Radiography Protocols – Adult - Radiology Associates of the Fox

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Radiography Protocols
Page 1 of 6
Radiography Protocols – Adult
For pediatric protocols, refer to Page 4 “Radiography Protocols – Pediatric”.
For Bone Survey examinations, refer to Pages 5-6 “Radiography Protocols – Bone Survey”.
If you have a question regarding a radiography protocol, consult the radiologist on duty.
Page numbers are for Bontrager KL and Lampignano JP, Bontrager’s Handbook of
Radiographic Positioning, 8th Edition, Elsevier, 2014.
Views (as listed in Bontrager’s Handbook, 8th Ed)
Page
AP Abdomen (KUB)
272
and Erect AP Abdomen
273
AC joints
Acromioclavicular (AC) joints
97
Ankle
AP Ankle
118
and Lateral Ankle
122
and AP Mortise
120
Arm (Humerus) AP Humerus
67
routine
and Rotational Lateral Humerus
69
Arm (Humerus) AP Humerus
67
trauma
and Trauma Lateral Humerus
71
Bone Age
PA Hand (Left)
33
Cervical Spine – routine AP for C1-C2 (Odontoid)
174
and AP Axial for Cervical Spine
177
and Lateral Cervical Spine
180
and Obliques, Cervical Spine
178
Cervical Spine – Trauma Patient in hard collar & on backboard for Lateral, AP, and
Odontoid; once hard collar is removed complete series
taking Obliques, upright Lateral and Odontoid (if not
obtained earlier).
Chest
PA Chest
4
and Lateral Chest
5
Clavicle
AP and AP Axial Clavicle
92
Coccyx
AP Coccyx
202
Lateral Coccyx
205
Elbow
AP Elbow
54
and Oblique Elbow (Internal and External)
57
Lateral Elbow
59
Facial Bones
Facial Bones – PA (Caldwell)
242
and Parietoacanthial (Waters)
240
and Submentovertex (SMV) Skull
232
and Facial Bones – Lateral
238
Femur
AP Femur
150
Lateral Femur
151
Finger – Digits 2 - 5
PA Hand
33
and PA Oblique Finger
24
and Lateral Finger
26
Finger - Thumb
PA Hand
33
and AP Thumb
27
Examination
Abdomen Series
Document: “Radiography Protocols 11-26-15”, available at www.foxvalleyradiology.com
Radiography Protocols
Foot
Forearm
Hand
Hands – rheumatoid
Hip - routine
Hip - trauma
Knee – routine
Knee - Trauma
Leg (Tib/Fib)
Lumbar
Mandible
Mastoids
Nasal Bones
Orbits
(Sinuses + Rhese)
Pelvis
Patella
Ribs
Sacroiliac (SI) Joints
Sacrum
Page 2 of 6
and Lateral Thumb
AP Foot
and AP Oblique Foot
and Lateral Foot
AP Forearm
Lateral Forearm
PA Hand
and PA Oblique Hand
and Lateral Hand (“fan” fingers)
PA Hand (Bilateral)
and Bilateral Oblique (Norgaard Method)
AP Pelvis
and Lateral Hip (Nontrauma)
AP Pelvis
and Lateral Hip (Trauma method)
AP Knee
and Lateral Knee
AP Knee
and Lateral Knee (Cross-table) (Rotate in PACS)
and AP Oblique Knee (Medial and Lateral)
AP Leg (Tibia-Fibula)
and Lateral Leg (Tibia-Fibula)
AP (PA) Lumbar Spine
and Lateral Lumbar Spine
and Lateral L5-S1 Lumbar Spine
Mandible – PA
and AP Towne (include mandible)
and Mandible – axiolateral obliques
OR Panorex only (if available)
No routine radiographs (perform CT)
Facial Bones – Parietoacanthial (Waters)
and Nasal Bones - Lateral
PA Paranasal Sinuses (Caldwell)
and Paranasal Sinuses (Waters)
and Lateral Paranasal Sinuses
and Optic Foramina (Rhese)
AP Pelvis
PA Patella
Lateral Patella
Patella – Tangential Projection (Settegast)
AP or PA Ribs – Above Diaphragm
and AP Ribs – Below Diaphragm
and Anterior Oblique Ribs – PA
and Posterior Oblique Ribs - AP
Sacroiliac Joints AP Axial
and Sacroiliac Joints Posterior Obliques (Bilateral)
AP Sacrum
Document: “Radiography Protocols 11-26-15”, available at www.foxvalleyradiology.com
30
108
109
111
51
52
33
35
36
33
38
162
157
162
160
128
131
128
129
125
126
190
192
193
253
226
255
240
250
263
264
261
245
162
137
138
141
217
218
220
221
207
208
201
Radiography Protocols
Scapula
Scoliosis
Shoulder - routine
Shoulder - trauma
Shunt Series
Sinuses
Skull
Soft Tissue Neck
Stent Graft Series
Sternoclavicular joints
Sternum
Thigh (femur)
TMJ
Thoracic/Dorsal Spine
Toes
Wrist - routine
Wrist – Scaphoid
Zygomatic Arches
Page 3 of 6
and Lateral Sacrum (and Coccyx)
AP Scapula
and Lateral Scapula
Scoliosis Series AP Ferguson
AP Shoulder [external rotation]
and Posterior Oblique (Grashey)
and Inferosuperior Axial
AP Shoulder [internal rotation]
and Posterior Oblique (Grashey)
and Lateral Shoulder Trauma Projection
AP Towne (Skull)
and Lateral Skull
and PA Chest (overlap exposure with skull)
and AP Abdomen (overlap exposure with chest)
PA Paranasal Sinuses (Caldwell)
and Parietoacanthial (Waters)
and Lateral Paranasal Sinuses
AP Towne
and Lateral Skull (bilateral)
and PA Skull (Caldwell)
and Parietoacanthial (Waters)
AP Neck
and Lateral Neck
AP Abdomen (KUB)
and Abdomen Dorsal Decubitus (Lateral)
and Bilateral 30 Oblique Abdomen
No routine radiographs (perform CT)
Oblique Sternum
and Lateral Sternum
AP thigh
Lateral thigh
Bilateral tomographs with mouth open & closed
AP Thoracic Spine
and Lateral Thoracic Spine
and Lateral Cervicothoracic Spine (Swimmer’s)
AP Toes
and AP Oblique Toes
and Lateral Toes
PA Wrist
and PA Oblique Wrist
and Lateral Wrist
and [for trauma] PA Wrist – Ulnar Deviation
PA Axial Scaphoid (15° and 25° CR Angles)
Facial Bones – PA (Caldwell)
and Facial Bones – Parietoacanthial (Waters)
and Bilateral Zygomatic Arches – AP Axial
and Zygomatic Arches – Bilateral (SMV projection)
Document: “Radiography Protocols 11-26-15”, available at www.foxvalleyradiology.com
204
94
95
197
73
81
75
73
81
88
226
228
4
272
263
264
261
226
228
230
240
272
276
212
213
150
151
186
187
181
102
103
105
40
41
43
45
46
242
240
249
246
Radiography Protocols
Page 4 of 6
Radiography Protocols – Pediatric
For any exams not listed here, refer to Pages 1-3 “Radiography Protocols – Adult”.
For Bone Survey examinations, refer Pages 5-6 “Radiography Protocols – Bone Survey” below.
If you have a question regarding a pediatric protocol, consult with the radiologist on duty.
Radiographic
Routines
Name
Abdomen
Series –
routine
survey
Abdomen
Series –
acute
abdomen
Abdomen
Series –
patient can
stand
Abdomen for
imperforate
anus
Bone age
Cervical
Spine
Follow Pediatric Protocol until age:
Bontrager’s Handbook
Description
Page
0 – 6 months
AP Pediatric Abdomen (KUB)
278
0-3 years
AP Pediatric Abdomen (KUB)
and Left Lateral Decubitus
Abdomen
278
275
3 – 16 years
AP Pediatric Abdomen (KUB)
and AP Erect Pediatric Abdomen
278
279
Newborn
Cross-table prone abdomen;
mark anal dimple with nipple
marker
PA Left Hand
AP pediatric lower limb
AP for C1-C2 (Odontoid)
and AP Axial for Cervical Spine
and Lateral Cervical Spine
AP Pediatric Chest
and Lateral Pediatric Chest
Pediatric AP Upper Limb
and Pediatric Lateral Upper Limb
Pediatric AP and Lateral Hips
Pediatric AP Lower Limb
and Pediatric Lateral Lower Limb
AP (PA) Lumbar Spine
and Lateral Lumbar Spine
and Lateral L5-S1 Lumbar Spine
PA Caldwell
and Lateral Skull
33
144
174
177
180
15
17
63
64
170
144
145
190
192
193
230
228
6 months and over
Less than 6 months
13
Chest
3 years
Elbow
0-2 years
Hips/Pelvis
Knee
0 – 2 years
0 – 2 years
Lumbar
spine
Add cone-down at age 13
Skull
0-3 years
Document: “Radiography Protocols 11-26-15”, available at www.foxvalleyradiology.com
Radiography Protocols
Page 5 of 6
Radiography Protocols - Bone Surveys
Examination
Bone Survey - Adult
Bone Survey – Pediatric
Initial Non-Accidental
Trauma: 31 images
Bone Survey – Pediatric
Follow-up NonAccidental Trauma: 17
images
Views (as listed in Bontrager’s Handbook)
Bilateral AP Ribs
Bilateral AP Shoulders
Bilateral AP Humeri
and Bilateral AP Femurs
and AP Pelvis
and AP Towne Skull
and Lateral Skull
and AP Thoracic Spine
and Lateral Thoracic Spine
and AP Lumbar Spine
and Lateral Lumber Spine
and Lateral Cervical Spine
Skull- 4 views
Ribs- AP and both oblique views
Right PA hand
Left PA hand
T spine- AP and lateral
L spine- AP and lateral
AP feet
AP knees
AP ankles
AP Elbows
AP wrists
Right humerus
Left humerus
Right forearm
Left forearm
Right femur
Left femur
Right tib/fib
Left tib/fib
Ribs AP
PA both hands
T-spine AP and lateral
L-spine AP and lateral
AP both feet
Right humerus
Left humerus
Right forearm
Left forearm
Right femur
Left femur
Right tib/fib
Left tib/fib
Page
217
73
67
150
162
226
228
186
187
190
192
180
Document: “Radiography Protocols 11-26-15”, available at www.foxvalleyradiology.com
Radiography Protocols
Bone Survey – Pediatric
Generic Study
(metabolic, neoplastic
issues): 20 images
Page 6 of 6
Skull- 4 views
PA both hands
T-spine AP and lateral
L-spine AP and lateral
AP both feet
Right humerus
Left humerus
Right forearm
Left forearm
Right femur
Left femur
Right tib/fib
Left tib/fib
Document: “Radiography Protocols 11-26-15”, available at www.foxvalleyradiology.com
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