Abdomen (PA prone view)
The PA prone radiograph is rarely performed and is often utilized when a patient is unable to lay supine. The projection is adequate for the examination of the abdominal cavity, however, not as practical for the renal structures due to magnification.
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Indications
This view is useful in visualizing bowel obstruction, neoplasms, calcifications, ascites and as scout images in contrast medium studies of the abdomen (i.e. intravenous urography).
It is not ideal if the kidneys are the primary interest as there is magnification from an increased object to image distance.
Patient position
- the patient is prone, either on the x-ray table (preferred) or on a trolley
- patients should be changed into a hospital gown, with radiopaque items (e.g. belts, zippers) removed
- the patient should be free from rotation; both shoulders and hips equidistant from the table/trolley
- the x-ray is taken in full inspiration
Technical factors
- PA projection
-
centering point
- the midsagittal place (equidistant from each PSIS) at the level of the iliac crest
-
collimation
- laterally to the lateral abdominal wall
- superior to the diaphragm
- inferior to the inferior pubic rami
-
orientation
- portrait
-
detector size
- 35 cm x 43 cm
-
exposure
- 70-80 kVp
- 30-120 mAs; AEC should be used if available
-
SID
- 100 cm
-
grid
- yes
Image technical evaluation
- lateral abdominal wall should be included
- inferior pubic rami should be included inferiorly
- if possible, the diaphragm should be included superiorly
- the abdomen should be free from rotation with a symmetry of the:
- ribs (superior)
- iliac crests (middle)
- obturator foramen (inferior)
- no blurring of the bowel gas due to respiratory motion
Practical points
For larger patients, it may be necessary to perform two x-rays using a landscape orientation of the detector to include the entire abdomen.
Exposure will need to be adjusted according to an imaging system (CR or DR) and patient size. Where possible mAs should be manipulated to ensure adequate image density and appropriate image contrast.
Ensure the patient has adequate head space to breath and hear instructions.
Related Radiopaedia articles
Radiographic views
- imaging in practice
- paediatric radiography
- general radiography (adult)
- shunt series
- chest radiography
- abdominal radiography
-
upper limb radiography
-
shoulder girdle radiography
- scapula series
-
shoulder series
- AP view
- internal rotation view
- external rotation view
- superoinferior axial view
- inferosuperior axial view
- modified trauma axial
- supine lateral
- modified supine lateral
- Y lateral view
- AP glenoid view (Grashey view)
- apical oblique view (Garth view)
- humerus (neck) AP view
- humerus axial (bicipital groove) view (Fisk view)
- outlet view (Neer view)
- Stryker notch view
- acromioclavicular joint series
- clavicle series
- sternoclavicular joint series
- arm and forearm radiography
- wrist and hand radiography
-
shoulder girdle radiography
-
lower limb radiography
- pelvic girdle radiography
- thigh and leg radiography
- ankle and foot radiography
- skull radiography
-
paranasal sinuses and facial bones radiography
- facial bones
- Caldwell view (angled skull PA view)
- nasal bones
- zygomatic arches
- orbits
- paranasal sinuses
- temporal bones
- dental radiography
- orthopantomography (OPG)
- mandible
- temporomandibular joints
- spine radiography