Radiographic Positioning and Methods Review

Comprehensive practice flashcards covering radiographic methods, specialized projections, positions, central ray angulations, and demonstrated structures across upper extremities, lower extremities, pelvic girdle, spine, bony thorax, skull, facial bones, and technical radiography principles.

Robert Method

An AP projection of the first CMC joint with the central ray directed perpendicular ($\perp$) to the first CMC joint to demonstrate it free from superimposition of the soft tissues of the hand.

Folio Method

A PA projection of the first MCP joints with the central ray directed perpendicular ($\perp$) midway between the hands at the level of the MCP joints, utilized for the diagnosis of UCL rupture or Skier's thumb.

Norgaard and Brewerton Methods

An AP oblique (APOB) projection with the central ray directed perpendicular ($\perp$) midway between the hands at the level of the MCP joints, indicated for the early detection of rheumatoid arthritis.

Daffner, Emmerling and Butterbaugh Method (PABED)

A PA projection of the wrist with a $30^\natural$ central ray angulation toward the elbow to elongate the scaphoid and capitate, or $30^\natural$ toward the fingertips to elongate the capitate.

Stecher Method

A PA axial projection of the scaphoid utilizing a $20^\natural$ elevation of the IR with a perpendicular ($\perp$) central ray directed to the scaphoid to project it free from superimposition.

Clements-Nakayama Method (Trapezium)

A PA axial oblique projection for trapezium fractures where the central ray is angled $45^\natural$ distally to the anatomical snuffbox and through the trapezium (rotating the elbow $30^\natural$ if the patient cannot deviate).

Lentino Method (Carpal Bridge)

A tangential projection of the wrist with the central ray directed $45^\natural$ caudad, entering $1\frac{1}{2}\text{''}$ to the wrist joint to demonstrate scaphoid fractures, lunate dislocation, foreign bodies, and chip fractures on the dorsal aspect of the carpals.

Gaynor-Hart Method

A tangential inferosuperior projection of the carpal canal with the central ray directed $25^\natural-30^\natural$ to the long axis of the hand, centered $1\text{''}$ distal to the base of the third metacarpal, demonstrating the carpal canal and hook of hamate.

Jones Technique

An acute flexion projection used for the distal humerus and proximal forearm to demonstrate the olecranon process and fractures of the elbow when the elbow cannot be extended.

Coyle Method

An axial lateromedial trauma projection of the elbow: a $45^\natural$ angle toward the shoulder with $90^\natural$ flexion visualizes the radial head, whereas a $45^\natural$ angle away from the shoulder with $80^\natural$ flexion visualizes the coronoid process.

Grashey Method (Shoulder)

An AP oblique (APOB) projection of the scapulohumeral joint with $35^\natural-45^\natural$ body rotation and the central ray perpendicular ($\perp$) to the glenoid cavity, centered $2\text{''}$ medial and inferior to the superolateral border of the shoulder.

Garth Method

An AP axial oblique projection with $45^\natural$ body rotation and a $45^\natural$ caudad central ray angulation to the scapulohumeral joint, recommended for acute shoulder trauma, posterior dislocations, and Hill-Sachs defect.

Stryker-Notch Method

An AP axial projection with the patient supine and the central ray angled $10^\natural$ cephalad to the coracoid process, used to evaluate the proximal humerus for Hill-Sachs defects.

Neer Method

A tangential projection of the supraspinatus outlet with the patient in a $45^\natural-60^\natural$ RAO/LAO erect position and the central ray angled $10^\natural-15^\natural$ caudad to the most superior aspect of the humeral head, used to assess shoulder impingement.

Pearson Method

A bilateral erect AP projection of the acromioclavicular joints taken in two exposures (without weights and holding $5-8\text{ lbs}$ of weights) with the central ray perpendicular ($\perp$) to the midline of the body at the level of the AC joints.

Tarrant Method

A tangential projection of the clavicle for patients with multiple injuries, performed seated with the central ray angled $25^\natural-35^\natural$ anteriorly and inferiorly to the midshaft of the clavicle.

Böhler's Critical Angle (Tuber's Angle)

The angle formed between the superior apex of the mid-calcaneus and the anterior process of the hamulus on a lateromedial weight-bearing foot radiograph; normally $20^\natural-40^\natural$, an angle of less than $20^\natural$ indicates a calcaneal fracture.

Broden Method

An AP axial medial and lateral oblique position utilizing a $45^\natural$ foam sponge to demonstrate the posterior and middle facets of the subtalar joint at varied cephalad central ray angulations ($10^\natural$, $20^\natural-30^\natural$, and $40^\natural$).

Rosenberg Method

A weight-bearing PA projection of the knees with $45^\natural$ knee flexion and a perpendicular or $10^\natural$ caudad central ray directed to evaluate femorotibial joint space narrowing and articular cartilage disease.

Camp-Coventry Method

A PA axial intercondylar fossa (tunnel view) projection where the knee is flexed $40^\natural$ or $50^\natural$ and the central ray is angled identically $40^\natural$ or $50^\natural$ caudad, demonstrating joint mice, osteochondritis dissecans, and lateral femoral condyle underdevelopment.

Merchant Method

A bilateral axial tangential projection of the patellae and patellofemoral joints performed supine with the knees flexed $40^\natural$ (relaxation of quadriceps femoris is critical) and the central ray directed $30^\natural$ caudad from the horizontal.

Settegast Method

A tangential projection of the patellofemoral articulation performed prone with acute, slow knee flexion; the central ray is directed perpendicular ($\perp$) or $15^\natural-20^\natural$ through the joint to assess vertical patellar fractures (contraindicated until transverse fracture is ruled out).

Chassard-Lapine Method (Jack-Knife)

An axial projection of the pelvis and hip joints performed with the patient seated and leaning forward so the central ray passes perpendicular ($\perp$) through the lumbosacral region at the level of the greater trochanters to demonstrate the bi-ischial diameter and relationship of the femoral head to the acetabulum.

Danelius-Miller Method

An axiolateral (inferosuperior lateral) projection for trauma hips where the unaffected hip and knee are elevated vertically and a horizontal central ray is directed perpendicular ($\perp$) to the long axis of the femoral neck.

Teufel Method

A PA axial oblique projection of the acetabulum with the unaffected side elevated $38^\natural$ and the central ray angled $12^\natural$ cephalad through the acetabulum to show the fovea capitis and superoposterior wall of the acetabulum.

Judet Method

Two $45^\natural$ posterior oblique positions of the pelvis: internal oblique shows the iliopubic (anterior) column and posterior acetabular rim, while external oblique shows the ilioischial (posterior) column and anterior acetabular rim.

Taylor Method (Outlet)

An AP axial projection of the anterior pelvic bones with the central ray directed $20^\natural-35^\natural$ cephalad for males and $30^\natural-45^\natural$ cephalad for females, entering $2\text{''}$ distal to the superior border of the pubic symphysis to display the pubic and ischial rami without foreshortening.

Lilienfeld Method (Pelvic Inlet)

A superoinferior axial projection where the patient sits upright, leaning backward $45^\natural-50^\natural$, with a perpendicular ($\perp$) central ray centered $1\frac{1}{2}\text{''}$ superior to the pubic symphysis to demonstrate the pelvic inlet.

Scottie Dog Anatomy (Lumbar Zygapophyseal Joints)

Anatomical landmarks visualized on an oblique lumbar projection: ear corresponds to the superior articular process, eye to the pedicle, nose to the transverse process, neck to the pars interarticularis (isthmus), body to the lamina and spinous process, foreleg to the inferior articular process, tail to the superior articular process of the opposite side, and hindleg to the inferior articular process of the opposite side.

Ottonello Method

An AP 'wagging jaw' projection where continuous movement of the mandible during exposure blurs the mandibular rami to allow visualization of all seven cervical vertebrae.

Twining Method (Swimmer's)

A lateral cervicothoracic projection performed upright with one arm elevated and resting on the head and the opposite shoulder depressed; the central ray is directed perpendicular ($\perp$) or $5^\natural$ caudad to $C7-T1$ to demonstrate $C5-T4$.

Ferguson Method (Scoliosis)

A PA evaluation of scoliosis involving two exposures: one in the standard standing/seated position and a second with the hip or foot on the convex side of the primary curve elevated $3\text{''}-4\text{''}$ to differentiate the primary curve from compensatory curves.

Lindblom Method

An AP axial lordotic projection performed with the patient standing approximately $1\text{ ft}$ in front of the vertical cassette holder and leaning backward into extreme lordosis to demonstrate the pulmonary apices free from clavicular superimposition.

Towne Method (AP Axial Cranium)

An AP axial skull projection with the central ray directed $30^\natural$ caudad to the OML (or $37^\natural$ caudad to the IOML), entering $2\frac{1}{2}\text{''}$ above the glabella to demonstrate the occipital bone, symmetric petrous pyramids, and dorsum sellae/posterior clinoids within the foramen magnum.

Haas Method

A PA axial projection of the cranium performed prone with the OML perpendicular ($\perp$) and the central ray angled $25^\natural$ cephalad entering $1\frac{1}{2}\text{''}$ below the inion, serving as the reverse Towne projection for hypersthenic or obese patients.

Rhese Method

A parieto-orbital oblique projection where the zygoma, nose, and chin contact the IR (placing the AML perpendicular and MSP at $53^\natural$ to the IR) with a perpendicular ($\perp$) central ray to project the optic canal 'on end' in the lower outer quadrant of the orbit.

Waters Method (Parietoacanthial)

A parietoacanthial projection of the facial bones and paranasal sinuses with the neck hyperextended so the OML forms a $37^\natural$ angle with the IR and the central ray exits the acanthion, projecting the petrous ridges below the maxillary sinus floors.

Stenvers Method (Temporal Bone)

A posterior profile axiolateral projection where the patient's head is rotated $45^\natural$ toward the IR (forehead, nose, cheek touching) and the central ray is angled $12^\natural$ cephalad, entering $3\text{''}-4\text{''}$ posterior and $\frac{1}{2}\text{''}$ inferior to the upside EAM to align the petrous pyramid parallel to the IR.

Valdini Method

A PA axial projection with the patient's head acutely flexed and the central ray directed perpendicular ($\perp$) entering the inion and exiting $0.5\text{ cm}$ distal to the nasion; demonstrates the dorsum sellae, labyrinth, and internal auditory meatus (IOML $50^\natural$), or external auditory meatus and tympanic cavity (OML $50^\natural$).

Cahoon Method

A PA axial projection for the styloid processes of the temporal bones with the neck flexed (OML and MSP perpendicular) and the central ray angled $25^\natural$ cephalad to the nasion to project the processes within or just above the maxillary sinuses.

Destructive Diseases (Radiolucent)

Pathological conditions that decrease tissue density and require a decrease in technical factors to prevent overexposure (e.g., pneumothorax, emphysema, osteoporosis, degenerative arthritis, osteolytic metastases, bowel obstruction).

Additive Diseases (Radiopaque)

Pathological conditions that increase tissue density and require an increase in technical factors to ensure adequate penetration (e.g., edema, pneumonia, pulmonary embolism, ascites, atelectasis, osteoblastic metastases, cirrhosis).