Chest

PA Projection

1. Patient in upright position;
2. Flexed of the arms with the back of the hands resting on the hips;
3. Extended the chin upward;
4. Adjust the shoulders in the same plane.

Central ray perpendicular at the lever T7.

Respiration: Full inspiration.

Evaluation Criteria:

• Visualization of the entire lungs, from the apices to the costophrenic angles;
• No rotation;
• Scapula projected outside the lung fields;
• Spine in the center of the image;
• Visualization of the first three dorsal vertebrae, and the others will be erasing progressively.

Lateral Projection

1. Patient in upright position;
2. Turn the patient to the lateral position;
3. Extended the upper limbs with the forearms above the head.

Central ray perpendicular on the midcoronal plane ate the level of T7.

Respiration: Full inspiration.

Evaluation Criteria:

• Superimposed of the ribs posterior in the spine;
• Sternum in profile without rotation;
• Visualization of the all lungs, from apices to costophrenic angles.

Ribs

PA/AP Projection

1. Patient in upright position;
2. Hands in resting at level of the hips (PA Projection) or extended arms to the vertical with the hands abose the head (AP Projection).

Central  ray perpendicular at the middle of the ribs in study.

Respiration: Suspended (totally ribs) or at the end of expiration (inferior ribs) or at the end of the inspiration (upper ribs).

 PA Projection

AP Projection

Evaluation Criteria:

• Visualization of the entire ribs;
• In a unilateral study, not visualization from the opposite side;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).

 PA Projection

AP Projection

 

AP/PA Oblique Projection

1. Patient in upright position;
2. Rotate the patient 45º placing the affected side closes to the IP ( AP Projection) or placing the affected side away from the IP (PA Projection);
3. Abduct the arm and elevate (AP Projection) or abduct the arm with he hand on the hip (PA Projection).

Central ray perpendicular to the center of the IP.

Respiration: Suspended (totally ribs) or at the end of expiration (inferior ribs) or at the end of the inspiration (upper ribs).

PA Projection

AP Projection

Evaluation Criteria:

• Ribs are projected free of superimposition;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).

 PA Projection

 AP Projection

Sternoclavicular Articulations Study

PA Projection

1. Patient in prone position;
2. Upper limbs along the side of the body.

Central ray perpendicular at the level T2-T3.

Respiration:Suspended at the end of expiration.

Evaluation Criteria:

• Both sternoclavicular joints in the center of the image;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).

PA Oblique Projection - RAO

1. Patient in prone position;
2. Rotation of the patient (25º) keeping the affected side adjacent to the IP.

Central ray perpendicular at the level T2-T3.

Respiration: Suspended at the end of expiration.

Evaluation Criteria:

• Sternoclavicular joint in the center of the image and with joint space opened;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).

Sternum

AP Oblique Projection

1. Patient in prone position;
2. Rotate the patient oblique (RAO) 15-20º;
3. Patient support on the forearm  and flexed knee.

Central ray perpendicular at the middle of the sternum.

Respiration: Suspended at the end of expiration.

Evaluation Criteria:

• Visualization all of the sternum, from jugular notch to the xiphoid process;
• Sternum free of superimposition from vertebral column and over the heart;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue

Lateral Projection

1.  Patient standing, in a lateral position;
2. Rotate shoulders posteriorly;
3. Raise slightly the chin.

Central ray perpendicular at the middle of the sternum.

Respiration: Suspended at the end of inspiration.

Evaluation Criteria:

• Visualization of all the sternum;
• Sternum free of superimposed by the ribs and soft tissue of the shoulders;
• Appropriate exposure values (visualization of the all bony trabeculation and soft tissue).