I have listed below the:

Guidelines in the Proper Use of Lead Markers in Radiographic Examinations 

1. Left or right markers must always be used in all films.
2. Markers should be placed on the cassette where they will be clearly seen on the radiograph but not obscuring the required anatomy.

a. Markers should not be placed over the patient’s identification number
b. Markers should be placed within the collimated film.
c. Markers should be placed away from the area where lead shielding on the px or the table may obscure the markers.

3. Markers should be placed appropriately to identify the px’s right or left side.
4. When the extremities and heart or shoulder girdles are being radiographed, markers should be placed on the lateral side of the body part.
5. When one film is being used for two projections of the same body parts, only one of the projections must be marked.
6. If bilateral projections are positioned in one film both left and right markers should be used to identify the corresponding sides.
7. Auxiliary markers should be used whenever possible and positioned away from the critical anatomy.
8. When lateral decubitus projections are performed, a marker indicating the side-up should be place on the upside of the cassette away from any anatomy of interest.
9. For lateral projection, a marker indicating the side closest to the film should be used.
10. When the spine is being radiograph in the lateral position, markers should be placed on the cassette anterior to the spine to be clearly visualized.
11. When the chest, abdomen or spine is being radiograph in an oblique position, the side nearest the film is generally marked. So when both sides are on the film, either marker can be used.

NOTE: The lead marker may also be used to identify the anatomical structures seen on the projection.

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.

The same as Hermodsson’s view but with internal rotation increased from 70 degrees to 100 degrees.
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 sit with the back of head against the skull table. Upper border of the skull table angled backward 15 degrees . Position the patient’s 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

Watch out for more live demos of radiographic positioning.

Inferosuperior (intraoral) Projection
• Place the arms in a comfortable position and adjust the shoulders to lie in the same transverse plane.
• Fully extend the neck, rest the head on the vertex, and adjust it so that the midsagittal plane is vertical.
• Central ray is directed perpendicular to the plane of the film packet and center it to the intersection of the midsagittal plane and a coronal plane passing through the second molars.
• Structure shown; floor of the mouth,lower dental arch and portion of the mandibular body which it supports is demonstrated.
• Evaluation criteria; all of the lower teeth should be demonstrated so that the mandibular body will be almost entirely included. Distance between the teeth and the outer border of the mandible symmetrically in both sides.

MANDIBULAR SYMPHYSIS

AP Axial (intraoral) Position
• Patient is placed in supine position.
• Rest the patient’s head on the occiput, with the midsagittal plane is vertical adjust the flexion of the neck so that the occlusal plane is vertical. Immobilize the head. Central ray is directed to the tip of the chin at an angle of 55 degrees cephalad.
• Patient is in erect position. Central ray is directed horizontally to the tip of the chin.
• Structure shown; an oblique position of the region of the mandibular symphysis, showing the alveolar process, the incisors, and the canine teeth, is shown.
• Evaluation criteria; mandibular symphysis should be demonstrated without self superimposition. Mandible should not be rotated.

Below are the directional terms used in radiographic positioning:

• Anterior or Ventral – front or forward aspect of the body or body part.
• Posterior or Dorsal – backward part of the body.
• Medial or Mesial – towards the median plane or middle part of the body.  Example: Spine is medial to the kidney.
• Lateral – refers to the position away to the median plane or middle part of the body. It is the opposite of medial position. Ex: kidneys are lateral to the spine.
• Proximal – parts close to the point of origin or attachment.
  Ex: elbow is proximal to the wrist.
• Distal – parts furthest to the point of origin.
  Ex: fingers are distal to the wrist.
• Cephalad – termed as cephalic, cranial or superior.
  - Pertaining to or towards the head.
• Caudal – termed as inferior.
  - Away from the head or towards the tail or feet.

1. Merchant Bilateral
2. Settegast Method
3. Kuchendurf Method- oblique axial (PA)
4. Hughston method
5. Beclere method

For intercondylar fossa:

1. Camp- Coventry method
2. Homblad method
3. Kuchendurf Method

Kuchendurf Method – CR 25- 30°C caudad, enters posterior of patella, knee slightly turned laterally, patella is free of superimposed structures.
Holmblad Method- 3 possible positions
1. Standing with the knee of interest and resting on a stool at the table side.
2. Standing with the affected knee flexed and place in contact with front of the casette.
3. Kneeling on table with the affected knee on the cassette at the table.
4. Kneeling on table with affected knee on cassette at the table.
*Knee is flexed 70 degrees from full extension.
*Widens the joint spaces between femur and tibia.

Camp Coventry – CR<40 degrees if knee is <40 degrees, CR 50 degrees, if knee is <50 degrees.

Read them below:

1. All radiographic examinations of the vertebral column include AP and lateral projections; oblique projections may be required or optional
2. The spine should be parallel with the long axis of the cassette for most projections
3. Instability of the injured cervical spine is a significant factor with respect to patient care and positioning
4. The cross-table lateral cervical spine is the initial projection obtained following trauma
5. Hyperflexion/hyperextension studies of the cervical and lumbar spine may be performed to evzluate AP mobility or potential instability as a result of injury, surgery or disease
6. A scoliosis series is performed to evaluate lateral curvature of the vertebral column; the PA projections is preferred to the AP to minimize dose to the radiosensitive breast
7. To minimize magnification, a 72 inches SID should be used for lateral and oblique cervical spine and scoliosis films
8. Although breathing instructions vary according to the area of interest, in general, the lateral cervical and all lumbar spine projections are obtained during suspended expiration; the thoracic projections may be obtained during shallow breathing
9. The kVp used for the vertebral column ranges from 60 to 100, depending on the AOI and paitne tposition
10. Although all other projections of the vertebral column should be obtained using a grid, the oblique and lateral cervical spine projections may be obtained without a grid due to increased OID which result to an air-gap technique
11. The anode-heel effect and compensating filters may be used to produce a more uniform density for thoracic spine and scoliosis studies.

• 2^nd – 5^th finger- with three phalanges (proximal, middle and distal)
• Thumb- with two phalanges (proximal and distal)

B. Hand

• Five metacarpal bones (base and head)

C. Wrist (Carpals)

Carpal bones (8)

Proximal Row (Lateral to Medial)

• Navicular/ Scaphoid
• Lunate/ Semilunar
• Triangular/ triquetrium/ triquetral
• Pisiform

Distal Row (Lateral to Medial)

• Greater Multangular/ trapezium
• Lesser Multangular/ trapezeus
• Capitate/ Os magnum/ Capitatum
• Hamate/ Unciform

Other Terms

Pollex- another term for thumb

Ungulate Process of tuft- supports fingernails

Description of each carpal bone

Pisiform- smallest carpal bone, pear- shaped

Capitate- the largest carpal bone, shaped like a head

Scaphoid- most commonly fractured carpal bone, boat- shaped

Lunate- crescent- shaped (half- moon)

Triquetrium- triangular- shaped

Trapezoid- similar to trapezium but smaller

Trapezium- four- sided bone

Hamate- hook- shaped