Overview
Decubitus chest radiographs are obtained with the patient lying on the side to detect small pleural effusions. Fluid layers dependably on the dependent hemithorax and becomes visible as a meniscus. This view is helpful when upright imaging is not feasible.
Technique
Position the patient in lateral decubitus with the affected side down for fluid detection. Use a horizontal beam to demonstrate layering of pleural fluid. Ensure adequate exposure and include the entire hemithorax.
Clinical Indications
Decubitus views are indicated when small effusions are suspected or to differentiate free fluid from loculated collections. They are useful in trauma and bedridden patients. They complement standard chest radiographs for comprehensive evaluation.
Image Assessment
Look for layering fluid along the dependent lateral chest wall and blunting of the costophrenic angle. Assess for associated consolidation or atelectasis. Correlate with clinical findings and consider ultrasound or CT for further evaluation.