POSITIONING GUIDE

D I G I TA L IMAGING GUIDELINES
Chest/Ribs
PA - Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Lateral - Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
AP Stretcher - Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
PA Stretcher - Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
AP Wheelchair - Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
PA Wheelchair - Erect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Lateral Decubitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
AP Lordotic - Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Ribs RAO - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Abdomen
AP Supine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
AP- Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Left Lateral Decubitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Upper Limb
Hand PA - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Elbow - Seated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Shoulder
AP - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Axial - Standing (Right) . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Axial - Standing (Left) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Axial - Seated (Right) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Axial - Seated (Left) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Axial - Supine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Clements Modication . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Lower Limb
Foot AP - Seated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
AP Bilateral Feet (Weight - Bearing) . . . . . . . 30
Lateral Foot (Weight - Bearing) . . . . . . . . . . . . . . . 31
Calcaneus - Axial (Seated). . . . . . . . . . . . . . . . . . . . . . . . 32
Ankle Lateral - Seated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
AP Bilateral Knees (Weight - Bearing) . . . 34
PA Bilateral Knees (Rosenberg Method) . 35
Sunrise / Skyline - Supine 40 . . . . . . . . . . . . . . . . . 36
Sunrise / Skyline - Supine 72 . . . . . . . . . . . . . . . . . 37
Sunrise / Skyline - Seated . . . . . . . . . . . . . . . . . . . . . . . . . 38
Sunrise / Skyline - Prone
(Hughston Method) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Femur AP - Supine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Pelvic Girdle
Pelvis AP - Supine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Hip Frog - Leg Lateral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Hip Lateral - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Left Hip Cross - Table Lateral 40 . . . . . . . . . . . 45
Left Hip Cross - Table Lateral 72 . . . . . . . . . . . 46
Left Hip Cross - Table Lateral 40 . . . . . . . . . . . 47
Right Hip Cross - Table Lateral 72 . . . . . . . . 48
Sacroiliac Joint - LPO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Sacroiliac Joint - RPO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

Cervical Spine
AP - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Lateral - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Swimmers Lateral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Lumbar Spine, Sacrum
Lumbar Spine Cross - Table Lateral . . . . . . . . . 56
Sacrum AP Supine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Skull
Waters - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Reverse Towne - Seated . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Submentovertex (SMV) . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Off Centre Positioning
Shoulder Axial - Supine. . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Shoulder Clements Modication . . . . . . . . . . . . . 27
Lower Limb Sunrise / Skyline Seated . . . . . . . 38
Pelvic Girdle Left Hip. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Digital Imaging Guidelines
Making the Transition to DR . . . . . . . . . . . . . . . . . . 63
Grid Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Collimation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Correct Exposure Indication . . . . . . . . . . . . . . . . . . . . 64
Unassigned Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Underexposure Flowchart . . . . . . . . . . . . . . . . . . . . . . . . 65
Overexposure Flowchart . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Chest/Ribs

CHEST/RIBS

CHEST

DETECTOR: 90 | CENTRAL RAY:

PA - E R E C T

CHEST

DETECTOR: 90 | CENTRAL RAY:

L AT E R A L - E R E C T

CHEST

DETECTOR: 90 | CENTRAL RAY: +3

A P S T R E T C H E R - E R E CT

CHEST

DETECTOR: 90 | CENTRAL RAY:

PA S T R E T C H E R - E R E CT

CHEST

DETECTOR: 82 | CENTRAL RAY: +3

A P W H E E L C H A I R - E R ECT

CHEST

DETECTOR: 90 | CENTRAL RAY:

PA W HE E L C H A I R - E R ECT

CHEST

DETECTOR: 90 | CENTRAL RAY:

L AT E R A L D E C U B I T U S

10

CHEST

DETECTOR: 90 | CENTRAL RAY: -15

AP LORDOTIC - ERECT

11

RIBS

DETECTOR: 90 | CENTRAL RAY:

R A O - S TA N D I N G

12

Abdomen

ABDOMEN

ABDOMEN

DETECTOR: 0 | CENTRAL RAY:

AP - SUPINE

14

ABDOMEN

DETECTOR: 90 | CENTRAL RAY:

AP - ERECT

15

ABDOMEN

DETECTOR: 90 | CENTRAL RAY:

L E F T L AT E R A L D E C U B I TUS

16

UPPER LIMB
Upper Limb

UPPER LIMB

DETECTOR: 90 | CENTRAL RAY:

HAND PA - STANDING

18

UPPER LIMB

DETECTOR: 0 | CENTRAL RAY:

ELBOW - SEATED

19

Shoulder

SHOULDER

SHOULDER

DETECTOR: 90 | CENTRAL RAY:

AP - STANDING

21

SHOULDER

DETECTOR: 90 | CENTRAL RAY:

AXIAL - STANDING (RIGHT)

22

SHOULDER

DETECTOR: 90 | CENTRAL RAY:

AXIAL - STANDING (LEFT)

23

SHOULDER

DETECTOR: 30 | CENTRAL RAY: + 5

AXIAL - SEATED (RIGHT)

24

SHOULDER

DETECTOR: 30 | CENTRAL RAY: + 5

AXIAL - SEATED (LEFT)

25

SHOULDER

DETECTOR: 90 | CENTRAL RAY: + 5

AXIAL - SUPINE

LAWRENCE METHOD (OFF CENTRE POSITIONING)

26

SHOULDER

DETECTOR: 90 | CENTRAL RAY: + 2

CLEMENTS MODIFICATION

OFF CENTRE POSITIONING

27

Lower Limb

LOWER LIMB

LOWER LIMB

DETECTOR: 45 | CENTRAL RAY: + 10

FOOT AP - SEATED

29

LOWER LIMB

DETECTOR: 0 | CENTRAL RAY: + 10

AP BILATERAL FEET

WEIGHT-BEARING

30

LOWER LIMB

DETECTOR: 90 | CENTRAL RAY:

LATERAL FOOT

WEIGHT-BEARING

31

LOWER LIMB

DETECTOR: 0 | CENTRAL RAY: -40

CALCANEUS - AXIAL (SEATED)

32

LOWER LIMB

DETECTOR: 0 | CENTRAL RAY:

ANKLE LATERAL - SEATED

33

LOWER LIMB

DETECTOR: 90 | CENTRAL RAY:

AP BILATERAL KNEES

WEIGHT-BEARING

34

LOWER LIMB

DETECTOR: 90 | CENTRAL RAY: +10

PA BILATERAL KNEES

ROSENBERG METHOD

35

LOWER LIMB

DETECTOR: 70 | CENTRAL RAY: | SID: 40

SUNRISE/SKYLINE - SUPINE

SUPEROINFERIOR PROJECTION

36

LOWER LIMB

DETECTOR: 70 | CENTRAL RAY: | SID: 72

SUNRISE/SKYLINE - SUPINE

SUPEROINFERIOR PROJECTION

37

LOWER LIMB
SUNRISE/SKYLINE - SEATED

DETECTOR: 90 | CENTRAL RAY: +10

SUPEROINFERIOR PROJECTION (OFF CENTRE POSITIONING)

38

LOWER LIMB

DETECTOR: 0 | CENTRAL RAY: -45

SUNRISE/SKYLINE - PRONE

HUGHSTON METHOD

39

LOWER LIMB

DETECTOR: 0 | CENTRAL RAY:

FEMUR AP - SUPINE

40

PELVIC GIRDLE
Pelvic Girdle

P E LV I C G I R D L E

DETECTOR: 0 | CENTRAL RAY:

PELVIS AP - SUPINE

42

P E LV I C G I R D L E

DETECTOR: 90 | CENTRAL RAY:

HIP FROG-LEG LATERAL

STANDING

43

P E LV I C G I R D L E

DETECTOR: 90 | CENTRAL RAY: -12

HIP LATERAL - STANDING

44

P E LV I C G I R D L E

DETECTOR: 90 | CENTRAL RAY: | SID: 40

LEFT HIP

CROSS-TABLE LATERAL

45

P E LV I C G I R D L E

DETECTOR: 90 | CENTRAL RAY: | SID: 72

LEFT HIP

CROSS-TABLE LATERAL

46

P E LV I C G I R D L E

DETECTOR: 90 | CENTRAL RAY: +2 | SID: 40

LEFT HIP

CROSS-TABLE LATERAL (OFF CENTRE POSITIONING)

47

P E LV I C G I R D L E

DETECTOR: 90 | CENTRAL RAY: | SID: 72

RIGHT HIP

CROSS-TABLE LATERAL

48

P E LV I C G I R D L E

DETECTOR: 0 | CENTRAL RAY:

SACROILIAC JOINT - LPO

49

P E LV I C G I R D L E

DETECTOR: 0 | CENTRAL RAY:

SACROILIAC JOINT - RPO

50

Cervical Spine

CERVICAL SPINE

CERVICAL SPINE

DETECTOR: 90 | CENTRAL RAY: -15

AP - STANDING

52

CERVICAL SPINE

DETECTOR: 90 | CENTRAL RAY:

LATERAL - STANDING

53

CERVICAL SPINE

DETECTOR: 90 | CENTRAL RAY:

SWIMMERS LATERAL

STANDING

54

Lumbar Spine, Sacrum

LUMBAR SPINE,
SACRUM

LUMBAR SPINE

DETECTOR: 90 | CENTRAL RAY:

CROSS-TABLE LATERAL

56

SACRUM

DETECTOR: 0 | CENTRAL RAY: -15

AP SUPINE

57

SKULL
Skull

SKULL

DETECTOR: 90 | CENTRAL RAY:

WATERS - STANDING

59

SKULL

DETECTOR: 90 | CENTRAL RAY:

REVERSE TOWNE - SEATED

-25 FOR HAAS METHOD

60

SKULL

DETECTOR: 115 | CENTRAL RAY:

SUBMENTOVERTEX (SMV)

SEATED

61

Guidelines

DIGITAL IMAGING
GUIDELINES

D I G I TA L IMAGING GUIDELINES
Making the Transition to DR

Grid Use

Technologists require the same basic radiographic skills with a

new understanding of digital radiography.

Scatter radiation is decreased when using a grid. This helps to

maximize image detail and contrast.

Dark images are not necessarily overexposed.

Use the standard 10 cm rule for grid use. Use a grid for
anatomy thicker than 10 cm.

Light images are not necessarily underexposed.

It is best to keep the anatomy centreed to the detector for
optimal image processing but with the Xplorer detector, any
part of the image receptor area may be used.
Lead blockers should be used to prevent direct exposure to
the image receptor for high exposures such as lateral lumbar
spines.
Use appropriate kVp to penetrate anatomy.
When using AEC, position carefully to ensure adequate
penetration.

Ensure the grid is removed prior to imaging small body parts

such as hands and feet.
The principle is the same as lm/screen imaging; exams
typically performed table top or directly on a cassette should
be performed without a grid.

Collimation
Collimation is especially important for the image processing to
work well.
The image processing software calculates everything within the
collimated eld.
Use the standard practice of collimation to the area of interest
on each exposure.

63

D I G I TA L IMAGING GUIDELINES
Correct exposure indication

Unassigned images

F#

The entire image receptor is sensitive to both incident and

scatter radiation.

0 = optimum exposure
1 = 2x required dose

-1 = 1/2 the required dose

2 = 4x required dose

-2 = 1/4 the required dose

3 = 8x required dose

-3 = 1/8 the required dose

If you make an exposure in the room without using the

detector, an acquisition may occur on the system resulting in
an unassigned image.
Please refer to the operator manual to assign unassigned
images or close Magellan acquisition interface before making
the exposure.

64

D I G I TA L IMAGING GUIDELINES
Underexposure: An underexposed image will appear grainy (quantum mottle).

UNDEREXPOSURE

Check the Grid

Was the appropriate

technique set?

Is the correct grid

being used?

Was the anatomy centreed over

the correct AEC chamber?

100 cm (40)
Focal Distance

180 cm (70)
Focal Distance

Was the exposure

adjusted for body
habitus?

Was the exposure

adjusted for patient
pathology?

Do not use grid

for extremities

65

D I G I TA L IMAGING GUIDELINES
Overexposure: When an image or an area of an image has been overexposed, the overexposed area will appear completely black. You can
tell the image is overexposed if no image information is available, even when adjusting the contrast and brightness.

OVEREXPOSURE

Check the Grid

Was the appropriate

technique set?

Is the correct
grid in?

Was the anatomy centreed over

the correct AEC chamber?

100 cm (40)
Focal Distance

180 cm (72)
Focal Distance

Was the exposure

adjusted for body
habitus?

Was the exposure

adjusted for patient
pathology?

Do not use grid

for extremities

66

D I G I TA L IMAGING GUIDELINES

These pictures were taken for positioning demonstration only.

In clinical practice, proper shielding should always be used.
For more information, please refer to your operators manual
or call your representative.

Imaging Dynamics Company Ltd.

151, 2340 Pegasus Way N.E.
Calgary, Alberta, Canada
www.imagingdynamics.com