1. The document discusses various radiographic positioning techniques for imaging different body parts. It includes techniques for imaging the upper limb bones and joints like the shoulder, elbow, wrist, and long bones of the arm. 2. Positioning techniques are described for imaging the subtalar joint, cervical spine, mandible, and sinuses. Oblique views, reverse waters view, and panoramic views are discussed. 3. Equipment for dental radiography and uses of split cassettes, grid cassettes, and backer's trays are also summarized. Indications for different imaging techniques are provided.

1. Radiographic positioning
3 Mark Questions and Answers for B.Sc MIT
By
Astalakshmi .K
Revaty .R
Aditya .T
Jayashri .R
Guided by
G.YOGANANTHEM - clinical instructor
DR. HARASHAVARDHAN - HOD

2. 1) Centering of upper limb bones and joints.
(by Astalakshmi)
Bones of the upper limbs
1. Bones of shoulder gridle include : clavicle & scapula
2. Bones of arm: Humerus
3. Bones of forearm :Radius lateral &unla medial
4. Bones of hand: Carpal bones 8
Metacarpal bones 5
Phalanges 14.
Joints of the upper limb
 Shoulder joint
 Elbow joint
 Wrist joint
SHOULDER JOINT
Anterio posteriorview centering point: 2.5 cm inferior to the coracoids processor2cm
inferior to the lateral clavicle at the level of the glenohumeral joint.
Lateral view PA projection
The level of the glenohumeral joint on the posterior aspectof the patient (5cm
below the top of the shoulder).
ELBOW JOINT
Anterio posteriorview centering point: Mid elbow which is approximately
the midpoint between the epicondyles

3. Lateral view centering point: Lateral epicondyle of the humerus
WRIST JOINT
Posterioranterior view centering point: The vertical Central Ray is centered to
a point midway between the radial and ulnar styloid process.
Lateral view centering point: The vertical Central Ray is centered over the
styloid Process ofthe radius.
UPPER LIMBS LONG BONES
Humerus AP view centering point: The vertical collimated x-ray beam is
centered to a mid point between the shoulder and elbow joints at the right
angels to the IR
Lateral view centering point: Mid humeral shaft.

4. 2) Swimmer’s technique. (by Revvaty)
This is an oblique view which projects humeral heads away
from the c-spine. The swimmer’s view may be useful in accessing alignment
at cervico-thoracic junction. If C7/T1 junction has not been aquentely on
lateral image or on a repeated lateral image with the shoulder’s lowered.
POSITION:
 The patient is supine or erect depending on trauma or follow up.
 The detector is placed landscape, running parallel to the long axis
of the cervical spine.
 The opposite arm is placed by the patient’s side, as posterior as
possible.
 In direct posterior of the patient the image will be take suspended
expiration.
REGION VIEWS CENTER
POINT
kVp mAs DISTANCE CASSETTE ANGULATION
Cervico-
thoracic
junction
Swimmer’s
view
2.5 cm
above the
jugular
notch at the
level of T7
70 25 100 cm 24cm×30cm CR perpendicular to
IR

5. 3) Split cassettes. (by Aditya)
The split cassetteis also called as the multisection cassette.
It is designed to hold 3-7 films with their respective intensifying screens and
spacers of about 5 or 10 min thickness.
Uses of the split cassette
● Most common use in tomography where there are used to producea set
of films each bearing an image of different layer height with in the body
with one exposure..
● Another use in the multiple radiography where by using single exposure
different images having varying densities and contract can be produced.
.
The multiple section cassette for tomography; a section of multsection
cassettes are available with a choice of the spacers thickness and number of
screen pairs..
● In the multiple radiography procedurethe cassette is loaded with set of
films and varying speed but no spacers…
Advantage of using spacers:
Films which are separated by 5 mm spacers will produceimages of body
section 5 mm a part likewise with 10 mm spacers.

6. 4) Views and techniques of the subtalar joint
 The subtalarjointalsoknownas the talocalcaneal.
 Jointitis a compoundjointpositioneddirectlybelow the calcaneusanda columnshaped
bone calledtalus.
Following X-ray projectionsare taken for subtalar joint
1) oblique medial
2) Oblique lateral
3) Lateral oblique.
They are three views;

7. Oblique medial:
 The patient lies supine on the x -ray table with the affected limb
extended
 The leg is internally rotated through 45degrees
 A non-opaque square pad and sand bag may be placed against the
plantar
Aspect of the foot to keep the ankle joint in dorsiflexion
Oblique lateral:
 The patient lies on table and leg is internally rotated with45degrees
 A pad is placed under knee for support
 The lower edge of the casseteis placed at the level of the plantar aspect
of the heel
Lateral oblique:
 The patient lies on the affected side
 The opposite limb is flexed and brought infront of the affected limb
 The affected foot and leg are now further rotated laterally until The
planter aspectof the footis aproximately 45degrees to cassete
Name of the
projection.
FFD Centering
point
Bucky Cassette
1) Oblique
medial
100cm Centre 2.5cm
distal to lateral
malleolus with
cranials
angulation
Non-bucky 1012inches
2) Oblique
lateral
100cm Centre2.5distal
to the medial
malleolus with
centre ray
angled 15
degrees
cranially
Non -bucky 1012inches
3)lateral oblique 100cm Centre to the
medial
Non-bucky 1012inches

8. mallelous with
the central ray
angled
20degrees
caudally
5) Reverse water’s view. (by Astalakshmi)
The acathioparital or reverse Waters view modified as Waters view used in trauma it
can be used toassess forfacial fractures,as well as for acute sinusitis skull radiographs,
in general are rapidly becoming obsolete, being replaced by much more sensitive CT
scans .The reverse Waters method is use to show the facial bones . when the patient
cannot be placed in prone position.

9. POSITION OF THE PATIENT
With the patient in the supine position center the MSP of the bodyto the
midline of the grid.
 Bringing the patient's chin up, adjust the extension of the neck so that
the OML froms
37°degree angle with the plane of the IR.if necessary ,place a support
under the
Patient shoulders to help them to extend the neck .
 The MML is approximately perpendicular to the plane of the IR.
 Adjust the patient head so that the MSP is perpendicular to the IR.
Central rays: perpendicular to enter the acanthion and centered to the
IR.
The beam angled 30° cephalad to the running parallel to the
mentomeatal line.
Cassettesize:24×30cm
Exposure:75-80kvp ,20-25mAs
Distance:100cm
Grid:yes
Evaluationcriteria
 Orbits are magnified
 Petrous ridges are projected below the maxillary sinus.

10. Acanthioparital facial bones reverse Waters method with neck extended
MML is perpendicular to the IR.
6) Panoramic tomographic views of mandible. ( by Revvaty)
The orthopantogram is also know as Orthopantogram(OPG) or
pantorex. It is a scanning of mandible and the upper and lower jaw. It shows a
three dimentional view of half circle from head to head using x-rays.
INDICATIONS:
 General dental health evaluation for caries or pulp origin
disease.
 Trauma assessmentfor tooth and jaw fracture.
 Salivary stone identification.

11. Figure 1 positioning of panoramic x-ray
POSITION:
 The patient should be either in a sitting or standing(erect).
 The tongue should not against the hard palate.
 The patient should be bite at the plastic bite block for few
minutes.
 Set the factors and expose it.
* Exposure factors: 70 kVp & 20mAs
* Grid: yes.
*Cassette: Panoramic x-rays films.

12. Figure 2panoramic x-ray machine
Figure 3 panoramic x-ray
7) Write about magnitude of tube shift in stereo radiography.
(by Aditya)
Definition of stereoradiography.
 Preparation of a pair of radiographs with appropriate shift of the x-ray
tube or film so that the images can be viewed stereoscopically to give a
three-dimensional appearance..
 It requires the exposure of the two films one for each eye as the tube is
shifted to 10% of film focal distance ,then there are viewed with
stereoscopethe uses either with mirror or prisms to coordinate the
accommodation..
The tube shift is also called as the SLOB technique ..

13.  The X-ray tube to the right and left of an axis perpendicular to the
detector.
 usually the total X-ray tube shift is 10% of the focus to detector
distance which correspondswith a stereo shift angle of 3deg tan 1..
 the stereographers are made at Angles of the same degree but an
oppositeside of the object radiographs
 consequently X-ray tube is shifted from approximately 4½ inch from
one side of the center a total shift of 2 ½ inches which is mean
interpupillary distance .
 this tube shift is variable for different focus film distance and for object
thickness ..
Tube shift/film focal distance = inetrpupillary distance /viewed
distance…

14. 8) Types of equipments and indications of dental
radiography (by Jayashree)
In Dental radiography following equipments are used:
 Dental Sterilization
 Dental cabinets
 X-ray film,cassette
 Chairs and operatory equipment

15.  Dental compressorand vaccums
 X-ray machine with standard company
 Aprons and glows
 Hand pieces
 Lasers and cotton
 Nitrous oxide system
 Rinsor,developer,fixer,water
 Barrium solutions et
INDICATIONS:
Indications taken for the dental x-rays are:
 Enforcement of regulatory prohibitions
 X-ray tube housing
 Collimation device restricting the size of the x-ray beam
 Taking x-ray beam filtration
 Wearing lead apron and gloves two hands
 Exposure cord(900-1350)
 Exposure timer(type exposure switch)
 Using fasting image receptor
 Protect patient from unnecessary radiation exposure
 Using proper KV and MA time setting
 Avoid high dose

16. 9) Submento vertical view. (by Astalakshmi)
Submento vertical view is primarily taken to demonstrate the spenoid
sinuses .fluid levels in spenoid sinuses are clearly shown in erect position.
Position of the patient
The patient may be imaged erect or supine. If the patient is unsteady then a
supine technique is advisable.
. ERECT POSITIONSUPINEPOSITION
*The patient sits facing the x-ray tube a short .

17. *The patients shoulder are raised and neck distance away from the vertical
Bucky.hyperextend to bring the vertex of the skull in *The neck is
hyperextend to allow the headcontact with the IR . To fall back until the
vertex of the skull.
*The head is adjust to bring the (EMS) Makes contact with center of the
vertical equidistant from the image receptor.
Image receptor:
*The MSP should be right-angle to the IR
*The head is adjust to bring the (EMS) along it’s midline equidistant from
theimage receptor .
*The orbito-meatal plane should be as near as
*The MSP should be at the right- anglepossible parallel to the IR.
to the IR along it’s midline.
*The orbito-meatal plane should be as near as possible parallel to the IR.
Central Ray: Directed to the MSP at the pointmid way between the angle of
the mandible . Which is
Approximately the point Midway between the EMS perpendicular to the IR
Pathology shown: inflammatory condition , sinusitis and secondary
osteomyelitis.
IR size: 18×24 cm
Grid: yes
Exposure: 70kvp,20 mAs
FFD: 100c

18. 10) Intra-oral periapical radiography. (by Revvaty)
Intra oral radiographic techniques are used in routine practice. It divides into
three categories:
1) periapical radiography
2) bitewing radiography
3) occlusal radiography
PERIAPICAL RADIOGRAPHY:
Periapical radiography is a lateral projection displaying both
the crown and root of the tooth and the surrounding bone.

19. Figure 4 Periapicalradiography.
CLINICAL INDICATIONS:
 Detection of apical infection/inflammation.
 Assesment of the peridontal statue.
 After trauma to the teeth and alveolar bone.
 During endodontic therapy.
There are two available techniques are:
1) the bisecting angle technique
2) the paralleling technique
1) BISECTING ANGLE TECHNIQUE : Bisecting angle is accomplished by
placing the receptor as close as to the x-ray beam should be directed
perpendicular to the imaginary line that bisects or divides the angle formed by
the long axis of the tooth and the plane of the receptor. Two methods are
employed to stabilize the image receptor intraorally:
* A film holder
* The patient’s finger.

20. Figure 5 Bisecting angle technique.
2) PARALLELING TECHNIQUE : The paralleling technique results in good
quality of x-rays with a minimum of distortion and is the most reliable
technique for taking periapical x-rays. The films is placed parallel to the long
axis of the tooth in question and the central x-ray beam should be directed
perpendicular to the long axis of the tooth.
Figure 6paralleling technique

21. 11)Autotomogram. (by Aditya)
The Autotomograph is a method of tomography involving movements of a
patient instead of X-ray tube.
(Auto:self tomo;incision,, graph; write).
It is a technique for obtaining clear X-ray images of deep internal structures
by focusing on a specific plane within the body. Structures that are obscured
by overlying organs and softtissues that are insufficiently delineated on
conventional X rays can thus be adequately visualized…
*The principles of autotomography are reviewed geometrically and
experimentally.
*Autotomography with a stationary roentenographic plate is geometrically
incorrect
*with this modality only the Axis of rotation shows lack of blurring.

22. *with small angles autotomograpghy yields excellent and sharp images
indistinguishable from those of the true tomography.
*classical auto tomography , therefore remains very useful technique
pnemoencephalography .
* True autotomography can be achieved by rotating the object and the
roentenographic plate.
* The modality has the advantages of preventing vibration of the Roentgen X-
ray tube. Therefore ,magnification tomography can be achieved.
**excellent images are obtained with a new pluridirectional autotomograph..
It's application for clinical use has to be restricted to small angles (up-to 15
deg), becauseof possibleorgan shift during rotation of the patient..
Abstract.
Autotomography permits improved visualization of the Atlas -axis and
occipito cervical articulations with virtually any X-ray equipments in less time
than is required for anterioposterior and lateral tomographs...this technique is
best applied in nontraumatic cases in which the density is not seen clearly on
the "open mouth view"..

23. 12) Backer’s tray. (by Jayashree)
Backer’s tray is also called as supporting tray or emergency tray. It is
used in Radiologically Investigations and Medical terms and also emergency
purpose.
 It contains medical indications
 In radiology some processesare handled
Ex:
1. Barium Sulphate solution in this following contains:
=> Barium Sulphate
=>ContrastBottles
=> Catheters
=>Syringes
=>Distilled Water
=>Gloves
=>Cotton

24. 2. IVP Process Contains
=>Kidney Tube
=>Radiographic Circuit
=>Canulla
=>Flexing Tape
=>Syringe 10ml Bottles
=>Dry cotton
=>Cottonswap
 Emergency Tray equipment s for all units are:
=>Ambubags at least two, checked for physical integrity once a week
=> Masks of different types and sizes
=>Flash light with extra batteries
=> Swabs, Sponges, Cottonand adhesive tapes
=> Gloves, sethoscope, Blood pressureset of good quality
=> Scissors etc…

25. 13) Grid cassettes. (by Astalakshmi)
Grid cassette is a cassettethat has its front replaced by a built in grid.
When the beam of x-rays passes through the patient ,the beam is absorbed and
scattered .The absorbed primarily beam is gives a useful shadow , while the
scattered radiation will tend to spoil the shadow . scattered radiation
contributes a constant background fog to the film image .This will increase the
noise in the image . The ratio between the amounts of scattered radiation
energy to the amount of primary radiation energy at a point is called scatter to
primary ratio (SPR). The SPR increases with thicker patient and larger x-ray
field size For example, inabdomen radiography , only 20% of the photons
contribute to the image formation and the remaining 80% goes as scattered
radiation. Hence, scattered radiation must be removed, in order to increase the
image contrast. Thescattered radiation can be removed by a grid , placed in-
between the film and the patient.The grid consist of a series of parallel lead or
tantalum strips of thickness c and of height separated by spacers of low
attenuating material of width b as shown in the picture aluminum or plastic
fibers are used as low attenuating spacers the grid is positioned between the
patient and the detector, so that it’s long axis is pointed towards the x-ray
beam .The primary x-rays coming out of the patient , passes through the inter
space, since it is parallel in direction.The scattered x-rays, which are in non
parallel direction , strike the grid bars and are being absorbed. The ratio of

26. primary transmission to the scatter transmission of a grid is called the
selectively.
14) Expiratory view. (by Revvaty)
An expiratory chestradiograph can be taken in either a PA or AP
projection, and can also be taken with a mobile/portable unit.
Indication
They are used to help detect small pneumothoraces (although sensitivity is not
increased over inspiratory chest radiographs 1), and to assess for inhaled
foreign bodies or gas trapping in COPD2,3.

27. Patient position
 patient is erect facing the upright image receptor, the superior aspectof the
receptor is 5 cm above the shoulder joints
 the chin is raised as to be out of the image field
 shoulders are rotated anteriorly to allow the scapulae to move laterally off
the lung fields, this can be achieved by either:
o hands placed on the posterior aspectof the hips, elbows partially flexed
rolling anterior or
o hands are placed around the image receptor in a hugging motion with
focus on lateral movement of the scapulae
 shoulders are depressed to move the clavicles below the lung apices
Technicalfactors
 posteroanterior or anteroposterior projection
respiration : suspended expiration
 centering point

28. o the level of the 7th thoracic vertebra, approximately the inferior angle of
the scapulae
o orientation
o portrait or landscape
 detectorsize
o 35 cm x 43 cm or 43 cm x 35 cm
 exposure
o 100-110 kVp
o 4-8 mAs
o SID : 180 cm

 Grid : yes
15) Invertogram. ( by Aditya)
Introduction
Invertogram first described by the WANGENSTEEN and RICE in 1930..
An invertogram may be used to investigate the extent of the defect in anal or
rectal atresia. The anus is marked with a radiopaque marker, and the baby
inverted..
*A lateral radiograph is taken. The air in the rectum will rise to the highest
point, giving an indication of the extent of the atresia….
Invertogram is also called as ANORECTAL MALFORMATION..
Anorectal malformations (ARMs) are among the more frequent congenital
anomalies encountered in pediatric surgery, with an estimated incidence

29. ranging between 1 in 2000 and 1 in 5000 live births.
Technique..
> six to eight hours after the birth,a new born baby with ARM should be held
upside and down for at least 3 minutes.
>strict lateral view is taken with the thighs of the baby flexed at hip, and beam
accurately centered on the great trochanter
>Anul dimple and the natal cleft should be outlined by barium paste,
coin,metal pointer..
In a correctly taken radiograph..
> boththe ishcial bones will accurately Superimpose
> the terminal blind bowel will be rounded and well distended..
THE THREE LINES ARE: (i) PC(pubococcygeal) line
(ii) the I (ischial) line or I point
(iii) the anal pit line

30. The main basic purposeof the invertogram is to identify the relationship of
the gas bubble in the blind pouch to the bony pelvis which in turn indicates
the relation of the levator ani muscle complex..
16) Judet view. (by Jayashree)
It is pelvis x-ray.The oblique pelvis otherwise known as the judet view in an
additional projection to the pelvic series when there is an acetubular fracture.
 It is mainly taken to see acetubular fracture. They are imaged by using
bilateral oblique views of the pelvis.
 The iliopectined or iliopubic line is an important landmark for examining
the anterior column of the acetabulum.
 In judes x-ray there are 2 positions.
1. Anterior oblique
2. Posterior oblique

31. Anterior oblique view:
 The patient lies prone on the x-ray table.
 The trunk is then rotated approximately 450 on to the unaffected side and
the affected side is rised in supported on non opaquepads.
 In this position the rim of the acetabulum nearest the table top is
approximately parallel to the cassette.
 A 24*30 cm cassette is placed longitudinally in the bucky tray.
Posterioroblique view:
 The patient lies supine on the x-ray table.
 The affected side is raised approximately 450 and supported on non
opaque pads.

32. Region Views KVP MAs Cassette Grid Distance(FFD) Center point
Pelvis hip
judet’s
view
Anterior
oblique
75-80
kvp
40
MAs
32*40cm
17’14
inches
Yes 100 cm Distalto the
coccyx,with central
beam directed 120
towards the head.
Pelvis
reverse
judets
view
Posterior
oblique
75-80
kvp
40-45
MAs
32*40cm
17’14
inches
Yes 100 cm Center to femoral pulse
on raised side . Central
ray directed 120
towards feet.

34. 17) Radiographic demonstration of left pars interarticulars
in lower lumbar spine. (by Astalakshmi)
RIGHT OR LEFT LUMBAR SPINE(OBLIQUEVIEW)
These projections demonstratethe pars interarticularis and the apophysealjoints
on the side
Nearest the image recptor both sides are taken for comparison.
POSITION OF THE PATIENT AND IMAGE RECPTOR
APoblique positionPA oblique position.
Anterior oblique
 Rotate the body45° to place spinal coloumn directly over the midline of
the grid.
 Flex the knee to stability and comfort.
 Supportlower back and pelvis with radiolucent sponge to maintain the
position.

35. CENTRALRAYS: center to L3 at the level of the lower costalmargin (4cm or 5
inch above the iliac crest).
Posterioroblique
 The patient is positioned on the bucky table and is then rotated 45° to the
right or left sides in turn.The patient arms are raised ,with the hands
resting on the pillow
 The hips and knees are flexed and the patient is supported with a
45°foam pad.
 The image receptor is centered at the lower costalmargin.
CENTRALRAYS: The collimatedvertical beam is centeredtowards the level
of iliac crestat the MSP and the Central Ray’s is perpendicular to the IR.
DECETORSIZE:35×43cm
EXPOSURE:70-80kvp, 60-80mAs.
SID: 110cm
GRID:Yes.Radiographicview

36. 18) Subtalar joint view. (by revvaty)
The subtalar joint, also known as the talocalcaneal joint, is a joint of the foot. It
occurs at the meeting point of the talus and the calcaneus.
Name of the projection Subtalar Joint - AP Axial Oblique - Medial Rotation (Isherwood)
Area Covered Distal tibia and fibula, entire talus and calcaneum, proximal tarsal
bones
Pathology shown Middle subtalar articulation, open sinus tarsi
IR Size & Orientation 18 x 24cm
Landscape
(CR and DR as recommended by manufacturer)
Bucky / Grid No

37. Filter No
Exposure 60 kVp
3.2 mAs
FFD / SID 100cm
Central Ray CR to a point 2cm distal and 2cm anterior to the lateral malleolus
10° cephalad
Collimation Four sides of collimation
collimate to ankle jont and calcaneum
Markers Distal and lateral
Marker orientation AP
Shielding Gonadal (check your department's policy guidelines)
Positioning  Patient in a semi seated position on table and turn with their
weight resting on the flexed hip and thigh of the unaffected side
 Patient's leg fully extended
 Lower leg in AP position, dorsiflex foot
 Place IR under the ankle
 Internally rotate leg 60°
 CR to a point 2cm distal and 2cm anterior to the lateral malleolus
10° cephalad

38. 19) Self rectification circuit. (by Aditya)
Self rectification explains that during Half cycle the anode is postive in relation
To the cathode so current flows and x rays Produced.during the second half cycle
the Anode is negative so there is no current Flow and no x-ray production..this is
called as Self rectification .because the tube does its Own rectification.

39.  The transformers of small x-ray units supplies that tube with alternately high
Tension current in other words it alternately surges first in one direction
from cathode to anode
 However the right tension current cannot flow from anode to cathode
because the anode is cold
Anddoesnot have a supply of electrons to carry the current
 This property of the tube to act as a valve and so suppress the reverse cycle
is termed self rectification in apparatus in which the tube has a heavier load
additional precautions have to be prevent such reversed flow of current
through the tube.
 The danger in using a self rectified system is that electrons can flow on
tbenegative Half of the cycle and badly damage the x-ray tube in half wave
rectification we throw away the Part of the electron flow that is in the wrong
directions.
 Self rectification is usually limited to dental and portable units. The highest
limits are about 30mAs at 90Kvp
 They are limited so because overstepping these bounds can cause
temperature rise in the anode target to the point of thermionic Emission

40.  In this event the inverse voltage can drive these available electron towards
the cathode filament with consequent damage or destruction of the tube .
 Although the concept of self rectification is important it is al but obslete
today.

41. 20) Plain radiographic evaluation in suspected left atrial
enlargement. (by Jayashree)
Left atrial enlargment
The left atruim is located in the upper left part of the heart. It is one of four
Chambers in the heart.too much pressure or too much blood volume can both
Cause the left atrium to become bigger which causes left atrial enlargment
 To see in x-ray images he chest right anterior oblique views is taken
Right anterior oblique projection
 It is use ful to see the enlargement of the heart or aorta,or abnormal vessels
Mainly to suspectthe left atrial enlargement
Positionof patient and cassette
 The patient is intially positioned facing the cassette which is supported
vertically in the casseteholder with the upper edge above the lungs apices
 With the right side of the trunk kept in a contact with cassete the patient is
rotated to bring the left side away from the cassete so that the coronal plane
forms as angle of 60degrees to the cassette.

42. Name of
the
projection
Centering
point
FFD Grid Cassette
size
Kvpand
mAs
Chest
Right
anterior
oblique
Direct the
horizontal
central ray
at right
angle to the
middle of
the cassette
at the level
of the sixth
thoracic
vertebrae to
show the
heart aortic
arch
May be
reduced to
150cms
Moving or
stationary
30 42cms 60-65 Kvp
18-20 mAs

43. 21) Grid ratio. ( by Astalakshmi)
The working of a grid is described by the grid ratio The grid ratio is used to
measure the scatteredradiation which is defined as the ratio of the height to the
width of the spacebetween the lead strips.
Grid ratio=h/b
A typical values of h and b are about 1.2mm and 0.12mm respectively .A grid ratio
of 8.1 is generally used for 70-90 kvp technique and 12.1 is used for> 90 kvp
technique.
Grid ratio ranging from 6.1 to 16.1
Grid frequency = 1/b ranging is 60cm -1
For mammography the grid ratio is 2.1 and grid frequency is 80cm-1.
The performance of a grid can be understood by contrastimprovement
factor.Thehigher grid ratio provides higher contrast improvement factor. It
increases the patient dose.

44. Types of grid
 Parallelgrid
 Crossedgrid
 Focusedgrid
 Moving grid( Potter-bucky)
Parallelgrid
In parallel grid the lead strips are parallel to each other in their longitudinal
axis.Most of x-ray table are provided with parallel grid system.
Crossedgrid
Crossed grid is made up of lead strips that are parallel to both long axis and short
axis. Usually , it is designed with two parallel grids ,that is perpendicular to each
other. The grid ratio of crossed grids is equal to sum of the ratios of the two
parallel grids.
Focusedgrid
Focused grid is made mainly to reduce grid cut off. The lead strips are parallel to
the divergence of the x-ray beam. The grid are marked with focal distance and the
side facing the target.
Moving grid
When a focused or parallel grid is used, each lead strips will appear on the
radiograph as very fine line. These lines may spoil the information in the
filmThese lines may be removed by the moving grid during radiographic exposure.
There are two types of moving grid, namely
 Reciprocating grid

45.  Oscillating grid.
22) Ball-catcher’s view. (by revvaty)
The ball-catcher’s view norgard projection or posterior oblique
view of both hands is an additional projection of the routine hand series. This
projection may be used in the diagnosis of rheumatoid arthritis. It can also be used
to demonstrate fractures of the base of the 5th metacarpals.
INDICATIONS:
 Rheumatoid arthiritis
 Joint erosion
 Erosive arthropathies.

46. Figure 7 Positionof ball-catcher's view
Central ray: To a point midway between the hands at the level of the 5th
metacarpophalangeal joints (MCPJ).
Detector size: 24cm×30cm.
Exposure – 50kVp & 20mAs
FFD – 100cm Grid – no
23) Anthosens view. ( by Aditya)
The anthosens view is also called as AP AXIALOBLIQUE VIEW with LATERAL
ROTATIONof subtalar joint.
● The anthosens view is taken for fractures involving in the subatalar joint.

47. .
NAME OF THE. ; ANTHOSENS VIEW
VIEW.
AREA COVERED : Distal tibia and fibula, entire talus and calcaneum,
proximal tarsal bones.
PATHOLOGY SHOWN :
* Fractures - in particular the involvement of the anterior and posterior
articulations of the subtalar joint, gives an end on image of the sinus tarsi and a
view of the lateral malleolus.
CENTRAL RAY. :
>center 2.5 CM distal to the medial melleolus with the central ray angled
15 degrees cranially.
SHILEDING. : gonadal
POSITIONING. :
➢ The patient lies supine on the X-ray table,with the affected limb extended.
➢ The ankle joint is dorsiflexed and the malleoli are equidistant from cassette.
➢ The leg is externally rotated through the 45 degrees.
➢ A pad is placed under the knee for the support.

48. ➢ A non opaquesquare pad and sand bag is May be placed against the plantar
acceptof the foot to keep the ankle joint in the dorsifelxion view
➢ The lower edge of the cassetteis placed at the level of the plantar acceptof
the heel.
Region View kVp
Mas
mAs Cassete Grid Distance Central
ray
Angulation
Ankle Anthosens 60 15 18X24 cm No 100cm center 2.5 central ray

49. view CM distal
to the
medial
melleolus
.
angled 15
degrees
cranially.
24) Plain radiographic demonstration of jugular foramen
(by Jayashree)
Jugular foramen is a cavity formed by the petrous part of the temporal bone
It is also called as sub-mentoverticular view. The main reason for this projection
Is to help dectectingtumours these days however imaging by CT or MRI is
Recommended for all evaluation
Postion of patient and cassette
The patient may be imaged erect or supine if the patient is unsteady then supine
Technique is advisable

50. Supine position :
 The patient’s shoulder are raised and the neck is hyper extended to bring the
vertex of the skull
In contact with the grid cassette or table
 The head is adjusted to bring the external auditory meatus equidistance from
cassette
 The median sagittal plane should be at right angled to the cassette along
its,midline
 The orbito meatal plane should be as near as possibleparallel to the cassette

51. Erect position:
 The patient sits a short distance away from a vertical bucky
 The neck is hyperextended to allow the head to fall back until
The vertex of the skull makes contact with the thecentre of the
verticalbucky
 The remainder of the positioning is as described for the supine technique
Name of the
projection
Centering
point
FFD Grid Cassette Kvp and
mAs
Sub
mentoverticular
(jugular
foramen)
Central ray
is directed
at right
orbitomeatal
plane and
centered
midway
between the
external
auditory
meatus
100cms Moving or
stationary
24 30cms
10
12inches
60-65Kvp
and 20-
30mAs
Radiological consideration
 Erosion of the bony margins of the skull base foramina is an important
indicator of destruction by tumor under-tilt,over-tilt and rotation reduce
the visibility of these foramina
 This is now an uncommon projection as CTdemonstartes more
completely the bony details of theskull basein axial and coronal planes
 The position is achieved much more easily if skull unit is used since the
object table. And tube can be adjusted to minimize hyperextension of the
neck.

53. 25) RIGHT SHOULDER JOINT TRANSAXIAL VIEW
(by Astalakshmi)
Transaxialview in shoulder joint : Means the division of shoulder joints into
an inferior and Superior parts.
Position of patient and image receptor
 SUPERIOR-INFERIOR (axil)
 INFERIOR-SUPERIOR (reverse axil)

54. Superior to inferior position
 Patient seated next to the IR
 The IR is at the mid thoracic height.The affected arm is abducted with the
elbow resting
on the detector.
 The arm must be abducted enough that the glenohumeral joint is Central to
the IR
(Patient may need to lean slightly).
 The patient head is to be tilted away towards the unaffected (and slightly
forward
If possible)The IR may be supported onpads to reduce the OFD .
CENTRAL RAYS: Centered over the mid glenohumeral joint with
5-15°towards the patient elbow.
Inferior to superior position
 The patient lies supine,with the arm of the affected side abducted and
supinated without causing discomfortto the patient.
 The affected shoulder and arm are raised on non-opaque pads.
 The receptor is positioned vertically against the shoulder and is pressed
against the neck to include as much as possible of the scapula within the
region of interest.
CENTRAL RAYS: The beam is centered towards the axilla with minimum
angulation towards the trunk.there is 20-30°medial angle aimed at the
glenohumeral joint.

55. REGION VIEWS kVp mAs CASSETTE GRID DISTANCE
Shoulder
Superior-
inferior
(axial)
50-60 8-15 18×24cm No 100cm
Inferior-
superior
(reverse
axial)
50-60 8-15 18×24cm No 100-150cm
RADIOGRAPHIC VIEWS

56. 26) RADIOGRAPHIC VIEWS OF LEFT CLAVICLE.
(by Revvaty)
Clavical : This projections can be very useful to assess the degree of any
fracture displacement and to show the middle end of the clavicle.
Sternoclavicular joint: This projections are required to joint spaceclear of
the vertebral column.
Acromioclavicular joint: The Acromioclavicular joint radiographic is used
to evaluate the acromioclavicular joint and the distal clavicle. The zanca view is a
specialized projection of the AC joint , demonstrate the AC joint from super
imposition.
REGION VIEWS CENTER
POINT
kVp mAs GRID IR&IT’S
SIZE
DISTANCE ANGULATION
clavicle
AP
Middle of
the clavicle 56 16 Yes 24×30cm 100cm
CR perpendicular
to IR
Axial
Middle of
the clavicle 60 25 Yes 24×30cm 100cm 15° towards the
shoulder& 30°
cephaled

57. The x-ray image of Clavicle
27) Radiographic demonstration of calcaneumspur (by Aditya)
Definition of calcaneum spur. (heel spur)
A bony growth that develops around the heel bone.
>Calcaneal spurs are typically detected by x-ray examination. It is a form of
exostosis. When a foot is exposed to constant stress, calcium deposits build up on
the bottom of the heel bone…
*The calcaneum spuris demonstrated in the view of calcaneum lateral position of
the ankle mainly..

58. NAME OF THE PROJECTIONS: CALCANEUM LATERAL
VIEW
INDICATION. :
* strains on foot muscles and ligaments
*stretching of the plantar fascia and repeated tearing of the membrane that covers
the heel bone.
CENTRAL RAY:
Center 2.5 CM distal to the medial malleolus ,with the vertical central ray
perpendicular to the cassette.

59. POSITIONING;
● The patient is in a lateral recumbent position on the table
● The leg is rotated until the medial and lateral malleoli are superimposed
vertically.
● At 15deg pad is placed under the anterior accept of the knee and the lateral
borderof the forefoot for support.
● The cassetteis placed with the lower edge just below the plantar accept of
the heel.
Region View Kvp mAs Cassette Grid FID Central ray
Calcaneum
Of the ankle
Calcaneum
lateral
50-60 10-12 18 X 24 cm No 100 Center 2.5
CM distal to
the medial

60. malleolus.
● Notes;
This projection is mainly taken to demonstrate the calcaneum spur, for
comparison both heels in the lateral position is necessary.
Figure shows the calcaneumspur. (formation of an extra bone around)

61. 28) Stryker’s view: ( by Jayashree)
This projection also known as the notch view was reported in 1959 as a useful
means for dectecing humeral head fractures associated with anterior dislocation of
the shoulder
 The stryker notch view is a specialised projection of the shoulder frequently
used to evalute the articulation of the gleniod and humeral head;it is an
effective projections in assesing for Hill-sachs lesions

62. Patient position
 The patient is preferably erect
 The midcoronal plane of the patient is parallel to the image receptor the
patients back is against the image receptor
 The gleno humeral joint of the affected side is at the center of the image
receptor
 The patient is turned towards the affected side is to show the glenohumeral
joint spacethis is achieved by rotating the patient 30-45degrees
 Affected arm is abducted anteriorly and rested on the patients head while
maintaining internal rotation
Centering point:
 10-15degrees cephalad angle of the x- ray tube.
 Mid axilla at the level of the glenohumeral joint
Collimation:
 Superior to include the entire neck of the humerus
 Inferior to included the gleniod
 Lateral to the extent of the humeral head medial to the extent of the humeral
head
Name of
the
projections
Cassette
size
Exposure SID/FFD Grid
Stryker’S
view
18 24cms 60 -70Kvp
and 10-
18mAs
100cms Yes

65. 29) PATELLA TANGIAL VIEW (by Astalakshmi)
This method is use to demonstrate the axial projection of the patella.
There are two projection to view the patella.
1. Skyline (merchant view) superior-inferior
2. Skyline ( Laurine view) inferior-superior
POSITION OF THE PATIENT AND THE IR
* Superior to inferior position
* Superior to inferior position

66. SUPERIOR TO INFERIOR POSITION
 The patient sits on the x Ray tabel, with the affected knee flexed over the
side.
 Ideally ,the leg should be flexed to 45° to reflect similar knee position to the
Conventional skyline projection.Too much flexion reduces the retropatellar
Spacing . sitting the patient on the cushion helps to achieve the optimum
position.
 The receptor is supported horizontally on a stoolat the level of the inferior
Tibial tuberosity border.
 This method describes the use of CR equipment ; howeverthis could be used
With DDR equipment using the erect detector placed in horizontal position
with the patient sat on a chair with a knee overhanging the detector
CENTRAL RAYS: centered over the posterior borderof the patella.
INFERIOR TO SUPERIOR
 The patient is semi recumbent on the table holding a detector superior of the
patella
In the landscape orientation.
 Patients feet should be very close to the tube side of the bed.
 The knee is bent close to 30°.
 Often a pillow should be placed behind the patient to assist them in
maintaining
the position .
CENTRAL RAYS: The Central Ray is cranially to pass through the apex of the
patella.

67. REGION VIEWS kVp mAs GRID DISTANCE ANGULATION
Knee
Patella
tangial view
Superior to
inferior
60-70 7-10 18×24cm No 100-120cm
Patella
tangial view
inferior to
superior
60-70 7-10 18×24cm No 100-120cm
RADIOGRAPHIC VIEWS Superior to inferior

68. 30) TELEROENTGENOGRAPHY (by Aditya)
Teleroentgenogram (TRG)is an X-ray examination necessary for
orthdontological therapy planning.
>TRG image is made by means of long-FFD radiography thus producing not
distorted object . due to parallel direction of X-rays due to the increased distance
between the object and the X-ray tube head.
Types of TRG Images..
*There are frontal and lateral projection teleroentgenograms:
★ TRG in direct projection enables dentition diagnostics in transversal
direction. It makes it possible to assess the symmetricity of structures of the
right and left halves of face and skull.
★ TRG in lateral projection in sagittal direction make it possibleto assess jaws
location in the spaceand teeth displacement in anterior-posterior dimension.

69. Teleroentgenogram makes it possible to obtain an image corresponding to the size
and shape of skull.

70. Teloroentgenography (investigations)
❏ Single exposure
❏ Single cassette
❏ Disadvantage : magnification error.
An X-RAY radiography taken at a distance of usually six feet ( 180degress) with
resultant practical parallelism of the rays and productionof shadows of real size.-
teleroentgenogram
Chest X-ray :
Note.
Due to six feet of distance in this chest xray the rays and shadowof the heart
will be in real size

71. 31) Zygomatic archs (by Jayashree)
Zygomatic arch is an bridge of bone extending from the temporal bone at the side
of the head around to the maxilla infront and including the Zygomatic bone as a
major portion
Zygomatic arches: infero- superior postion
This projection is essentially a modified submento-vertical (smv) projection.It is
often reffered as the jug-handle projection as the whole length of the zygomatic
arch is demonstrated profile against the side of the skull and facial bone.

72. Patient position
 The patient lies supine with one or two pillows under the shoulders to allow
the neck to be extended fully
 An 18 24cMs cassette is placed against the vertex of the skull such that its
long axis is parallel with the axial plane of the bodyIt should be supported
in this position with foam pads and sandbags
 The flexion of the neck is now adjusted to bring the long axis of the
zygomatic arch parallel to the cassette
 The head is now tilted five to ten degrees away from the side under
examination this allows the zygomatic arch under examination to be
projected on to the film without superimposition of the skull vault or facial
bones.
Name of the
projection
Centering point FFD Cassette Grid Kvp and
mAs
Zygomatic
arches of infero
superior
Central ray should be
perpendicular to the cassette
and long axis of the zygomatic
arch a Centering point should
be located such that the central
ray Passes Through the space
between mid point or
zygomatic arch
100cm 18 ×24cm No 60-65Kvp
12mAs