Radiographic Positioning Guide for Radiologic Technologists

This is the continuation of the positioning guides that have been pending for posting months ago… This second part are positioning Methods starting from letters D – J.

D

  • DANELIUS-MILLER METHOD – Routine horizontal beam view of the hip.
  • 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 – See Le Quesne method.
  • FEIST-MANKIN METHOD – See Isherwood method.
  • FERGUSON’S VIEWV – iew 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 ramiRef: 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 METHODSkyline 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 casesCentre 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) – 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.
  • 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 viewPatient 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 VIEWView 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.
    HUGHSTONPatella view.Ref:: Hughston (1968). Subluxation of the Patella, J. Bone and Joint Surg., 50-A:1003-26.

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 end-on 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.

For now, we’ll end up here. Watch out soon for my post on the continuation of this alphabetical positioning guide.

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One Response to “Radiographic Positioning Guide for Radiologic Technologists”

  • Juan Carlos Eraso says:

    Hi,

    Just proud to see my dad’s technique/method on your site (Eraso Method). He loved to teach in the local university in Colombia; and would be glad to see that his method is still relevant after so many years in a fast moving, technological environment.

    I’m not in the medical field, but can tell the method you describe is as he explained it to me ….in very simple terms.

    Regards,

    Juan

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