Bony Thorax

PA OBLIQUE
PROJECTION
PP: Prone or upright (trauma patient); RAO; body rotated 15-20 (prevents superimposition of sternum & vertebrae); long
o
exposure time: slow, shallow breaths during exposure; short exposure time: suspend breathing at the end of expiration
RP: T7 of elevated side of posterior thorax & 1 in. lateral to MSP
CR: ┴
SS: Best projection to demonstrate sternum
• Sternum free of superimposition from vertebral column
• Sternum projected over the heart
AP Oblique Projection:
• LPO position
• For trauma patients in supine position

MOORE METHOD
PA OBLIQUE PROJECTION
PP: Modified prone position; tube positioned over the patient’s right side; patient stand at the side of table; bend at the waist;
arms above shoulders; palms down on table
RP: level of T7 & 2 in. to the right of spine
CR: 25 toward MSP; large patient (less angulation); small patient (more angulation)
o
SS: Sternum free of superimposition from vertebral column

ER: Perform on an ambulatory patient who is having acute pain to provide comfort & to produce high-quality sternum image
• Sternum projected over the heart

LATERAL PROJECTION
R or L Position
PP: Lateral recumbent/upright or dorsal decubitus (for patient with severe injury); patient in true lateral position; broad surface of
sternum ┴ to IR; suspended deep inspiration
RP: Lateral border of midsternum
CR: ┴
SS: Best demonstrate the entire length of sternum & its surrounding tissue

D.) STERNOCLAVICULAR JOINTS

PA PROJECTION
PP: Prone or upright (trauma patient); arms along the sides; palms facing upward; head turned facing the affected side for
unilateral examination (rotates the spine slightly away from side of interest); head rested on chin for bilateral examination
RP: T3
CR: ┴
SS: Sternoclavicular joints

KURZBAUER METHOD
LATERAL PROJECTION
PP: Lateral recumbent; affected side against IR; hips & knee flexed; arm of affected grasp the end of table (for support); arm of
unaffected side grasp the dorsal surface of hip (depressed shoulder); anterior surface of manubrium ┴ to IR
RP: Lowermost sternoclavicular articulation
CR: 15 caudad
o
SS: Unobstructed sternoclavicular joint

Body Rotation Method
PP: Prone or seated-upright (trauma patient); RAO/LAO; body rotated 10-15 toward affected side (projects vertebrae well
o
behind the SC joint)

RP: Level of T2-T3 (3 in. distal to vertebral prominens) & 1-2 in. lateral from MSP
CR: ┴
• Entrance: right side (left SC joint); left side (right SC joint)

Central Ray Angulation Method
PP: Prone or seated-upright (trauma patient); chin rested on table or rotated toward the side of interest
RP: Level of T2-T3 (3 in. distal to vertebral prominens) & 1-2 in. lateral from MSP
CR: 15 toward MSP
o
• Entrance: right side (left SC joint); left side (right SC joint)


D.) RIBS

PA PROJECTION
PP: Upright/prone; hands rested against hips; palms turned outward; chin rested on chin; suspend at full inspiration (depresses
diaphragm)
RP: T7
CR: ┴ or 10-15 caudad (to demonstrate 7th-9 ribs)
o th
SS: Anterior ribs (1 -9 ) above the diaphragm

st th

AP PROJECTION
PP:
• Upright: to image ribs above diaphragm; IR top board 1.5 in. above shoulder; shoulder rotated forward; suspend at full inspiration
(to depress diaphragm)
• Supine: to image ribs below diaphragm; shoulder in the same transverse plane; suspend at full expiration (to elevate diaphragm)
RP: T7 (upper ribs) or T10 (lower ribs)
CR: ┴
SS: Posterior ribs above the diaphragm (1 -10 ) & below the diaphragm (8 -12 )
st th th th

AP OBLIQUE PROJECTION
PP: RPO/LPO; body rotated 45 (affected side down); arm of affected side abducted; opposite hand on hip
o
• Upright: to image ribs above diaphragm; hand rested on head; suspend at full inspiration (to depress diaphragm)
• Supine: to image ribs below diaphragm; hip elevated; suspend at full expiration (to elevate diaphragm)
CR: ┴
SS: Axilliary ribs closest from IR

PP: RAO/LAO; body rotated 45 (affected side up)
o
• Upright: to image ribs above diaphragm; forearm of affected side rested on grid device; suspend at full inspiration (to depress
diaphragm)
• Supine: to image ribs below diaphragm; patient rested on forearm; knee of elevated side flexed; suspend at full expiration (to
elevate diaphragm)
CR: ┴
SS: Axilliary ribs away from IR

AP AXIAL PROJECTION
PP: Supine; head rested directly on table (to avoid accentuating the dorsal kyphosis); arms along sides of the body
RP: 2 in. superior to xiphoid process
CR: 20 cephalad
o
• Increase 5-10 angle (patient w/ pronounced dorsal kyphosis)

o
SS: Costal joints
• Costovertebral & costotransverse joints

Bony Thorax

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PA OBLIQUE

SS: Sternum free of superimposition from vertebral column

behind the SC joint)

• Entrance: right side (left SC joint); left side (right SC joint)

SS: Anterior ribs (1 -9 ) above the diaphragm

• Increase 5-10 angle (patient w/ pronounced dorsal kyphosis)

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