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Off focus radiation

During x-ray generation, off-focus radiation refers to the emission of x-ray photons which originate outside of the anode focal spot. Essentially a form of scatter, photons produced in this manner may result in blurring and are of no use for diagnostic purposes. They are shielded as much as poss...

Facial bones (reverse Waters)

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. Indications trauma facial fractures acute sinusitis Patient position the patient is supin...

Cervical spine series

The cervical spine series is a set of radiographs taken to investigate the bony structures of the cervical spine, albeit commonly replaced by the CT, the cervical spine series is an essential trauma radiograph for all radiographers to understand. Indications Cervical spine radiographs are indi...

Elbow (acute flexion AP)

The elbow acute flexion AP is a modified elbow AP projection for patients who cannot straighten their arm for examination. It is comprised of two views demonstrating the distal humerus and proximal forearm structures. Indications This is a modified projection (chosen by the radiographer when ...

Elbow (internal oblique view)

The elbow internal oblique view is a specialized projection, utilized to demonstrate both the coronoid process in profile and the olecranon process sitting within the olecranon fossa of the humerus. The affected limb is pronated. Indications The medial oblique view is not a standard projection...

Pediatric hip (abduction-internal rotation view)

The abduction-internal rotation view (AIR view), also known as the Von Rosen view, is a radiographic projection of the hip demonstrating the relationship between the femoral head and the acetabulum. Indications The von Rosen view is used in the diagnosis of developmental dysplasia of the hip i...

Densitometric vertebral fracture assessment

Densitometric vertebral fracture assessment (VFA) is an image of the lumbar and thoracic spine acquired on dual energy x-ray absorptiometry (DXA) scanners, for the purpose of diagnosing osteoporotic vertebral fractures. Terminology The technique is available on DXA scanners under a variety of...

Paranasal sinuses and facial bones radiography

Paranasal sinuses and facial bones radiography is the radiological investigation of the facial bones and paranasal sinuses. Plain radiography of the facial bones is still often used in the setting of trauma, postoperative assessments and dental radiography.

Skull radiography

Skull radiography is the radiological investigation of the skull vault and associated bony structures. Seldom requested in modern medicine, plain radiography of the skull is often the last resort in trauma imaging in the absence of a CT. Indications Skull radiographs are indicated for a variet...

Systematic radiographic technical evaluation (mnemonic)

Systematic radiographic technical evaluation is an important aspect to evaluative, effective radiography. It is the process of assessing a radiographic image to ensure it meets a high level of diagnostic standard. Two mnemonics are commonly used when assessing a radiographic image: PACEMAN ...

Double contrast barium enema technique

Double contrast barium enema (DCBE) technique is a method of imaging the colon with fluoroscopy. "Double contrast" refers to imaging with the positive contrast of barium sulfate contrast medium (rarely water-soluble iodinated contrast) as well as with the negative contrast of gas (CO2 preferable...

Cervical spine (flexion and extension views)

The cervical spine flexion and extension views demonstrate the seven vertebrae of the cervical spine when the patient is in a lateral position. Indications These views are specialized projections often requested to assess for spinal stability. Note, such functional views should not be perform...

Cervical spine (lateral view)

Cervical spine lateral view is a lateral projection of the cervical spine. As technology advances, computed tomography (CT) has replaced this projection, yet there remain many institutions (especially in rural areas) where CT is not readily available. Indications This projection helps to vis...

Cervical spine (odontoid view)

The odontoid or 'peg' projection, also known as the open mouth AP projection (or radiograph), is an AP projection of C1 (atlas) and C2 (axis) with the patient's mouth open. Indications This view focuses primarily on the odontoid process of C2, and is useful in visualizing odontoid and Jefferso...

Hip (AP view)

The AP hip is part of a radiographic series examining the anatomy of the hip joint and proximal femur. Indications This view helps to visualize any potential fractures, dislocations, bone lesions or degenerative diseases to the hip joint. It is also often requested in post-operative examinatio...

Knee (Beclere method intercondylar view)

The Béclere method intercondylar view is an additional projection of the knee, used to better examine the tibial plateau and femoral intercondylar spaces 1. It is anecdotally known as a 'notch view'. Indication The commonest indications for this additional knee view is for the assessment of a ...

Knee (oblique view)

The knee oblique view is an additional projection requested to examine the knee joint in greater detail, often in the absence of a CT scanner. The view is comprised of both an internal and external oblique. Indications The internal and external oblique views of the knee can showcase pathology ...

Toes (sesamoid view)

The sesamoid view of the toes is a specialized view examining the sesamoid bones of the first metatarsal. Indications This view provides a better profile of any fractures or dislocation of the sesamoid bones with their articulation at the first metatarsophalangeal joint 1. Patient position ...

Bone age (radiograph)

The bone age radiograph of the hand and wrist is a commonly performed examination to determine the radiographic age of the patient via the assessment of growth centers. Indications Bone age radiographs may be indicated for both clinical and non-clinical purposes 6,7: for the investigation ...

Wrist (radial deviation view)

The wrist PA radial deviation view is specialized projection employed to better demonstrate the carpal bones that lay on the ulnar aspect of the wrist. Indications Suspected abnormality at the ulnar aspect of the wrist, or in conjunction with a PA and ulnar deviation view to assess carpal move...

Radiographic distortion

Several factors contribute to radiographic distortion whereby the anatomy examined is misrepresenting on the plain radiograph. X-ray beam The x-ray beam originates from a point source within the x-ray tube. It is due to this point source nature that x-ray beams will all possess 'beam diverge...

Radiographic contrast

Radiographic contrast is the density difference between neighboring regions on a plain radiograph. High radiographic contrast is observed in radiographs where density differences are notably distinguished (black to white). Low radiographic contrast is seen on radiographic images where adjacent r...

Scoliosis (lateral bending view)

Scoliosis lateral bending views are additional scoliosis projections accompanying the standard PA/AP and lateral views. Indications The aim of this view is to assess patients' lateral range of spinal motion 1 in the vertebral column as part of a scoliosis series. Patient position patient er...

Scoliosis (erect lateral view)

The scoliosis erect lateral view is performed to visualize the thoracic and lumbar vertebrae of interest in profile. Indications This projection is done in cases of scoliosis and often done upon first presentation as a useful examination in identifying spondylolisthesis and the degree of kyph...

Scoliosis (PA/AP view)

The scoliosis posteroanterior/anteroposterior (PA/AP) view allows for visualizing the thoracic and lumbar vertebral bodies of interest. Indications This projection is used in determining scoliosis in patients and allows for the severity of lateral spinal curvature to be assessed 1. Patient po...

Scoliosis radiography

Scoliosis radiography is useful in identifying the degree of the scoliosis curvature (major/minor or primary/compensatory curves), as well as observing progression to determine the best treatment method 1. Indications Scoliosis radiographs are performed specifically when the disease is suspe...

Orthogonal projection

The orthogonal projection or view is, by definition, a radiographic projection obtained 90° from the original view. It forms the basic requirements of a 'radiographic series', having 'two orthogonal projections of the region of interest'. The importance of two views has been known for many years...

Lumbar spine (flexion and extension views)

The lumbar spine flexion and extension views images the lumbar spine which consists of five vertebrae. Indications These views are specialized projections to provide functional tests 1 of lumbar spine instability, often in the context of spondylolisthesis. Patient position the patient is ...

Schuss view

Schuss views are PA weight-bearing knee radiographs taken in 30 degrees of flexion. They are a variant of the Rosenberg view. Several studies have shown them to be more sensitive to detect early knee osteoarthritis than standard extension AP views 1.

Knee (Rosenberg view)

The Rosenberg view of the knees is a specialized projection often used to detect early signs of osteoarthritis. It should be the initial study for any patient with a suspicion of knee osteoarthritis. Indications The Rosenberg view is performed for any patient with a suspicion of knee osteoarth...

Cervical spine alignment

When assessing cervical spine alignment, look for four parallel lines connecting structures in the cervical spine: anterior vertebral line: anterior margin of the vertebral bodies posterior vertebral line: posterior margin of the vertebral bodies (also known as George's line) spi...

Radiographer abnormality detection system

The radiographer abnormality detection system, otherwise known as the red dot system, is a system that was first trialled during 1981 in London, United Kingdom at the Ealing Hospital, and soon after at Northwick Park Hospital. The results of the trial were reported in 1985 1. Radiographers commu...

Elbow (external oblique view)

The elbow external oblique view is an additional projection of the elbow often used to better demonstrate the radial head free from superposition. Indications This external oblique view is an additional projection often used to separate the proximal radius from the ulna for closer inspection o...

Pelvis (flamingo view)

The flamingo view series of the pelvis is a specialized orthopedic series consisting of three separate pelvis projections consisting of a nuertal, left foot raised and right foot raised view. Indications It is used for assessing instability of the pubic symphysis, often in the context of previ...

Dacryocystography

Dacryocystography (DCG) is a fluoroscopic contrast examination of the nasolacrimal apparatus. The nasolacrimal duct is cannulated enabling iodinated contrast to be instilled into the nasolacrimal system. Indications The most frequent indication is epiphora: excessive tearing or watering of the...

Sternoclavicular joint (serendipity view)

The serendipity view is a specialized radiographic projection utilized in the setting of suspect dislocations of the sternoclavicular joint. The projection is seldom used in departments with functioning computed tomography, but still utilized in postoperative imaging. Indications The serendipi...

Sternoclavicular joint (anterior oblique views)

The anterior oblique projections of the sternoclavicular joints are complimentary to the front on PA view in the sternoclavicular joint series The side of obliquity pertains to the joint of interest i.e. RAO to assess the right sternoclavicular joint. However, this projection is often performed...

Sternoclavicular joint (PA view)

The sternoclavicular PA view is part of the plain radiographic series assessing the sternoclavicular joint. The projection produces a bilateral view of the sternoclavicular joints in the posteroanterior plane. Indications The PA view of the sternoclavicular joint is often requested in the con...

Scapula (AP view)

The scapula AP view is a specialized projection of the scapular bone, performed in conjunction with the lateral scapular view. This projection can be performed erect or supine, involving 90-degree abduction of the affected arm. Indications This view is rarely requested due to the accessibility...

Scapula series

The scapula series is the plain radiographic assessment of the scapular bone of the shoulder girdle, seldom used in departments with 24 hour computed tomography departments. Many radiographic departments, do not have a stand alone scapula series, rather include the assessment of the scapula in ...

Grid cutoff

Grid cutoff is an unwanted absorption of x-rays via an x-ray grid, observed when a grid is employed incorrectly, most often seen with parallel grids. The term cutoff stems from the phenomenon in which the primary x-ray beam is 'cut off' by grid lines, leading to an overall decrease in optical de...

Triple-rule-out CT

Triple-rule-out CT (TRO CT) angiography may be ordered in the setting of acute chest pain to examine the thoracic aorta and the coronary and pulmonary arteries. The protocol helps exclude life-threatening causes of acute chest pain, especially if atypical, or if alternative causes to acute coron...

Shoulder (Stryker notch view)

The Stryker notch view is a specialized projection of the shoulder, aimed at assessing the posterior humerus. Indications The Stryker notch view can be used post anterior glenohumeral dislocation, assessing for Hill-Sachs defects 1. Patient position the patient is preferably erect the ...

Shoulder (Garth view)

The apical oblique projection or the Garth view of the shoulder is the tangential projection of the shoulder used in trauma 4. Indications The view is best for evaluating the glenohumeral joint for dislocations and trauma to the glenoid of the scapula; this projection can be used as a replacem...

Shoulder (outlet view)

The outlet or Neers projection of the shoulder is a specialized projection demonstrating the coracoacromial arch often utilized in the investigation of shoulder impingement 1. This projection is most commonly seen in orthopedic clinics and closely resembles a lateral scapular projection but in...

Shoulder girdle radiography

The radiography of the shoulder girdle is a commonly requested plain radiographic examination; the particular radiographic series will be dependent on the suspected pathology or injury. The extent of each series is determined by the radiography department protocols. Radiographic series sh...

Sternum (oblique view)

The oblique sternum view a radiographic investigation of the entire sternum often complimenting the lateral sternum projection. Indications The oblique view will show the sternal body in the AP plane, it is used to query fractures or infection 1. Patient position the patient is RAO facin...

Ribs (PA view)

The ribs PA view is a specific projection employed in the assessment of the anterior ribs. Unlike a standard chest radiograph, this projection applies a lower kV higher mAs technique to highlight bony structures. Indications The PA view specifically focuses on the anterior ribs. The rib series...

Ribs (AP view)

The ribs AP view is a specific projection employed in the assessment of the posterior ribs. Unlike a standard chest radiograph, this projection applies a lower kV higher mAs technique to highlight bony structures. It often involves two projections, one of the supradiaphragmatic ribs and two of ...

Chest (lateral decubitus view)

The lateral decubitus view of the chest is a specialized projection that is now rarely used due to the ubiquity of CT. It is chiefly used in the pediatric population. Indication Undertaken to demonstrate small pleural effusions, or for the investigation of pneumothorax and air trapping due to...

Abdomen (dorsal decubitus view)

The dorsal decubitus view is a supplementary projection often replacing the lateral decubitus view in the context of an unstable patient who is unable to roll nor stand. Used to identify free intraperitoneal gas (pneumoperitoneum). It can be performed when the patient is unable to be transferred...

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. Indications This view is useful in visualiz...

Abdomen (oblique view)

AP oblique supine radiograph is a projection often used in barium studies and foreign body localization. Indications This view is normally performed when localizing foreign bodies or lines within the abdominal cavity. Additionally, the oblique abdominal series can be utilized in the assessment...

Digital Imaging and Communications in Medicine (DICOM)

Digital Imaging and Communications in Medicine (DICOM) is a worldwide standard for the storage and transmission of medical imaging. The standard therefore defines both a file format and a networking protocol. The standard also has some specifications in terms of file storage on some types of med...

Digital image

A digital image is a numerical representation of an image via a set of picture elements known as pixels. This simplified article lists three parameters of a digital image that moderate spatial and contrast resolution. Image matrix The image matrix is comprised of columns (M) and rows (N) that ...

Computed radiography

Computed radiography (CR) is the use of photostimulable phosphor as an image receptor. The image receptor is held in a similar casing (cassette) to that of the traditional film screen. Computed radiography harnesses the absorption of radiation, trapping electrons at energy levels via the process...

Computed bone maturity (bone age) measurement

Computed bone age measurement refers to the automatic computer analysis of a left hand radiograph in order to estimate accurately bone age in cases of suspected growth delay. Function Advanced digital processing of data from automatic computer analysis of the phalangeal/carpal bones and/or ep...

Hip (Clements-Nakayama view)

The Clements-Nakayama view of the hip is a highly specialized lateral projection utilized on patients with bilateral femoral fractures, or patients unable to mobilize due to postoperative requirements. When performed correctly the projection can yield images of a high diagnostic quality comparab...

Shoulder (inferior-superior axial view)

The inferosuperior axial view also known as a Lawrence view of the shoulder is a modified axial projection best utilized with supine patients. It is an orthogonal projection to the AP view and replaces the lateral shoulder projection. Indications It is an appropriate projection to assess suspe...

Shoulder (superior-inferior axial view)

The axial shoulder view is a supplementary projection to the lateral scapula view for obtaining orthogonal images to the AP shoulder. It is an appropriate projection to assess suspected dislocations, proximal humerus pathology, and glenohumeral articular surface abnormalities 1-3. Indication T...

Ankle and foot radiography

Ankle and foot radiography is the plain radiographic investigation of the distal tibia and fibula, the tarsal bones and metatarsals. Radiographic examination of the foot and ankle are often requested together, however, there is a plethora of literature to aid in the correct request of x-ray exam...

Ribs (AP oblique view)

The AP oblique rib projection is performed to best demonstrate the axillary ribs. Oblique ribs may be conducted either as an anterior oblique or posterior oblique view. Indications The AP oblique view specifically focuses on the axillary ribs. The rib series is often considered to be an unnece...

Aliasing artifact (CT)

Aliasing artifact, otherwise known as undersampling, in CT refers to an error in the accuracy proponent of analog to digital converter (ADC) during image digitization. Image digitization has three distinct steps: scanning, sampling, and quantization. When sampling, the brightness of each pix...

Windowing (CT)

Windowing, also known as grey-level mapping, contrast stretching, histogram modification or contrast enhancement is the process in which the CT image greyscale component of an image is manipulated via the CT numbers; doing this will change the appearance of the picture to highlight particular st...

Temporomandibular joint (axiolateral oblique view)

The axiolateral oblique temporomandibular joint (TMJ) view allows for visualization of the articular tubercle, mandibular condyle and fossa of the temporomandibular joint (TMJ). Indications This projection is useful in identifying structural changes and displaced fractures, assessing excursion...

Hip (Dunn view)

The Dunn view is a radiographic projection of the hip that demonstrates and examines the hip joint, femoral head, acetabulum, and particularly the relationship of the femoral head and acetabulum. Indications The Dunn view is the preferred projection to aid in the diagnosis of femoroacetabular ...

Iterative reconstruction (CT)

Iterative reconstruction refers to an image reconstruction algorithm used in CT that begins with an image assumption, and compares it to real time measured values while making constant adjustments until the two are in agreement. Computer technology limited early scanners in their ability to per...

Noise (CT)

Noise in computed tomography is an unwanted change in pixel values in an otherwise homogeneous image. Often noise is defined loosely as the grainy appearance on cross-sectional imaging; more often than not, this is quantum mottle. Noise in CT is measured via the signal to noise ratio (SNR); co...

ADIR position

The ADIR (ADduction and Internal Rotation) position relates to MR arthrography of the shoulder joint. When added to a neutral-position shoulder protocol, MR arthrography in the ADIR position facilitates the diagnosis of labroligamentous lesions in patients with recurrent shoulder dislocations, ...

Cervical spine (PA oblique view)

The PA oblique cervical spine projections are supplementary views to the standard AP, odontoid and lateral images in the cervical spine series and are always done bilaterally for comparison purposes. The PA oblique projection is preferred as it reduces radiation dose to the thyroid 1, compared t...

Cervical spine (AP view)

The anteroposterior (AP) cervical spine projection is part of the cervical spine series. Indications This projection helps to visualize pathology relating to C3-C7 in the anatomical position, demonstrating any compression fractures, clay-shoveler fractures and herniated nucleus pulposus (HNP) ...

Cervical spine (AP oblique view)

The AP oblique cervical spine projections are supplementary views to the standard AP, odontoid and lateral images in the cervical spine series and are always done bilaterally for comparison purposes. However, the PA oblique projection is preferred as it reduces radiation dose to the thyroid 1 co...

Shoulder (modified transthoracic supine lateral)

The modified transthoracic supine lateral scapula is a modification of the supine lateral shoulder, used to safely image patients on spinal precautions, or patients who are unable to move; often employed in major trauma hospitals, it produces a diagnostic lateral projection of the shoulder with ...

Shoulder (supine lateral scapula view)

The supine lateral scapula view (anterior oblique AP) is a modified lateral shoulder projection often utilized in trauma imaging. Orthogonal to the AP shoulder (note so is an axillary view); It is a pertinent projection to assess suspected dislocations, scapula fractures and degenerative changes...

Oral cholecystography

Oral cholecystography is a procedure used to image the gallbladder, now largely superseded by ultrasound and MRCP. It was first described by Graham et al. in 1925, using sodium tetraiodophenolphthalein. Although rarely performed now, more modern techniques use other cholegraphic agents such as ...

Orbitomeatal line

The orbitomeatal line, also known as the canthomeatal line, was the traditional axial plane used for CT of the brain. It was easily identified on the inspection of the patient's head when tilting the gantry or patient's head to achieve a standard axial plane. The orbitomeatal line was defined ...

Knee (skyline Merchant view)

The knee skyline Merchant view is a superior-inferior projection of the patella. It is one of many different methods to obtain an axial projection of the patella. Clinical Indications This view is used in trauma patients to assess for a patellar fracture or subluxation and in orthopedics for ...

Knee (skyline Laurin view)

The knee skyline Laurin view is an inferior-superior projection of the patella. It is one of many different methods to obtain an axial projection of the patella. Indication This view is used in trauma to assess for a patellar fracture or subluxation and in orthopedics for patellofemoral joint ...

Coccyx (AP view)

The coccyx anteroposterior (AP) view is used to demonstrate the coccyx, in conjunction with the sacrum and coccyx (lateral view). Follow departmental protocol in relation to imaging this region. Indications This projection helps to visualize the pathology of the coccyx, especially fractures. ...

Air gap technique (mammography)

The air gap technique is utilized for the magnification mammography view. Magnification mammography is a high dose imaging technique which is generally utilized as a follow-up to a standard mammogram image series when a focal area needs to be more clearly examined 1. The air gap technique is ut...

Air gap technique (general radiography)

The utilization of the air gap technique in general radiography is limited due to the need for equipment facilitation to create the air gap when it is not inherent in the standard technique. Horizontal-beam lateral hip There are many different methods of performing the horizontal beam lateral ...

Sacroiliac joint (PA oblique view)

The posteroanterior (PA) oblique sacroiliac joint view demonstrates the sacroiliac joints (SIJs) in an open profile. It is commonly used in conjunction with the sacroiliac AP view. Indications This projection examines both left and right sacroiliac joints for comparison purposes in the evalua...

Sacroiliac joint (AP sacrum view)

The AP sacrum projection is part of the sacroiliac series that includes an oblique projection (PA/AP) of the joint on both sides. Although usually taken as an AP projection it can also be taken PA with a reverse caudal central ray angulation of 30° to 35° when patients cannot assume supine posit...

Sacroiliac joint (PA sacrum view)

The posteroanterior sacrum projection is a useful part of the sacroiliac series and demonstrates the opened sacroiliac joint spaces and L5-S1 intervertebral joint space. Indications This view is useful in visualizing any fractures, sacroiliac joint dislocations or subluxations, and possible in...

Sacroiliac joint (AP oblique view)

The sacroiliac joint anteroposterior (AP) oblique view of the sacroiliac joint is one of the projections that make up the sacroiliac series. Indications This projection examines both left and right sacroiliac joints for comparison purposes in the evaluation of sacroiliitis and ankylosing spond...

Thoracic spine series

The thoracic spine series is comprised of two standard projections along with a range of additional projections depending on clinical indications. The series is often utilized in the context of trauma, postoperative imaging and for chronic conditions. Radiographs of the thoracic spine are consi...

Chest (AP lordotic view)

The AP lordotic chest radiograph (or AP axial chest radiograph) demonstrates areas of the lung apices that appear obscured on the PA/AP chest radiographic views. Indication The AP lordotic projection is often used to evaluate suspicious areas within the lung apices that appeared obscured by ov...

Sacrum and coccyx (lateral view)

The sacrum and coccyx lateral view is utilized to demonstrate the most distal region of the spine in a lateral position. Indications This projection is commonly used in conjunction with the AP projection or can be used as a sole projection, depending on department protocols. It helps to visual...

Lumbar spine series

The lumbar spine series is comprised of two standard projections along with a range of additional projections depending on clinical indications. The series is often utilized in the context of trauma, postoperative imaging and for chronic conditions such as ankylosing spondylosis. Lumbar spine r...

Sacrum (AP view)

The sacrum anteroposterior (AP) view is used to demonstrate the sacrum and its articulations. The efficacy of this radiographic projection is debatable, with radiographers encouraged to follow department protocol when imaging this region 1. Indications This view can be utilized in the event o...

Lumbar spine (oblique view)

The lumbar spine oblique view is used to visualize the articular facets and pars interarticularis of the lumbar spine. Indications This view is used most commonly to assess for a pars interarticularis defect, although this has largely been superseded by CT and MRI. Additionally, it is a frequ...

Lumbar spine (lateral view)

The lumbar spine lateral view images the lumbar spine which generally consists of five vertebrae (see: lumbosacral transitional vertebra). Indications This projection shows an orthogonal view of the AP/PA view and is utilized in many imaging contexts including trauma, postoperatively, and for ...

Lumbar spine (AP/PA view)

The lumbar spine anteroposterior or posteroanterior view images the lumbar spine in its anatomical position. The lumbar spine generally consists of five vertebrae (see: lumbosacral transitional vertebra). Indications This projection is utilized in many imaging contexts including trauma, postop...

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