AP side down PA side up
Caldwell Sinus Projection Film This view will provide a clear view of the frontal and ethmoid sinuses. The super orbital rims can be evaluated for fracture when facial bone are of interest. To project the petrous ridges farther down, increase angle to 30 degrees
Sinus Lateral Lateral – External auditory meatus externally and mandible inferiorly with supracillary arch superiorly in view. CR centered to zygoma, midway between outer canthus and EAM Midsagittal plane is parallel to IR IPL is perpendicular to IR
Lateral Sinus Anatomy
Positioning: Waters Prone or seated upright Chin on bucky -OML 37 angle with plane of cassette Mentomeatal line should be perpendicular to film with mouth closed. Nose 3/4 inch from IR Suspend respiration CR perpendicular to exit acanthion
Waters Radiograph Distance from lateral border of skull and orbit equal on each side Petrous ridges projected immediately below maxillary sinuses
Modified Parietoacanthial (Modified Waters) OML 55 degrees to the IR Chin and nose on table Petrous pyramids are seen mid-maxillary sinus CR exits acanthion Blowout Fractures See pg. 355 (Merrill’s 12th Edition)
Modified Waters Radiograph Petrous ridges projected immediately below the inferior border of the orbits Equal distance from lateral orbit to lateral skull on both sides
Reverse Waters Supine Extend neck so OML is 37 degree with plane of IR MML perp Suspend respiration CR perpendicular and enters acanthion
Lateral Nasal Bones Semiprone IPL perpendicular CR perpendicular to the bridge of nose at a point ½ inch distal to the nasion
Bilateral Arches - SMV IOML parallel to IR and perpendicular to CR CR midsaggital and collimate to outer edges of zygoma
Oblique Tangential Same position as SMV except head tilt 15 degrees toward side of interest (Merrill’s p. 362 12 ed)
Esophagus RAO Left side elevated 35-40 degrees Center at T-5 or T-6
Stomach PA Center at pylorus L2 (midway between xiphoid and umbilicus) Expiration RAO L side elevated 40-70 degrees Between vertebrae and elevated surface Center at duodenal bulb Lateral Recumbant (R lateral), Erect (L lateral) Between axilla and anterior surface Center at pylorus
Small Bowel Central ray at iliac crest (or slightly above for early exposures)
Colon PA or AP PA Axial (may be done AP) Bilat Obliques Center at iliac crest PA Axial (may be done AP) Prone Center @ iliac crest CR 30-40 degrees caudad Sigmoid Colon Smaller IR; CR enters @ ASIS Bilat Obliques Lateral Decubitus Lateral Rectum Enter at ASIS
Intravenous Urography KUB Obliques Rotated 30 degrees – kidney farthest from IR is parallel; kiney closest is perpendicular to film AP Bladder CR at ASIS
Cystography AP Axial Oblique PA Bladder Lateral 10-15 degrees caudal CR 2-3 in above pubic syphysis Oblique 40-60 degrees PA Bladder CR 1 in distal to tip of coccyx 10-15 degree cephalad angle Lateral