Trager. Lower Extremity: X-Ray view technique position, collimation clinical AP Pelvis

80 kVp, 40” FFD, 14x17 ” (H), M: midway btw. pubic symphysis & iliac crest CR: . internally rotate feet 25°, no ♀ gonad shield. exhale, hold.

AP Hip hip joint series: AP full pelvis, AP hip spot, frog leg (or oblique) (≥2 views)

70 kVp, M: CR: hip joint. 10x12”. small focal spot if possible. internally rotate leg

specialized views: flamingo (pubic instability), weight bearing (DJD), inlet-outlet (Fx and dislocations), obturator, lateral pelvis

Hip: Frog Leg (oblique view)

same as AP. remove pants, underwear, wear a gown, give pt. a towel to cover genitals over gown.

Oblique SI Joint SIJ series: PA each side, bilateral PA comparison (≥3 views)

80kVp, 40”FFD, M: CR: PSIS. 8x10” film (V). gonad shield.

PA SI Joints

80 kVp, 40”FFD (or 60” or 72” standing) 8x10” film. M: CR: 1” inf. to PSISs. Use AP lumbar or pelvis Tx box. 25° caudal tilt prone. prone preferred. no gonad shield for ♀

AP Sacrum sacrum and/or cccyx series: AP and Lateral (≥2 views)

prep with enema, & void bladder. 70 kVP, 300MA, 40” FFD. 10x12” film (V). M: CR: midway btw. ASIS/Pubic bone. 15° cephalad tilt.

Lateral Sacrum

80 kVp. 40”FFD. 10x12” film. M: CR: 2” anterior to S2 tubercle.

AP Coccyx sacrum and/or cccyx series: AP and Lateral (≥2 views)

prep with enema, empty bladder. 70kVp, 40”FFD, M: CR: just cephalic to ASIS. 8x10” film. 15°-20° caudal tilt. 5x5” collimation

Lateral Coccyx

80 kVp. 40” FFD. 8x10” film. M: CR: through sacrococcygeal junction, 2” ant. to the posterior body surface

AP & lateral Femur femur series: AP and lateral (2 views)

rule of long bone: must include at least one end. use AP hip tx.

AP Knee knee series: AP, lateral, tunnel, sunrise (complete, ≥ 4 views)

65 kVp M: CR: apex of patella. 8x10” film. Grid? use 600 sped film/screen combo. Table top? 100 speed cassette (extremity). 10° cephalic tilt

Lateral Knee

65 kVp M: CR: joint line. 8x10” film. Grid? use 600 sped film/screen combo. Table top? 100 speed cassette (extremity). 10° cephalic tilt

Tunnel knee (camp-coventry method) / intercondylar

70kVp, 40” FFD. 8x10” film. M: CR: popliteal depression. Grid? use 600 sped film/screen combo. Table top? 100 speed cassette (extremity). 45° caudad tilt

Tangential (skyline, sunrise, sunset, patellofemoral joint, settegast)

65kVp, 40” FFD. 8x10” film. Grid? use 600 sped film/screen combo. Table top? 100 speed cassette (extremity). 10° tilt cephalad optional

AP Tibia and Fibula & Lateral Tibia and Fibula leg series: AP and lateral (2 views)

65kVp, 40” FFD. 8x10” film. Grid? use 600 sped film/screen combo. Table top? 100 speed cassette (extremity)

AP Ankle (AP talocrural view) ankle series: AP, medial oblique, lateral (≥ 3 views)

55 kVp, 40”FFD, 10x12” film, Use half film for AP, half for medial oblique. Dorsiflex ankle slightly, internally rotate leg so that malleoli are parallel to film

Medial Oblique Ankle (Mortise view)

55 kVp. 40” FFD. 10x12” film.M: CR: midway btw. medial/lateral malleolus.. Dorsiflex ankle slightly, internally rotate leg.

Lateral Ankle

55 kVp. 40”FFD. 8x10” (V) film. M: thru malleoli. CR: medial malleolus. lateral surface of ankle contacts film, dorsiflex foot slightly

Dorsoplantar (AP) Foot Foot series: Dorsoplantar, everted oblique, lateral (complete, ≥3 views)

55 kVp. 40” FFD. 10x12” film. M: through tarsometatarsal junction @ base of 3rd metatarsal. CR: base of 3rd metatarsal. 15° cephalic tilt.

Medial Oblique Foot (internal oblique)

50-60 kVp. 40” 15° tube tilt cephalad. Foot forms 35° with film, with 5th digit elevated. 10x12” split in half, other side fits dorsoplantar. compensating filter

Lateral Foot

50-60 kVp, 40” FFD. M: navicular to 5th metatarsal. CR: @ navicular

Upper Extremity: AP AC Joint. AC joint series (AP without weights, b/l. AP with weights b/l)

70 kVp, 40”FFD, 8x10” film. M: coracoid process. CR: through AC joint. collimate 5x5”. 10° cephalic tilt. limit 1° leak

AP internal rotation shoulder Glenohumeral joint series: internal rotation, external rotation, baby arm ± suppl.

70kVp, 40”FFD, 10x12” (V). M: btw coracoid/ scapula CR: coracoid process.

AP External Rotation Shoulder

70kVp. 40”FFD. 10x12” film. M: btw. coracoid process/scapula. CR: coracoid process arm externally rotated

Abduction shoulder (baby arm, cleopatra, active abduction, scapular neck, stop sign view, Bennet)

70kVp, 40”FFD, 10x12” film (H). M: btw. coracoid and posterior shoulder. CR: midclavicular line, @ level of coracoid. collimate to film

AP Humerus, Lateral Humerus Humerus series: AP & lateral humerus (≥2 views)

70kVp, 40”FFD, 14x17” (V) film. M: AP @ epicondyles. CR: elbow, btw. and 1” distal to epicondyles. put arm in anatomical position*

AP Elbow. Elbow series: AP, lateral, pronated oblique, jones (≥3 views) & Pronated Oblique

60 kVp, 40”FFD, 10x12” film. elbow fully extended, arm & forearm parallel to film. pronated oblique: pronate the forearm.

Lateral Elbow

60 kVp. 40”FFD. 10x12” film. M: CR: mid-elbow joint, just anterior to lateral epicondyle. elbow flexed 90°, shoulder abducted to 90°. hand in anatomical position

Tangential (Jones) Elbow (axial, acute flexion, inferior-to-superior)

60 kVp. 40” FFD. 10x12” film. M: 2” distal to olecranon

AP Forearm Forearm series: AP, Lateral (≥2 views)

60 kVp, 40”FFD, 7x17” or half of 14”x17”. lead under cassette

Lateral Forearm

60 kVp, 40”FFD, 7x17” or half of 14”x17”. lead under cassette. thumb side up

PA Wrist (dorsal-palmar view). wrist series: PA, lateral, pronated oblique, specialized 4th (complete, ≥ 3 views)

60 kVp, 40” FFD. M: CR: midcarpal region . 10x12” collimate to film. lead vinyl must be put on non-exposed film, also beneath the cassette

Lateral Wrist

60 kVp, 40” FFD. 10x12” film. M:CR: midcarpal area. wrist neutral, dorsal surface perpendicular to film plane. place lead under cassette, give pt. lead apron

Pronated Oblique Wrist

60 kVp, 40”FFD, M:CR: scaphoid. 10x12” film, divided into fourths by lead vinyl. wrist neutral, 45° to film. lead under cassette, and lead apron.

Scaphoid (special)

60 kVp. 40” FFD, 10x12” film.M: CR: snuffbox. divide film into fourths, using lead. wrist neutral, forearm 45°. tube tilt 45°

PA Hand. hand series: PA, pronated oblique, lateral (≥ 3 views)

60 kVp, 40” FFD. 10x12” film, divided in half by lead vinyl. wrist neutral, hand flat. M: CR: 3rd MCP joint. place lead uder cassette, give pt. lead apron

Lateral Hand

60 kVp, 40” FFD, M: CR: 2nd MCP joint. 10x12” film. wrist neutral, hand 90° to film, fingers flared

Pronated Oblique Hand

60 kVp, 40” FFD, 10”x12”. divide in half by lead vinyl. wrist neutral, hand 45° to film plane. M: CR: 3rd MCP joint. lead under, give lead apron

skull AP axial (Towne). skull series: PA caldwell, PA towne, left & right lateral (≥4 views)

10x12” film. M: CR. ~ 20cm. use skull PA Tx. Canthomeatal line perpendicular to film. 35° caudal tilt.

Lateral Skull 10x12” (H) film. Pt.

is prone oblique. Interpupillary line perpendicualr to film. CR coincides with interpupillary line.

Caldwell Skull 10x12” film. M:

CR. use skull PA Tx. Canthomeatal line perpendicular to film. Pt. should “tuck chin”. 15° caudal tilt

Caldwell Sinuses

Waters Sinus