Rob Trager. Lower Extremity:
X-Ray view
AP Pelvis
technique
position, collimation
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), inletoutlet (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 ♀
clinical
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 (campcoventry 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
65kVp, 40” FFD.
8x10” film. Grid?
use 600 sped
film/screen combo.
Table top? 100
speed cassette
(extremity). 10° tilt
cephalad optional
Tangential (skyline,
sunrise, sunset,
patellofemoral joint,
settegast)
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)
Medial Oblique
Ankle
(Mortise view)
Lateral Ankle
Dorsoplantar
(AP) Foot
Foot series:
Dorsoplantar,
everted oblique,
lateral (complete,
≥3 views)
Medial Oblique
Foot (internal
oblique)
Lateral Foot
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
55 kVp. 40” FFD.
10x12” film.M: CR:
midway btw.
medial/lateral
malleolus..
Dorsiflex ankle
slightly, internally
rotate leg.
55 kVp. 40”FFD.
8x10” (V) film. M:
thru malleoli. CR:
medial malleolus.
lateral surface of
ankle contacts film,
dorsiflex foot
slightly
55 kVp. 40” FFD.
10x12” film. M:
through
tarsometatarsal
junction @ base of
3rd metatarsal. CR:
base of 3rd
metatarsal. 15°
cephalic tilt.
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
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
Lateral Elbow
Tangential (Jones)
Elbow (axial, acute
flexion, inferior-tosuperior)
60 kVp, 40”FFD,
10x12” film. elbow
fully extended, arm
& forearm parallel
to film.
pronated oblique:
pronate the forearm.
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
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 (dorsalpalmar 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