Alphabetical List of Named Radiographic Projections A ADAMS (MODIFICATION OF HERMODSSON'S VIEW) The same as Hermodsson's view but with internal rotation increased from 70 degrees to 100 degrees. See Hermodsson’s view. Ref:Rockwood and Green's Fractures in Adults, Lippincott. AHLBACK METHOD Weight-bearing AP view of the knee in full extension. ALBERS-SCHONBERG Demonstrates the TMJs. Head in the lateral position, then rotate the head 20 degrees towards the film. Centre to the TMJ in contact with the film, with the tube angled 20 degrees upwards. ALEXANDER METHOD View of the optic canal in cross section. Both sides for comparison. Patient sat with the back of head against the skull table. Upper border of the skull table angled backward 15 degrees . Position the patients head so that the midsagittal plane makes an angle of 40 degrees to the plane of the bucky. Head extended so that the acanthomeatal line is at right angles to the plane of the bucky. Centre to the lower outer margin of the orbit away from the film. ALEXANDER METHOD (ACJ) Routine lateral oblique view of the acromio-clavicular joint. Ref: K.Clarke. Positioning in Radiography, 11th Ed ALEXANDER STRESS VIEW View of the acromio-clavicular joint. Position as for lateral scapula. Patient then asked to thrust the affected shoulder forward. Ref: Alexander, O.M.Radiography of ACJ articulation, Med. Radiogra. 30:34-39, 1954. ALTSCHUL Position as for Townes (half-axial skull view) view but angle 35 degrees rather than 30 degrees. ANTHONSON'S VIEW Subtalar joint view. Foot in the lateral position. Dorsi-flex the foot. Angle the vertical central ray 25 degrees towards the foot and, 30 degrees towards the toes. Centre immediately below the medial malleolus. ARCELIN Demonstrates the petrous temporal region. Head in the AP position and rotate 45 degrees away from the side being examined with the radiographic baseline at right angles to the film. Centre to the baseline at a point 2.5cm in front of the EAM, with the tube angled 10 degrees to the feet. Ref: Goldman and Cope. A Radiographic Index. Wright B BALL CATCHERS VIEW See Norgaads view. BALL’S METHOD (AP) Pelvimetry view. Patient erect, centre the horizontal beam to the midline at the level of the superior border of the symphysis pubis. BALL’S METHOD (LATERAL) Pelvimetry view. Patient erect in the lateral position. Centre horizontal central ray to the level of the superior border of the acetabulum. BECLERE METHOD View of the intercondyloid fossa in profile. Patient supine. Knee flexed so that the long axis of the femur is at 120 degrees to the long axis of the tibia. Direct the central ray at right angles to the long axis of the tibia and centre to the knee joint. BERQUIST VIEW See Capitellum view BERTEL Demonstrates the orbital floors and the infra-orbital fissure. Head in the PA position with radiographic baseline at right angles to the film. Centre to the nasion with the tube angled 20 degrees towards the head Ref: Goldman and Cope. A Radiographic Index. Wright Publishing, Bristol. BETT'S VIEW View to demonstrate the trapezium. Shows the trapezium without the overlapping of other carpal bones. Gedda / Betts or Clements view. It’s basically an offsetview where you externally rotate the wrist and hand obliquly it to the image plate at about 45 degrees, and angle cranially about 5 degrees It not only gives you a full view of the trapezium, but it gives you a good CMC view and then isolates the STT and TT joints. It helps to stage arthritic disease and in the selection of surgical technique BIGLIANI'S VIEW (Y VIEW) Hip projection. Pelvis in the AP position. Flex, abduct and externally rotate the hip. Centre to the hip joint. BLACKETT-HEALY METHODS Shoulder views 1. A tangential projection of the insertion of the teres minor. Patient prone. Internally rotate the arm, flex the elbow and place the hand on the back. Centre to the head of the humerus. 2. A tangential projection of the insertion of the subscapularis. Patient supine. Abduct the arm, flex the elbow, and pronate the hand. Centre to the shoulder joint. BLONDEAU OM facial bones overtilted by 5 degree BLOOM AND OBATA See Velpeau. BRATTSTROM METHOD Skyline patella. BREWERTON'S VIEW To show erosions of the metacarpal heads and the bases of the phalanges. Hand in the AP position i.e. palm facing upwards. The metacarpal-phalangeal joints are flexed to 45 degrees with the phalanges in contact with the film. Tube angled 20 degrees (from ulnar side) to the head of the third metacarpal. BRIDGEMAN VIEW See Stecher Method, point 1. BRODEN I Subtalar joint view. Foot positioned as for AP ankle, then rotate the foot 45 degrees medially. Angled the tube cranially between 10 degrees and 40 degrees . BRODEN II Subtalar joint view. Foot positioned as for AP ankle, then rotate the foot 45 degrees externally. Angle the tube cranially 15 degrees. Ref: Hansen and Swiontkowski, ORTHOPAEDIC TRAUMA PROTOCOLS, Raven Press. BUTTERFLY VIEWS Elongated views of the rectosigmoid segments of large intestine. AP BUTTERFLY Centre 5cm inferior to the anterior-superior iliac spine (ASIS) and angle the vertical central ray 40 degrees towards the head. LPO BUTTERFLY Centre 5cm inferior to and 5cm medial to the right ASIS. Angle the vertical central ray 40 degrees towards the head. PA BUTTERFLY Centre to the ASIS and angle the vertical central ray 40 degrees towards the feet. RAO BUTTERFLY Centre to the level of the ASIS and 5cm to the left of the lumbar spinous processes. Angle the vertical central ray 40 degrees towards the feet. C CAHOON View to demonstrate the styloid processes of the skull. Position as for Bertel's view and angle the tube 25 degrees cranially. Ref: Goldman and Cope. A Radiographic Index. Wright Publishing, Bristol.. CALDWELL Routine OF 20 view of the skull. Ref: K.Clarke. Positioning in Radiography. 11th Ed. CAMP COVENTRY METHOD View of the intercondylar notch. Patient prone. The tibia is elevated by 40-50 degrees. The central ray is directed to the knee joint so that it makes a right angle with the long axis of the tibia. CAPITELLUM VIEW (BERQUIST VIEW) View to demonstrate fractures of the radial head. Patient positioned as for lateral elbow. The tube is angled 45 degrees to the forearm along the humeral axis. Centre to the radial headwards. Ref: Berquist, T. (1993). Diagnostic Radiographic Techniques in the Elbow. The Elbow and its Disorders, 2nd ed. WB Saunders, Philadelphia 98-119. CARPEL BOSS Demonstrates bony protuberance on the dorsum of the wrist at the level of the second and third carpo-metacarpal joints.Wrist slightly ulnar deviated with the ulnar side to the cassette. 30 degree supination of the wrist to place the dorsal prominence at the dorsoradial aspect of the second to third carpo-metacarpal joints and at a tangent to the vertical central ray. Centre to pass through the dorsal prominence. Ref: Gilula and Yin. Imaging of the Wrist and Hand, Saunders. CARPAL BRIDGE VIEW A tangential projection of the carpus. Demonstrates fractures of the scaphoid, lunate dislocations, and foreign bodies in the dorsum of the wrist. The back of the hand rests on the cassette with the forearm at right angles to the hand. Direct the central ray 4cm proximal to the wrist joint with a 45 degree angle towards the fingers. Ref: Lentino, W. et al (1957). The carpal bridge view, J. Bone Joint Surg. 39-A:88-90. CARPAL CANAL Routine carpal tunnel view. Ref: K.Clarke. Positioning in Radiography. 11th Ed. CAUSTON METHOD Oblique foot projection to demonstrate the sesamoids. Foot lateral with the medial side against the cassette. Angle the central ray 40 degrees towards the ankle and centre to the first metatarsophalangeal sesamoids. Ref: Causton, J. (1943):Projection of the sesamoid bones in the region of the first metatarsophalangeal joint, Radiology 9:39. CHASSARD'S VIEW View to show the sigmoid colon. Patient sits with both legs over the side of the table and leans forward slightly. Centre fairly high up the patients back. CHAUSSE II Oblique transoral view of the foramen jugulare. The patient is positioned as for an AP skull with the mouth wide open. Rotate the head 10 degrees away from the side in question. Direct the central ray up through the open mouth so that it makes an angle of 35 degrees to a line joining the superior border of the EAM and the anterior nasal spine. Ref: Chausse, C. (1950).Trois incidences pour l'exam du rocher, Acta Radiol. 34:274287. CHAUSSE III Head in the PA position then rotate the head 5-10 degrees towards the unaffected side. Centre along the radiographic baseline midway between the outer canthus and the EAM. CHAUSSE IV See Stenvers view (C-Ear). CINCINATTI VIEW Supine chest x-ray coned to the mediastinum, a high kV filter is used. The filter consists of 0.5mm copper and 0.4mm tin inserted so that the copper layer is nearest the tube. A CT scoutview (topogram) is an alternative. CLEAVES METHOD (HIP) Axial projection of the femoral heads, necks, and trochanteric areas projected onto one film. Position as a frog-leg lateral and centre to the symphysis pubis with the central ray angled to be parallel with the long axes of the femoral shafts. CLEAVES METHOD (SHOULDER) An axial projection of the shoulder. This technique requires non-cassette film. Ref: Cleaves, E.N.(1941).A new film holder for roentgen examination of the shoulder, A.J.R. 45:288-290. CLEMENTS view. It’s basically an offsetview where you externally rotate the wrist and hand obliquly it to the image plate at about 45 degrees, and angle cranially about 5 degrees It not only gives you a full view of the trapezium, but it gives you a good CMC view and then isolates the STT and TT joints. It helps to stage arthritic disease and in the selection of surgical technique CLEMENTS NAKAYAMA METHOD Lateral view of acetabulum and femoral head. This method can be used where the opposite hip cannot be raised for a horizontal beam lateral hip. COALITION VIEW Demonstrates a calcaneotalar coalition. Patient standing with the cassette under the long axis the calcaneum. Angle the central ray 45 degrees and direct it through the posterior surface of the flexed ankle to the level of the base of the fifth metatarsal. COBEYS VIEW is a weight bearing AP ankle projection used to demonstrate the angulation between the long axix of the calcaneum and the tibia (some call it a Buckview) It is a PA projection done on a special radiolucent platform. The patient stands on the platform equal weight on both feet with the toes on the side of interest against a 7 X 17 IR. (no grid, 40 SID) The platform holds the IR at a 20 degree tilt from vertical (away from the patient) The CR is angled caudal at 20 degree centered at the level of the ankle joint. (The tube and IR will be parallel to eachother.) Collimate to include as much of the tib/fib possible. A radiopaque marker is placed just behind the heel for measuring purposes when analizing alignment.e tibia, radiographically imaging the coronal plane alignment of the hindfoot. COLCHER-SUSSMAN PROJECTION (AP) Pelvimetry view. Metal ruler engraved at cm intervals (Colcher-Sussman pelvimeter) is required. Patient supine with the knees flexed and the thighs abducted so that the ruler can be placed horizontally, centred to the gluteal fold at the level of the ischial tuberosities. Centre the vertical central beam 2.5cm above the symphysis pubis. COLCHER-SUSSMAN PROJECTION (LATERAL) Pelvimetry view. Metal ruler engraved at cm intervals (Colcher-Sussman pelvimeter) is required. Patient lies in the lateral position thighs extended so that they do not obscure the symphysis pubis.The ruler is horizontal at the height of and against the mid sacrum. Centre horizontal beam to the greater trochanter. COYLE TRAUMA METHODS Projections of the radial head and/or the coronoid process of the ulna Radial head view Elbow flexed 90 degrees and hand pronated. Vertical central ray angled 45 degrees towards the shoulder. Centre to the radial head. Coronoid process view Elbow flexed 80 degrees from extended position with the hand pronated. Vertical central ray angled 45 degrees away from the shoulder and directed to the elbow joint. Ref: Coyle, George F.(1980).Radiographing Immobile Trauma Patients, Unit 7, Special Angled Views of Joints - Elbow, Knee, Ankle. Multi-Media Publishing, Inc., Denver. CRANIODORSAL HEADVIEW Hip view.Supine hip with the knees extended and legs internally rotated. Central ray angled 30 degrees caudally, centre over the hip. Ref: Schneider (1964). CRANIOVENTRAL HEADVIEW Hip view. Supine hip centred on the femoral head with the leg raised 45 degrees. Ref:Schneider (1964). D DANELIUS-MILLER METHOD Routine horizontal beam view of the hip. DANELIUS-MILLER MODIFICATION OF LORENZ METHOD See Danelius-Miller Method. DENEER METHOD See Dunlop Method. DIDIEE VIEW Shoulder view. Patient prone with cassette under the shoulder. Arm parallel to the table top with a 7.5cm pad under the elbow. Dorsum of hand on the hip with the thumb directed upward. Beam angled 45 degrees. DUNCAN-HOEW METHOD Flexion and extension views of the lumbar spine (PA and lateral). DUNLAP, SWANSON, AND PENNER METHOD Projection to show the acetabula in profile. The patient is sat upright on the bucky table with their legs over the side. The vertical central ray is directed 30 degrees towards the lateral aspect of the pelvis towards the acetabulum. Ref: Dunlap et al (1956).Studies of the hip joint by means of lateral acetabular roentgenograms, J.Bone Joint Surg. 38-A:1218-1230 DUTT'S VIEW (JOHNSON AND DUTT) PA oblique of the cribiform plate. Head in the PA position. The head is then rotated towards the affected side until the median-sagittal plane is 40 degrees to the perpendicular. Raise the chin until the radiographic baseline is 30 degrees to the perpendicular. Centre through the orbit in contact with the film, with the tube angled 10 degrees towards the feet. E ERASO METHOD Projection of the jugular foramina. The patient is positioned as for an AP skull. The chin is then raised and the central ray is angled upwards to make an angle of 65 degrees to the OM line. Centre to the midline at the level of the EAM. Ref: Eraso, S.T. (1961). Roentgen and clinical diagnosis of glomus jugulare tumors, Radiology 77:252-256. F FALSE PROFILE VIEW (click here for a good article) See Le Quesne method. FEIST-MANKIN METHOD See Isherwood method. FERGUSON'S VIEW View of the sacro-iliac joints. The patient is supine and the tube is angled 25-30 degrees cranially. With this projection, the symphysis pubis overlaps the sacrum. Ferguson view, the patient is in the same position as for the AP Pelvis. The tube in angled 30-35 degrees cephalic and is centered to the midportion of the pelvis. It shows the SI joints more clearly and helps in evaluating injury to the sacral bone, the pubis, and the ischial rami Ref: Positioning in Radiography, K.Clarke, 11th Ed. p139. FISK METHOD A projection of the bicipital groove. Patient erect. Flex the elbow, rest the forearm on the cassette and supinate the hand. Centre to the bicipital groove. Ref: Fisk, C. (1965).Adaption of the technique for radiography of the bicipital groove, Radiol. Technol. 37:47-50. FLAMINGO VIEWS Stress views of the symphysis pubis. Two views. Patient stands on each leg in turn. Centre to the symphysis pubis. FLYING ANGEL Routine lateral thoracic inlet view. Ref: K.Clarke. Positioning in Radiography. 11th Ed. FRIEDMAN METHOD An axiolateral projection of the femoral head, femoral neck and upper femur. Position as for turned lateral hip but angle the vertical central ray 35 degrees cephalad. Kisch recommends the central ray be angled 20 degrees cephalad. FROG-LEG POSITION (MODIFIED LAUENSTEIN AND HICKEY METHOD) Lateral projection of both hips. Patient supine with the knees flexed and legs abducted so the soles of the feet are in contact. Ref: K. Clarke, Positioning in Radiography, 11th Ed. FUCHS METHOD Projection of the temporal styloid process. Position the patient as for a lateral skull view. Angle the central ray cranially 10 degrees and anteriorly 10 degrees and centre to the styloid process against the film. Both sides for comparison. FURMAIER METHOD Skyline patella. Ref: The Journal of Bone and Joint Surgery (1974). 56-A, NO.7, OCTOBER G GARTH'S VIEW Apical axial oblique view of the shoulder - useful for trauma dislocation cases Centre to the head of the humorous. Patient erect or Supine rotated 45 degrees to the affected side, central ray angled 45 degrees caudaly. Ref: Merrill Volune 1 page 145 Discussion: - used in the instability patient to visulaize the anterior/inferior glenoid rim for fractures or calcification following dislocation; - Technique: - patient is seated with the arm at the side; - cassette is placed posterior, parallel to the spine of the scapula - beam is directed thru the glenohumeral joint toward the cassette at angle of 45 deg degrees to the plane of the thorax, and directed 45 deg caudally; Roentgenographic demonstration of instability of the shoulder: the apical oblique projection. A technical note. JBJS. 66-A: 1450-1453, Dec. 1984. GAYNOR-HART METHOD Inferosuperior carpal tunnel projection. Ref: K.Clarke. Positioning in Radiography. 11th Ed. See also Templeton and Zim method. GEDDA / Betts or Clements view. It’s basically an offsetview where you externally rotate the wrist and hand obliquly it to the image plate at about 45 degrees, and angle cranially about 5 degrees It not only gives you a full view of the trapezium, but it gives you a good CMC view and then isolates the STT and TT joints. It helps to stage arthritic disease and in the selection of surgical technique GRANDY METHOD Routine lateral cervical spine. GRASHEY METHOD (SHOULDER) Routine view of the shoulder to demonstrate the glenohumeral joint space (shoulder turned through 45 degrees). Ref: K.Clarke. Positioning in Radiography. 11th Ed. GRASHEY METHOD (SKULL) Demonstrates ? Patient positioned as for AP skull with the OM baseline horizontal. Angle the horizontal central ray down 30 degrees and centre between the upper borders of the EAMs. GRASHEY METHODS (FOOT) Oblique plantodorsal projections of the foot. Patient prone, dorsal surface of foot in contact with cassette. Centre to the base of the third metatarsal. 1. To demonstrate the space between the first and second metatarsals, rotate the heel medially 30 degrees. 2. To demonstrate the spaces between the second and third, the third and fourth, and the fourth and fifth metatarsals, adjust the foot so that the heel is rotated laterally 20 degrees. H HAAS Demonstrates the petrous temporal region, foraman magnum, and dorsum sellae. Head in the PA position with the radiographic baseline at right-angles to the film. Centre in the midline to the external occipital protuberance with the central ray angled 25 degrees cranially. Ref: Haas, L.(1927).Verfahren zur sagittalen Aufnahme der Sellage gend, Fortscr. Roentgenstr. 36:1198-1203. HARRIS Axial projection of the heel. Useful for demonstrating talo-calcaneal bars. Patient stands with both feet on the film. The patient leans forward slightly. The tube is positioned behind the patient and the central ray is angled 45 degrees towards the heels and is centred between the medial malleolus. HARRIS AND BEAM (SKI JUMP) Three axial projections of the calcaneum (both sides). Patient standing, central ray central ray centred between the feet and the angled 35 degrees, 40 degrees and 45 degrees. HAYES VIEW To demonstrate the superior-inferior sacro-iliac joints. Patient sat upright on the bucky table with their legs over the side. The vertical central ray is directed along the plane of the sacro-iliac joint in question. HENKELTOPF Routine infero-superior view of the zygomatic arches (jug handles). HENSCHEN Demonstrates the petrous temporal region. Head in the lateral position. Centre 5cm above the EAM away from the film, with the tube angled 15 degrees towards the feet. HERMODSSON'S VIEW (INTERNAL ROTATION VIEW) Shoulder view. Patient supine with the humerus horizontal to the top of the table. Arm adducted to the side of the patient, the humerus is internally rotated 45 degrees, and the forearm lies across the anterior trunk. Vertical central ray is angled 15 degrees towards the feet and centred over the humeral head. Ref: Rockwood and Green's Fractures in Adults, Lippincott. HERMODSSON'S VIEW (TANGENTIAL) Shoulder view Patient prone. The elbow is flexed 90 degrees and the dorsum of the hand is placed behind the trunk, over the upper lumbar spine. The thumb points upward. The film is placed superior to the adducted arm. The x-ray tube is placed posterior, lateral and inferior to the elbow joint, making a 30 degree angle with the humeral axis. HICKEY (skull) The profile view of the mastoid region. HICKEY (HIP) See Lauenstein and Hickey Methods. HILL-SACHS VIEW AP shoulder with arm in marked internal rotation. HIRTZ The routine SMV projection. Some cases overtilt by 15 degrees HOBB'S VIEW View of the sterno-clavicular joints. Centre to the midline at the level of the sterno-clavicular joints. HOLMBLAD METHOD View of the knee. HOUGH METHOD Projection of the sphenoid strut. Patient positioned as for a PA skull with the radiographic baseline horizontal. Turn the head 20 degrees towards the side being examined. The horizontal central ray is angled downwards by 7 degrees so that is emerges through the orbit on the side being examined. Ref: Hough, J.E.(1968).Sphenoid strut: parieto-orbital projection, Radiol. Technol. 39:197-209. HSIEH METHOD PA oblique projections of the hip. Demonstrates posterior dislocations of the femoral head. Patient prone with the unaffected side raised by 45 degrees. Direct the vertical central ray between the posterior surface of the iliac blade and the femoral head. Hsieh, C.K.(1936). Posterior dislocation of the hip, Radiology 27:450-455. HUGHSTON Patella view. Ref:: Hughston (1968). Subluxation of the Patella, J. Bone and Joint Surg., 50-A:100326. I INLET AND OUTLET VIEWS (PELVIS) See Pennal's views. ISHERWOOD METHODS (subtalar region) 1. Projection to demonstrate the anterior subtalar articulation. Medial border of the foot at a 45 degree angle to the cassette. Centre 2.5cm distal and 2.5cm anterior to the lateral malleolus. 2. Projection to demonstrate the middle articulation of the subtalar joint and give an endon view of the sinus tarsi. Foot in the AP ankle position. Rotate the ankle 30 degrees medially. Centre to a point 2.5cm distal and 2.5cm anterior to the lateral malleolus with a 10 degree cephalad angulation. 3. Projection to demonstrate the posterior articulation of the subtalar joint in profile. Foot in the AP ankle position. Rotate the ankle 30 degrees laterally. Centre to a point 2.5cm distal to the medial malleolus with a 10 degree cephalad angulation. J JAROSCHY METHOD See Hugheston. JOHNER VIEW Tangential shoulder view. Patient supine with the elbow flexed and the forearm resting on the abdomen. Film placed vertically against the superior aspect of the shoulder. Angle the central ray 20 degrees medially and 20 degrees below the horizontal. Centre to the head of the humerus. JOHNSON METHOD An axiolateral projection of the femoral head and neck. Patient in the AP pelvis position. Place the cassette vertically against the lateral aspect of the hip of interest. Tilt the cassette backward 25 degrees. Direct the horizontal central ray 25 degrees cephalad and 25 degrees downwards and centre to the femoral neck. Ref: Johnson,C.R (1932).A new method for roentgenographic examination of the upper end of the femur, J. Bone Joint Surg. 30:859-866, JOHNSON AND DUTT See Dutt's view. JONES POSITION View of the elbow in flexion. Demonstrates the olecranon process in profile and the distal humerus. Place the humerus on the cassette and flex the arm. Two projections taken, one with the central ray angled at right angles to the forearm (for olecranon) and another with the central ray angled at right angles to the humerous (for distal humerus). JUDET VIEWS Oblique views of the acetabulum. 1. Raise the affected side by 45 degrees and centre to the affected hip. 2. Raise the unaffected side by 45 degrees and centre to the affected hip. Ref: K.Clarke. Positioning in Radiography. 11th Ed. JUG HANDLE VIEW SMV projection of the zygomatic arches. K KANDEL METHOD Suroplantar projection to demonstrate clubfoot. The patient stands on the cassette. The vertical central ray is angled 40 degrees and directed to the heel so that it emerges from the midfoot. Ref: Kandel, B. (1952). The suroplantar projection in the congenital clubfoot of the infant, Acta Orthop. Scand. 22:161-173. KASABACH METHOD Oblique projection of the odontoid process. Patient supine. Rotate the head 45 degrees away from the side being examined. Angle the vertical central ray 10 degrees caudal and centre to a point midway between the outer canthus and the EAM. Ref: Kasabach, H.H. (1939). A roentgenographic method for the study of the second cervical vertebrae, A.J.R 42:782-785. KEMP-HARPER METHOD SMV projection of the jugular foramina. Patient with back to the vertical bucky. Chin elevated until the OM line is vertical. Angle the horizontal central ray 20 degrees downwards. Centre below the chin so that the central ray passes between and through the EAM on the side in question. Ref: Kemp Harper, R.A.(1957). Glomus jugulare tumors of the temporal bone, J.Fac. Radiologists 8:325-334. KISCH METHOD See Friedman method. KITE METHODS Projections to demonstrate clubfoot. True lateral and dorsoplantar projections of the foot. KNUTSSON METHOD Skyline patella. Ref: The Journal of Bone and Joint Surger (1974). 56-A, NO.7, October KOVACS METHOD Profile image of the lowermost lumbar intervertebral foramen. Patient lies on the affected side and then rotate the pelvis 30 degrees anteriorly. Centre along a straight line extending from the superior edge of the uppermost iliac crest through the fifth lumbar segment to the inguinal region of the dependent side. Ref: Kovacs, A. (1950) .X-ray examination of the exit of the lowermost lumbar root, Radiol. Clin. 19:6-13. KUCHENDORF METHOD Oblique PA projection of the patella. Patient prone, elevate the hip on the affected side and slightly flex the knee. Centre to the joint space between the patella and the femoral condyles at an angle of 30 degrees caudal. KURZBAUER METHOD Unobstructed lateral projection of the sterno-clavicular articulation. Patient lies on the affected side with the arm of that side next to the head. Vertical central ray directed 15 degrees caudal and centred to the lowermost sterno-clavicular articulation. L LAQUERRIERE AND PIERQUIN METHOD Ulnar groove projection. Ref: K.Clarke. Positioning in Radiography. 11th Ed. LAUENSTEIN AND HICKEY METHODS Lateral hip projection demonstrating the acetabulum and upper end of femur. LAUENSTEIN Routine turned lateral hip projection. LAUENSTEIN AND HICKEY METHOD As for turned lateral hip but angle the vertical central, ray 20 degrees cephalad. LAURINS VIEW View of the patella. LAW Demonstrate the petrous temporal region. Head in the lateral position, then rotate the head 15 degrees towards the film. Centre 5cm above and 5cm behind the EAM away from the film with the tube angled 15 degrees towards the feet. LAW METHOD (FACIAL BONES) Projection to demonstrate the floor and posterior wall of the antrum. Patient sitting PA with the head fully extended so that the chin and zygoma of the side of interest, and the nose, are in contact with the cassette. Angle the central ray upward 30 degrees from the horizontal and centre to the lower antrum. Ref: Law, F.M.(1933). Nasal accessory sinuses, Ann. Roentgenol. 15:32-51, 53-76. LAWRENCE METHOD Lateral view of the proximal humerus. Supine, horizontal beam axial shoulder. LAWRENCE METHOD Transthoracic lateral humerus. LENTINO METHOD See carpal bridge view. LEONARD-GEORGE METHOD Demonstrates the femoral head and neck. Patient supine. A curved cassette is placed on the medial aspect of the leg of interest (between the thighs). Direct the central ray perpendicular to the femoral neck. LEQUESNE METHOD (FALSE PROFILE VIEW) View of the acetabulum in profile. Patient standing with their back against the vertical bucky. Move the unaffected hip forward so that the pelvis makes an angle of 60 degrees with the bucky. Central the horizontal central ray the affected hip. See also Urist's view. LETOURNEL VIEW Iliac wing view. LEWIS METHOD The routine view of the sesamoid bones of the first metatarsal. Ref: K.Clarke. Positioning in Radiography. 11th Ed. LILIENFELD (CALCANEUM) See coalition view. LILIENFELD (HIP) A posterolateral projection of the ileum and acetabulum. Patient prone then raise the unaffected side by 75 degrees. Centre at the level of the greater trochanter of the hip in contact with the film. LILIENFELD (SYMPHYSIS PUBIS) An superoinferior projection of the pubic and ischial bones and symphysis pubis. Position as for AP pelvis then raise the body by 45 degrees. Centre in the midline at the level of the greater trochanter. See also Staunig Method. LINDBOLM AP lordotic chest. Patient leans back 30+ dgerees, centre to mid sternum. LODGE-MOOR PROJECTIONS Lateral oblique projections to demonstrate the cervical articular facets (four views in total). Patient supine with the X-ray tube on the right hand side. First projection with the patients right side elevated by 20 degrees. Second projection with patients left side elevated by 20 degrees. For both views, centre the horizontal central ray to C5. When the raised side is nearest to the tube then angle 5 degrees cephalad. When the raised side is away from the tube then angle 5 degrees caudal. Repeat the two projections from the left side. LORENTZ METHOD (MODIFICATION) See Danellus-Miller method. LOW-BEER METHOD Parietotemporal projection. Position the head in the lateral position. Angle the horizontal central ray upward 10 degrees and anteriorly 33 degrees. Centre to the back of the head so that the beam enters at the level of the lower orbital margin and passes through the foraman magnum. Similar appearances to Stenvers view. LOWENSTEIN'S VIEW Routine frog lateral hips. LYSHOLM METHOD Profile view of the petrosa, IAM, and the mastoid cells. Head in the lateral position then rotate 15 degrees towards the affected side. Angle the central ray 30 degrees from the vertical and centre through the foraman magnum. M MAY View View to demonstrate the zygomatic arch. Head in the PA position with the chin raised as far as possible. The head is then rotated 15 degrees away from the side being examined. Centre through the zygomatic arch, with the tube angled towards the feet so that the central ray is at right-angles to the radiographic baseline. MACNAB'S VIEW View of the patella. MACQUEEN-DELL Transpharyngeal view of the head of the mandibular condyle. The film is parallel to the median sagittal plane and centred to the EAM of the affected side. The central ray is angled 5 degrees cranially and 5 degrees posteriorly towards the condyle to be examined. MARTZ AND TAYLOR Two AP projections of the pelvis to demonstrate the relationship of the femoral head to the acetabulum in patients with CDH. First projection with the central ray at right angles to the symphysis pubis. Second projection with the central ray directed 45 degrees towards the head and centred to the symphysis pubis. This casts an anteroirly displaced femoral head above the acetabulum. A posteriorly displaced head is cast below the acetabulum. Ref: Martz and Taylor (1954). The 45 degree angle roentgenographic study of the pelvis in congenital dislocation of the hip, J.Bone Joint Surg. 36-A:528-532. MAYER To demonstrate the petrous temporal region. Patient in the AP position with the radiographic baseline at right-angles to the film. Rotate the head 45 degrees towards the side being examined, and centre through the EAM nearest the film, with the tube angled 45 degrees towards the feet. MERCEDES VIEW Routine superior-inferior axial shoulder view, or lateral scapula view MERCHANT'S VIEW View of the patella. Patient supine. Knees flexed 45 degrees over the end of the table. Position femora so that they are parallel to the table top. Place knees and feet together. Angle the central ray 30 degrees from the horizontal ( 30 degrees to femora). Centre midway between patellae. Ref: Merchant, A, et al (1975). Reontgenographic Analysis of Patellofemoral Congruance, J. Bone and Joint Surg., 56-A: 1391-96, Oct. MILLER METHOD Projection of the hypoglossal canal. Patient positioned as for an AP skull with the radiographic baseline horizontal. Rotate the head 45 degrees towards the side in question. The horizontal central ray is angled downwards an unknown number of degrees so that it passes through the foraman magnum. MILLER'S VIEW To demonstrate anterior or posterior dislocation of the shoulder. The patient is positioned as for the routine trauma shoulder view. The tube is then angled 45 degrees towards the feet and centred to the glenoid. If the head of the humerus is projected below the glenoid then the dislocation is anterior. If the head of the humerus is projected above the glenoid then the dislocation is posterior. MODIFIED CLEAVES Hip view. Frog view with the thighs abducted to approx. 40 degrees. Centre 2.5cm above the symphysis pubis. MODIFIED FUCHS METHOD Projection of the temporal styloid process. Details not known. MORTISE VIEW True AP ankle. N NOLKE METHOD Projection of the upper sacral canal. Patient sits upright on the bucky table with the feet over the side of the table and leans forward. Centre to the sacrum. NORGAADS VIEW (BALL CATCHERS VIEW) Projection of both hands. Supination of each hand to an angle of 35 degrees . Centre midway between the heads of the fifth metacarpals. O OPPENHEIM'S VIEW Cephaloscapular projection. X-ray beam passed from superior to inferior across the glenoid face to a cassette behind the patient who is leaning forward. OUTLET VIEW See supraspinatus outlet view. P PAWLOW METHOD Swimmer's view with the patient on their side. PEARSON METHOD A bilateral AP projection of the acromoclavicular joints. Both joints taken in one expose on a wide film. PENNAL'S VIEWS (TILE'S VIEW) Trauma views to show the pelvic inlet and outlet. VIEW 1 Patient positioned as for an AP pelvis. Angle the central ray 40 degrees caudally and centre midway between the ASIS. VIEW 2 Patient positioned as for an AP pelvis. Angle the central ray 40 degrees cranially and centre in the midline 4cm below the upper border of the symphysis pubis. Ref: Tile M. and Pennal G. Fractures of the Pelvis. Chapter 15. PILLAR VIEWS Cervical spine views to demonstrate the posterior intervertebral joints. Position as for AP cervical spine. Take two exposures, one with the head rotated at rightangles to the left and one with the head rotated at right-angles to the to the right. Angle the vertical central ray 30 degrees towards the feet. Centre just behind the angle of the mandible with the top of the cassette at the level of the EAM. Ref: K.Clarke. Positioning in Radiography, 11th Ed, p157. PIRIE This is the routine OM 30 sinus view with the mouth open. Ref: Goldman and Cope. A Radiographic Index. Wright Publishing, Bristol.. PORCHER-POROT Oblique transmaxillary view of the foramen jugulare. The radiographic baseline is vertical. The tube is angled 55 degrees cranially. The head is then rotated 40 degrees away from the affected side. Centre midway between the EAM and the angle of the mouth on the affected side. PRAYER POSITION Lateral calcanei. Legs abducted and the planar surfaces of the feet placed together. Centre between the heels. Q QUESADA METHOD Projections of the clavicle. Patient prone. 1. Centre to the midpoint of the clavicle at an angle of 45 degrees caudal. 2. Centre to the midpoint of the clavicle at an angle of 45 degrees cephalad. Ref: Quesada, F (1926). Technique for the roentgen diagnosis of fractures of the clavicle, Surg. Gynecol. Obstet. 42:424-428. R REVERSE TOWNES Demonstrates the condyles, condylar heads and condylar hypo/hyperplasia. PA Townes ( half-axial skull) with 30 degree angulation. REVERSE WATERS Method (AP) facial bones. RHESE METHOD The routine PA oblique of the optic foramen Ref: K. Clarke. Positioning in Radiography, 10th ed. RIPPSTEIN METHOD Foreshortened view of the femurs and femoral neck. Requires a Rippstein leg support. Patient supine with the hips flexed 90 degrees and abducted 20 degrees. The legs are parallel in a Rippstein leg support. Vertical central ray centred to the symphysis pubis. Ref: Rippstein, J. (1955). On Assesment of the Neck of the Femur by Means of Two Xrays. Z. Orthop. 86; 345-360. RISSER METHOD Demonstrates both iliac crests and epiphysis. Patient supine. Centre to the iliac crests. Ref: Risser, J.C.(1958). The Iliac Apophysis: An invaluable sign in the management of scoliosis, Clin. Orthop. 11: 111-119. ROCHER AP Skull centred through orbits ROBERT'S VIEW True AP thumb. ROSENBERG METHOD 45 degree posteroanterior flexion weight-bearing view of the knee. Ref: Rosenburg T. et al. The Journal of Bone and Joint Surgery S SANSREGRET MODIFICATION OF CHAUSSE III METHOD Slight oblique projection of the petrosa and attic wall. Patient supine. Rotate the head 10 degrees away from the side of interest. Adjust the infraorbitomeatal line so that it is 30 degrees from the vertical. Centre to a point 2.5 cm medial to the EAM at the level of the upper orbital margin on the affected side. Ref: Sansgret, A.(1963), Technique for the study of the middle ear, A.J.R. 90:1156-1166. SCHNEIDER METHOD Demonstrates the upper contour of the femoral head. 1. Patient supine with the femour flexed 60 degrees. 2. Patient supine with the femour flexed 30 degrees. Vertical central ray centred to the hip joint. SCHULLER Lateral view of the petrous temporal region. SERENDIPITY VIEW View of the sterno-clavicular joints. Patient supine. Angle the horizontal central ray 40 degrees towards the head. Centre midway between the sterno-clavicular joints. SETTEGAST METHOD Tangential projection of the patella. Patient prone. Knee flexed to at least 90 degrees . Centre to the patellofemoral joint space. The degree of angle is dependent on the amount of knee flexion but should be 1520 degrees towards the joint space. SIMMONS VIEWS To demonstrate congenital talipes equinovarus. 1.AP of both feet with the x-ray tube angled 30 degrees to the hindfoot. 2.AP of each foot with the foot held in the position of fullest correction. The x-ray tube is angled 30 degrees to the hindfoot. 3.Lateral of each foot. The film is placed against the medial aspect of the foot and a horizontal beam is used. Ref: Simmons G.W (1977), Analytical radiographs of club foot. Journal of bone and joint surgery. 59B(4): 485-9. STAUNIG METHOD An inferosuperior projection of the pubic and ischial bones and symphysis pubis. Patient prone. Centre to the symphysis pubis with the central ray angled 35 degrees cephalad. See also Lilienfeld Method. STECHER METHODS Projections of the scaphoid. 1. PA wrist position with the cassette inclined by 20 degrees so that the hand is higher than the wrist. Centre to the scaphoid. Bridgeman view has the wrist in ulnar flexion. 2. PA wrist position with the forearm horizontal and the central ray angled 20 degrees towards the elbow. Similar projection to 1. 3. PA wrist position with the fist clenched. This position tends to widen the fracture line. Ref: Stecher, W.R. (1937). Roentgenography of the carpal navicular bone, A.J.R. 37:704705. STENVER Oblique view of the petrous temporal region. Ref: K. Clark, Positioning in Radiography, 11th Ed. STOCKHOLM C Similar to Stenver's view but designed for use with a skull unit. Head in the lateral position, with the centre of the bucky 2.5cm in front of the EAM and 1cm above the orbitimeatal line. The tube is angled 10 degrees towards the head, and 30 degrees towards the face. The grid must be rotated accordingly. Ref: Goldman and Cope. A Radiographic Index. Wright Publishing, Bristol.. STORK METHOD See Flamingo view. STRYKER'S VIEW Technique: - the patient is supine; - a cassette is placed under the involved shoulder - the palm of the hand of the affected extremity is placed on top of the head with the fingers toward the back of the head; - the beam is centered over the occur; - coracoid process and tilted 10 deg cephalad; Demonstrates defects in the posterolateral aspect of the humeral head Ref: K.Clarke. Positioning in Radiography. 11th Ed. SUPRASPINATUS OUTLET VIEW Modification of the scapular Y (transscapular) view. Demonstrates the anterior third of the acromion. Patient standing and position 30-40 degrees posterior obliquely or 40-60 degrees anteriorobliquely, and the horizontal central ray is angled 10-15 degrees caudally. Demonstrates Shoulder Impingment. SWANSON METHOD See Dunlop method. T TALAR NECK VIEW Foot view. Patient lies supine. The knee is flexed so that the sole of the foot is in contact with the cassette then internally rotate the foot by 15 degrees. The vertical central ray is angled 15 degrees towards and centred to the midfoot. TARRANT METHOD A method to demonstrate the clavicle projected above the thoracic cage. Patient sitting with the cassette on the lap. Central ray directed from behind the patient to the clavicle. The central ray is at right angles to the coronal plane of the clavicle. Ref: Tarrant, R.M. 91950). The axial view of the clavicle, X-ray Techn. 21:358-359. TAYLOR METHOD (MASTOID) SMV projection to demonstrate the mastoid processes,IAM ,EAM and inferior petrosal sinuses. Patient sitting, OM line vertical. Centre to the midline 2.5cm anterior to the level of the EAM at an upward angle of 20 degrees. Ref: Taylor, H.K. (1931). The roentgen findings in suppuration of the petrous apex, Ann Otol. Rhinol. Laryngol 40:367-395. TAYLOR METHOD (PELVIS) An inferosuperior projection of the pubic and ischial rami. Position as for AP pelvis. Centre 5cm distal to the upper border of the symphysis pubis with a 25 degree cephalad angulation (male) or a 40 degree cephalad angulation (female). TEMPLETON AND ZIM METHOD Superoinferior carpal tunnel projection. The forearm is placed at right angles to the cassette with the hand in contact with the cassette. Direct the vertical central ray through the carpal tunnel at an angle of 40 degrees towards the fingers. Ref: Templeton, A.W., and Zim, I.D.(1964). The carpal tunnel view, Mo. Med. 61:443444. See also Gaynor-Hart method. TEUFEL METHOD Acetabulum and femoral head margin including the fovea capitis. Patient in 35-40 degrees anterior oblique position. Centre 2.5cm superior to the level of the greater trochanter. Central ray angled 12 degrees cephalic. THOMS’ METHOD (AP, PELVIC INLET) Pelvimetry view. Requires the use of the Thoms’ positioning device (patient positioning platform with backrest). The patient is seated on the positioning device at an angle of 50 degrees. The backrest is then adjusted to bring the plane of the pelvic inlet parallel to the plane of the film. Abduct legs and place posterior indicator arm of device against the area of L4/L5. Anterior indicator arm is positioned between the legs against the pelvis, 1 cm below the symphysis pubis. Centre vertical central ray 6cm posterior to the symphysis pubis. THOMS’ METHOD (LATERAL) Pelvimetry view. Patient standing in the lateral position. Metal centimetre marked ruler is placed between the buttocks against the sacrum. Horizontal central ray directed to a point between the symphysis pubis and the depressed area located inferior to L5. TIEGE'S VIEW Trauma axillary view. Patient supine with the cassette above the shoulder. The forearm is brought across the chest and the horizontal central ray is centred to the shoulder joint. TILE See Pennal’s view. TITTERINGTON The routine OM 30 view. TOWNES The routine half-axial view of the skull. Ref: K.Clarke. Positioning in Radiography. 11th Ed. TUBEROSITY VIEW View of the elbow. Elbow AP, angle 20 degrees towards the olecranon. Various degrees of rotation are used. TWINNING METHOD Swimmer's view for C7/T1 U URIST'S VIEW View of the acetabular rim in profile. Patient supine, injured side elevated 60 degrees. See also Lequesne method. V VEIHWEGER METHOD Ulnar groove projection. Ref: Positioning in Radiography , K.Clarke, 11th ed. VALDINI Demonstrates the squamous portion of the occipital bone and the foramen magnum. Head in the PA position with the chin tucked in as far as possible and the frontal region resting on the film, with the radiographic base-line tilted 45-50 degrees downwards. Centre in the midline at the level of the EAM. Ref: Goldman and Cope. A Radiographic Index. Wright Publishing, Bristol.. VELPEAU VIEW Axillary lateral view of the shoulder. Patient stands with their back against the table and leads backwards. Centre the vertical central ray to the shoulder joint. Ref: Rockwood and Green's Fractures in Adults, Lippincott. VOGT BONE-FREE PROJECTIONS AP and lateral views of the eye using dental film. W WALLACE-HELLIER VIEW View of the shoulder. The patient sits with their back to the table and the affected shoulder is turned towards the table so that the blade of the scapula is parallel to the table side. The vertical central ray is angled 30 degrees towards the anterior aspect of the shoulder. Centre to the shoulder joint. Ref: Wallace H A and Hellier M, Improving radiographs of the injured shoulder, Radiography, 1983, 49, 229-233. WATERS The routine OM view of the sinuses. Ref: K.Clarke. Positioning in Radiography. 11th Ed. WEST POINT SHOULDER (WEST POINT AXILLARY LATERAL) Patient prone. Shoulder raised on a pad. Head turned away from affected side. Cassette against superior aspect of shoulder. Centre to the axilla. Angle 25 degrees downward from the horizontal and 25 degrees medially. This gives a tangential view of the anteroinferior rim of the glenoid. WIGBY-TAYLOR METHOD Open mouth oblique projection of the styloid process of the skull. Position the patient as for an AP skull then rotate the head 78 degrees to the affected side. Angle the central ray cranially 8 degrees and centre to the styloid process nearest the film. Both sides for comparison. WILLIAMS METHOD Projection to demonstrate the costovertebral and costotransverse joints. Patient supine. Angle the central ray 20 degrees cephalad and centre to the sixth thoracic vertebrae. WINDOW VIEW Demonstrates the kidneys during an IVP in an infant. Child positioned as for an AP abdomen. Angle the vertical central ray 35 degrees towards the feet. This projects the kidneys through the liver on the right and the stomach on the left. Ref: RADIOGRAPHY; XLV:538. WORMS AP skull 25 degree angle between OM baseline and central ray Y Y VIEW Axial shoulder or lateral scapula. Z ZANCA'S VIEW As for the routine view of the ACJ but with a 10-15 degree cephalic tilt of the x-ray beam. ZANELLI METHOD Projection to demonstrate the TMJs in the open and closed positions.Patient lateral with the head 30 degrees away from the vertical i.e. top of head against the cassette. Centre 2.5cm anterior to the EAM. ZIMMERS VIEW Transorbital TMJ view. Patient holds cassette behind TMJ. Mouth open wide. Position the tube at the outer canthus of the opposite eye and aim downwards and backwards across the orbit to the condyle under investigation. Ref: Eric Whaites , Essentials of Dental Radiography and Radiology Churchill Livingston. ZITER'S VIEW Scaphoid view. Wrist PA with ulnar deviation. Angle the tube 25 degrees up towards the elbow. Centre between the styloid processes. Ref: Radiography (1983), 49, 229-233. Adapted from a list by A.J.Watkins LLB(Hons), DCR(R), SRR, BSc(Hons), FGS