Sternum (lateral view)
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The lateral sternum view a radiographic investigation of the entire length of the sternum in profile. The view is used to query fractures or infection 1.
This view is invariably undertaken for one of two reasons, to assess for a fracture or metastasis. It may also rarely be performed to assess for osteomyelitis or concerns related to median sternotomy wires.
- patient is erect with the left or right side of the thorax adjacent to the image receptor
- patient's hands are behind their back
- chin is raised as to be out of the image field
- arms are brought together behind their back so the chest is pushing outwards (pigeon chest)
- patient is standing upright
- midsagittal plane must be parallel to the image receptor
- lateral projection
- suspended inspiration
- midway between the jugular notch and the xiphoid process
- superiorly above the jugular notch
- inferior to the xiphoid process
- anteroposterior from the skin border to 2 cm behind the sternum
- 24 cm x 30 cm
- 75 -85 kVp
- 20 -25 mAs
- 100 cm
Image technical evaluation
- there should be no superimposition of structures over the sternum
- the entire length of the sternum can be seen in profile; the image is exposed enough that it is possible to trace the bony cortex the whole way around.
The patient may be in a lot of pain due to the mechanism of the injury (normally blunt force). So be sure to only ask the patient to do what is within their abilities, some may not be able to push their chest out to get the sternum in profile, and in these situations, collimation will be key to avoiding scatter.
It is not uncommon to use an aluminum filter over the anterior portion of the sternum to aid scatter reduction; this is normally the case for larger patients.
This image can be done supine with a horizontal beam using the same principles.