Facial bones (reverse Waters)

Last revised by Andrew Murphy on 23 Mar 2023

The reverse Waters view is a modified alternative to the Waters view. However, skull radiographs are rapidly becoming obsolete in general, being replaced by much more sensitive CT scans.

  • the patient is supine
  • the mid-sagittal plane is perpendicular to the image receptor 
  • acanthioparietal projection
  • centering point
    • acanthion
    • central beam angled 30° cephalad to be running parallel to the mentomeatal line
  • collimation
    • superior to the skin margins
    • inferior to include the most inferior aspects of the skull
    • lateral to include the skin margin
  • orientation  
    • portrait
  • detector size
    • 24 cm x 30 cm
  • exposure
    • 75-80 kVp
    • 20-25 mAs
  • SID
    • 100 cm
  • grid
    • yes (this can vary departmentally)
  • orbits are magnified 
  • petrous ridges are projected below the maxillary sinus 
  • learn your skull positioning lines, it makes for reading position guides a lot easier
  • this projection results in distorted anatomy and should hence only be used on patients unable to stand up

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