This article lists examples of normal imaging of the brain and surrounding structures, divided by modality and protocol.
example 1: C- axial, coronal, sagittal
example 2: C- axial, coronal, sagittal & axial bone
example 3: C- axial, C+ axial, coronal, sagittal
example 4: C-...
The foot series is comprised of a dorsoplantar (DP), medial oblique, and a lateral projection. The series is often utilised in emergency departments after trauma or sports related injuries 2,4.
See: approach to foot series.
Foot radiographs are performed for a variety of indicatio...
Cassettes are rigid holders used in conventional and computed radiography (CR) for the screen film system and imaging plate respectively.
The back side of the cassette has a rubber or felt for adequate contact between screen film system or with the imaging plate. The front is made of low atomi...
A pilon fracture is a type of fracture involving the distal tibia. These are considered to represent 1-10% of all lower limb fractures 6.
Typically occurs as a result of an axial loading injury which drives the talus into the tibial plafond.
Several classification s...
Artifacts can present in a variety of ways including abnormal shadow noted on a radiograph or degraded image quality and have been produced by artificial means from hardware failure, operator error and software (post-processing) artifacts.
There are common and distinct artifacts for film, comp...
This article lists examples of normal imaging of the genitourinary tract and surrounding structures, divided by modality.
KUB: example 1
abdominal x-ray: example 1
Intravenous Urogram (IVU) / Intravenous Pyelogram (IVP)
IVU: example 1
This article contains a list of commonly and less commonly used MRI pulse sequence abbreviations and their meaning. If available, an explanation is included in a separate article.
spin echo sequences (SE)
T1: T1 weighted
IR: inversion recovery
T2 : T2 weighted
RARE: rapid acquisition with r...
Windowing, also known as gray-level mapping, contrast stretching, histogram modification or contrast enhancement is the process in which the CT image grayscale component of an image is manipulated via the CT numbers; doing this will change the appearance of the picture to highlight particular st...
The anatomic position, also referred to as the standard anatomic position, is the consistent position of the human body in which positional reference is made for anatomical nomenclature. It is not reliant on whether the patient is standing, supine, prone, sitting, etc.
The position is defined a...
Abdominal radiography can be useful in many settings. Before the advent of computed tomography (CT) imaging, it was a primary means of investigating gastrointestinal pathology and often allowed indirect evaluation of other abdominal viscera.
Although abdominal radiography has lower...
This article lists examples of normal imaging of the head and neck and surrounding structures, divided by region and modality.
For normal spinal imaging, please see: normal spinal imaging
soft tissue: example 1
soft tissue: example 2
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...
Dual-energy x-ray absorptiometry (DEXA) is a technique used to aid in the diagnosis of osteopenia and osteoporosis.
Values are calculated for the lumbar vertebrae and femur preferentially, and if one of those sites is not suitable (e.g. artifact, patient mobility, histor...
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 ...
Flat panel computed tomography (FPCT), otherwise, know as flat panel volume tomography are multidetector computed tomography scanners that utilise a large area detector rather than a fixed array of detectors 1,3.
Flat panels have a significantly wider z-axis area coverage that can cover larger ...
This page lists examples of normal imaging of the lower limb, divided by region and modality.
example 1: frontal
example 2: frontal (young adult)
example 3: paediatric
example 4: paediatric (9 months, 11 months, and older child)
example 5: trauma sup...
This page lists examples of normal imaging of the upper limb, divided by region and modality.
sternoclavicular joint: example
clavicle: example, example 2, example 3
example 1: with Y view
example 1: axial...
This article lists examples of normal imaging of the breast and surrounding structures, divided by region and modality.
MLO and CC (standard mammographic views)
lateral: example needed
compression: example needed
cleavage view: example
axillary lymph n...
The knee series is a set of radiographs taken to investigate knee joint pathology, often in the context of trauma. It usually comprises an AP and lateral projection, although other non-standard, modified projections can be used for specific indications.
See also knee radiograph (an approach).
The scaphoid PA axial view is part of a four view series of the scaphoid, wrist and surrounding carpal bones. It is a complementary projection to the PA view demonstrating the scaphoid free from superimposition.
patient is seated alongside the table
the affected arm if possib...
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.
Cervical spine radiographs are indi...
The acanthioparietal or reverse water's view modified Water's view used in trauma. It can be used to assess for facial fractures, as well as for acute sinusitis. Skull radiographs, in general, are rapidly becoming obsolete, being replaced by much more sensitive CT scans.
The occipitomental (OM) or Waters view is an angled PA radiograph of the skull, with the patient gazing slightly upwards. It can be used to assess for facial fractures, as well as for acute sinusitis. Skull radiographs, in general, are rapidly becoming obsolete, being replaced by much more sensi...
The Caldwell view is a caudally angled PA radiograph of the skull, designed to better visualise the paranasal sinuses, especially the frontal sinus.
the patient is seated in front of the upright detector
the patient's forehead is placed against the image detector
The inferosuperior axial view of the shoulder is a modified axial projection best utilised with supine patients. It is an orthogonal projection to the AP view and replaces the lateral shoulder projection.
It is an appropriate projection to assess suspected dislocations, proximal humerus patholo...
The inferior-superior elbow view is a modified elbow projection for patients in acute flexion greater than 90 degrees, it is also an additional projection to better demonstrate the olecranon process.It is comprised of two views demonstrating the distal humerus and proximal forearm structures
The elbow AP view is part of the two view elbow series, examining the distal humerus, proximal radius and ulna.
The projection demonstrates the elbow joint in its natural anatomical position allowing for adequate radiographic examination of the articulations of the elbow including the radiohum...
The elbow series is a set of radiographs taken to investigate elbow joint pathology, often in the context of trauma. It usually comprises an AP and lateral projection, although other non-standard, modified projections are utilised for specific indications.
Elbow x-rays are indicate...
The elbow acute flexion AP is a modified elbow AP projection for patients whom cannot straighten their arm for examination. It is comprised of two views demonstrating the distal humerus and proximal forearm structures
Distal humerus projection
patient is seated alongside the ...
The elbow medial oblique view is a specialised projection, utilised to demonstrate both the coronoid process in profile and the olecranon process sitting within the olecranon fossa of the humerus.
the patient is seated alongside the table
fully extended arm and forearm, in a ...
The von Rosen view is a radiographic projection of the hip that demonstrates the relationship between the femoral head and the acetabulum.
The von Rosen view is used in the diagnosis of developmental dysplasia of the hip in paediatric patients. This view forces dislocation of the affected hip(s...
The hand series consists of a posteroanterior and oblique projection, although additional radiographs can be taken for specific indications.
The series primarily examines the radiocarpal and distal radioulnar joints, the carpals, metacarpals and phalanges.
Hand x-rays are indicate...
The shoulder series is fundamentally composed of two orthogonal views of the glenohumeral joint including the entire scapula. The extension of the shoulder series depends on the radiography department protocols and the clinical indications for imaging.
Shoulder radiographs are perf...
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 .
The AP cervical spine projection is part of the cervical spine series.
patient positioned erect in AP position unless trauma the patient will be supine
patient’s shoulders should be at equal distances from the image receptor to avoid rotation, the head facing straight forward...
Developer solution is used in the darkroom for developing (i.e. converting latent image to visible image) x-ray films used in conventional (screen film) radiography.
developer: hydroquinone (for high contrast) + metal/phenidone (for low contrast)
the developer itself gets oxidised ...
Eklund modified compression technique is a technique which can be used for patients with augmented or reconstructed breasts post mastectomy.
It consists of posterosuperior displacement of the implants simultaneously to an anterior traction of the breast, pushing the implants towards...
Radiographic contrast is the density difference between neighbouring 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 ...
Tardus parvus refers to a pattern of Doppler ultrasound spectral waveform resulting from arterial stenosis. The phenomenon is observed downstream to the site of stenosis, and is due to reduced magnitude of blood flow through the narrowed vessel during ventricular systole 7.
This characteristic ...
Contrast media extravasation (CMEV) refers to the leakage of contrast media from the normal intravascular compartment into surrounding soft tissues; It is a well-known complication of contrast-enhanced CT scanning. It can also occur in MRI studies, but the complications are rare given the low vo...
Iodinated contrast-induced thyrotoxicosis is rare and may occur in patients with pre-existing thyroid disease and through complications of thyrotoxicosis (e.g. cardiac arrhythmia) may be fatal. Patients with a normal thyroid gland are unaffected.
Patients with existing thyrotoxicosis should no...
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...
This article lists examples of normal imaging of the spine and surrounding structures, divided by region and modality.
example 1: AP, lat, obliques only
example 2: PEG view
example 3: flexion and extension views only
example 4: paediatric - 12 years old
This article lists examples of normal imaging of the gastrointestinal tract and surrounding structures, divided by modality.
example 1: abdominal film
example 2: erect and supine
example 3, example 4: paediatric
example 5: young adult male
example 1, exampl...
This is a basic article for medical students and other non-radiologists
CT abdomen is an increasingly common investigation that is used to help make diagnoses of a broad range of pathologies. A CT abdomen in its simplest form is a CT from diaphragm to symphysis pubis performed 60 seconds after ...
The lateral chest view may be performed as an adjunct to a frontal chest radiograph in cases where there is diagnostic uncertainty. The lateral chest view examines the lungs, bony thoracic cavity, mediastinum, and great vessels. Lateral radiographs can be particularly useful in assessing the ret...
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.
The technique is available on DXA scanners under a variety of...
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 a last resort in trauma imaging in the absence of a CT. However, still utilised in the setting of skeletal surveys
The closed mouth odontoid AP view (Fuchs view) is a nonangled AP radiograph of C1 and C2. This view focuses primarily on the odontoid process. The standard Fuchs view should not be used in a trauma setting and the modified Fuchs view may be used instead.
supine or erect
Radiographic positioning terminology is used routinely to describe the position of the patient for taking various radiographs. Standard nomenclature is employed with respect to the anatomic position.
Basic terms of relations
anterior is towards the front of the body (Latin: before...
The general radiography section covers in detail the various clinical presentations that require specific plain radiographic investigation, the anatomy covered, and how it is displayed via the chosen view. It outlines standard and modified radiographic technique to accommodate for a wide range o...
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:
Sinus and facial bone radiography is the radiological investigation of the facial bones and sinuses. Plain radiography of the facial bones are still often utilised in the setting of trauma, postoperative assessments and dental radiography.
The renal arterial resistive index (RI) is a sonographic index to assess for renal arterial disease.
It is measured as
RI = (peak systolic velocity - end diastolic velocity ) / peak systolic velocity
the normal value is ≈ 0.60
with 0.70 being around the upper limits of normal
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 resolution.
The image matrix comprised of columns (M) and rows (N) that define the elements or p...
The supine anteroposterior chest view is the alternative to the PA view and the AP erect view when the patient is generally too unwell to tolerate standing leaving the bed, or sitting 1. The supine view examines the lungs, bony thoracic cavity mediastinum and great vessels.
This particular ches...
CT polytrauma/multitrauma, also called trauma CT, whole body CT (WBCT) or panscan, is an increasingly used investigation in patients with multiple injuries sustained after significant trauma.
Clinical assessment and mechanism of injury may underestimate injury severity by 30% 8. There is some e...
The scoliosis anteroposterior (or posteroanterior) view allows for the visualisation of the thoracic and lumbar vertebral bodies of interest in scoliosis and allows for the severity of lateral spinal curvature to be assessed 1.
patient erect (or supine depending on protocol)
The scoliosis erect lateral view is performed to visualise the thoracic and lumbar vertebrae of interest in profile in cases of scoliosis. It is also often done upon first presentation and is useful for identifying spondylolisthesis and the degree of kyphosis and/or lordosis 1,2.
Scoliosis radiography is useful in identifying the degree of the scoliosis curvature (major/minor or primary/compensatory curves), as well as observe its progression to determine the best method of treatment 1.
Scoliosis radiographs are performed specifically when the disease is...
Scoliosis lateral bending views are additional scoliosis projections accompanying the standard PA/AP views with the aim of assessing the patient’s lateral range of spinal motion 1.
patient erect or supine
patient bending their upper body laterally (right and left) from the h...
The oblique pelvis otherwise known as the Judet view is an additional projection to the pelvic series when there is suspicion of an acetabular fracture.
The Judet view is comprised of two projections, first the iliac oblique for assessment of the posterior column and anterior wall of the acetab...
Gymnast wrist is a term that used to describe variety of chronic overuse injuries of the wrist in gymnasts with immature skeleton. Gymnast wrist is a combined of osseous and ligamentous injury and usually manifests as a chronic Salter-Harris type I fracture of the distal radial physis on radiogr...
Peroral pneumocolon is a technique that can be used during a small bowel follow through (SBFT) to better visualize the ascending colon and terminal ileum.
The goal of a peroral pneumocolon is to create a double contrast study (oral contrast and gas) of the ascending colon and termina...
This article lists examples of normal imaging of the liver and biliary tree and surrounding structures, divided by region and modality.
liver silhouette: example
example 1 with shear wave elastography
liver Doppler ultrasound: example ne...
The skull lateral view is a nonangled lateral radiograph of the skull. This view provides an overview of the entire skull rather than attempting to highlight any one region.
the sagittal midline of the patient's head is parallel to the image detector
sella turcica in profile
An intraosseous pseudomeningocele is an intradiploic CSF collection communicating with the subarachnoid space.
Intraosseous pseudomeningoceles are rare sequelae of a skull fractures of traumatic or iatrogenic ethology occurring in infants and young children. They can be seen in an...
Beam hardening is the phenomenon occurring when an x-ray beam comprised of polychromatic energies passes through an object, resulting in selective attenuation of lower energy photons. The effect is conceptually similar to a high-pass filter, in that only higher energy photons are left to contrib...
The chest radiograph (CXR) is the most ubiquitous radiological investigation.
The chest radiograph is performed for a broad content of indications, including but not limited to 1-4:
suspected pulmonary embolism
Cervical spine flexion-extension lateral views are specialised projections of the cervical spine often requested to assess for spinal stability.
Cervical spine flexion-extension lateral views should not be performed on trauma patients without strict instructions of a qualified clinician.
Posteroanterior (PA) chest view is the most common radiological investigation in the emergency department 1. The PA view examines the lungs, bony thoracic cavity, mediastinum and great vessels. The chest X-ray is frequently used to aid diagnosis of acute and chronic conditions.
The odontoid or 'peg' projection is an AP projection of C1 (atlas) and C2 (axis).
patient positioned erect in AP position unless trauma the patient will be supine
patient’s shoulders should be at equal distances from the image receptor to avoid rotation, the head facing strai...
The Towne view is an angled AP radiograph of the skull, used to evaluate for fractures of the skull and neoplastic changes
the patient's nuchal ridge is placed against the image detector
the infraorbitomeatal line (IOML) is perpendicular to the image receptor
The skull AP view is a nonangled AP radiograph of the skull. This view provides an overview of the entire skull rather than attempting to highlight any one region.
the back of patient's head is placed against the image detector
The skull PA view is a non-angled PA radiograph of the skull. This view provides an overview of the entire skull rather than attempting to highlight any one region.
the patient is erect
the patient's forehead is placed against the image detector allowing for the nose to be in...
Cervical spine lateral view is a lateral projection of the cervical spine. It is often performed in the setting of trauma.
As technology advances, computed tomography (CT) has replaced this projection, yet there remain many institutions (especially in rural areas) where CT is not readily availa...
The Beclere method intercondylar view is an additional projection of the knee, used to better examine the tibial plateau and femoral intercondylar spaces. It is anecdotally known as a 'notch view'
patient is supine on the table with the knee flexed 40 degrees
image receptor ...
The Rosenberg view of the knees is a specialised series often used to detect early signs of osteoarthritis. It should be the initial study for any patient with a suspicion of knee osteoarthritis.
It consists of a PA radiograph with weight bearing and 45 degrees of knee flexion. It is more sensi...
The AP hip is part of a radiographic series examining the anatomy of the hip joint and proximal femur.
patient is supine
lower limbs are internally rotated 15-25° from the hip (do not attempt this if a fracture is suspected)
Dual energy CT utilises two separate energy sets to examine the differing attenuation properties of matter, having a significant advantage over traditional single energy CT. Independent attenuation values at two energy sets can create virtual non-contrast images from contrast enhanced imaging as...
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.
patient is supine on the table with the knee and ankle joint in contac...
The sesamoid view of the toes is a specialed view examing the sesamoid bones of the first metatarsal.
the patient may be supine or sitting upright with their leg straighten on the table
the foot is in dorsiflexion
the toes pulled back toward the patient
The bone age, hand and wrist PA is a commonly performed examination to determine the radiographic age of the patient via the assessment of growth centres
patient is seated alongside the table
the non-dominant hand is placed, palm down on the image receptor
shoulder, elbow, a...
Several factors contribute to radiographic distortion whereby the anatomy examined is misrepresenting on the plain radiograph.
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...
The wrist series is comprised of a posteroanterior, oblique, and lateral projection. The series examines the carpal bones that are consisting of the scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate and hamate. It also examines the radiocarpal and distal radiocarpal joint al...
The horizontal beam lateral hip radiograph or shoot through hip is the in the purist terms the orthogonal view of the neck of the femur to the AP projection 1,3.
The projection is used to assess the neck of the femur in profile during the investigation of a suspected neck of femur fracture 2.
The toes series is comprised of an AP, AP oblique, and a lateral projection. The series is often utilised in trauma situations. It examines the entirety of the proximal middle and distal phalanges of the foot.
Toe radiographs are performed for a variety of indications including 1:...
The wrist PA radial deviation view is specialised projection employed to better demonstrate the carpal bones that lay on the ulnar aspect of the wrist.
patient is seated alongside the table
the affected arm if possible is flexed at 90° so the arm and wrist can rest on the tab...
The lateral elbow view is part of the two view elbow series, examining the distal humerus, proximal radius and ulna. It is deceptively one of the more technically demanding projections in radiography 1-3.
The projection is the orthogonal view of the AP elbow allowing for examination of the ulna...
The orthogonal projection (or view) is, by definition, a radiographic projection obtained 90 degrees to the original view. It forms the basic requirements of a 'radiographic series', that being 'two orthogonal projections of the region of interest'
Cases can appear normal in one...
The carpal bridge view an additional view to the three view series of the wrist and carpal bones. It is used to assess the dorsal aspect of the scaphoid, lunate and the triquetrum.
the patient is seated alongside the table
dorsal aspect of affected wrist is placed on the dete...
Gage sign is a V-shaped lucent defect at the lateral portion of the epiphysis and/or adjacent metaphysis. It is pathognomonic for Legg-Calve-Perthes disease.
It may occur early in the disease and is one of the five indicators of a worse prognosis, which are:
calcification lateral t...
The lumbar spine flexion and extension views images the lumbar spine which consists of five vertebrae. They are specialised projection, assessing for instability of the lumbar spine often in the context of spondylolisthesis.
the patient is positioned erect:
ideally, spinal i...