TMJ Open Closed
4
Feb

Overview

TMJ open and closed mouth radiographs evaluate condylar translation and joint space changes. Paired views demonstrate dynamic motion and detect dislocation or degenerative change. Proper positioning ensures reproducible comparison between states.

Technique

Obtain closed mouth and open mouth projections with the detector centered to the TMJ and the patient in a true lateral or modified Towne position. Use appropriate exposure and instruct the patient on mouth opening degree. Immobilize the head to reduce motion.

Clinical Indications

TMJ open closed views are indicated for pain dysfunction and suspected dislocation. They help assess condylar translation and joint space narrowing. MRI is preferred for soft tissue and disc evaluation when indicated.

Image Assessment

Compare condylar position between open and closed views and assess for translation limitation. Evaluate joint space asymmetry and osseous degenerative changes. Report findings relevant to dental or surgical management.

Mandible Panoramic
4
Feb

Overview

Panoramic radiography provides a broad overview of the mandible maxilla and dentition in a single projection. It is useful for evaluating fractures impacted teeth and dental pathology. Proper patient positioning is essential for diagnostic quality.

Technique

Position the patient with the occlusal plane aligned to the machine guide and the head stabilized. Use appropriate exposure and instruct the patient to remain still during the rotational acquisition. Remove metallic objects that may cause artifacts.

Clinical Indications

Panoramic mandible imaging is indicated for trauma dental assessment and preoperative planning. It detects mandibular fractures cysts and impacted teeth. CT or cone beam CT provides higher resolution for complex surgical planning.

Image Assessment

Assess mandibular continuity tooth root integrity and presence of radiolucent or radiopaque lesions. Evaluate condylar morphology and temporomandibular joint when included. Report findings relevant to dental or maxillofacial management.

Facial Bones Caldwell
4
Feb

Overview

The Caldwell projection images the frontal sinuses orbital rims and nasal bones with the forehead against the detector. The beam is angled caudally to project the petrous ridges below the orbits. This view complements Waters and lateral projections for facial trauma evaluation.

Technique

Position the patient with the forehead and nose against the detector and angle the tube approximately 15 degrees caudad. Center the detector to the mid face and use appropriate exposure. Immobilize the head to minimize motion.

Clinical Indications

Caldwell view is indicated for frontal sinus trauma suspected orbital rim fracture and nasal bone assessment. It aids in detecting sinus fluid levels and anterior table fractures. CT is preferred for complex facial fractures and surgical planning.

Image Assessment

Evaluate frontal sinus integrity orbital rim continuity and nasal bone alignment. Look for air fluid levels and displaced fractures. Recommend CT for definitive assessment when indicated.

Facial Bones Waters
4
Feb

Overview

The Waters projection images the maxillary sinuses orbits and zygomatic arches with the chin elevated. This view is useful for detecting orbital floor fractures and maxillary sinus disease. Proper head extension optimizes visualization of the facial skeleton.

Technique

Position the patient with the chin extended so the orbitomeatal line forms a 37 degree angle to the detector. Center the detector to the mid face and use appropriate exposure. Immobilize the head to reduce motion artifact.

Clinical Indications

Waters view is indicated for facial trauma suspected orbital floor fracture and sinus pathology. It complements lateral and Caldwell views for comprehensive facial assessment. CT is preferred for complex fractures and surgical planning.

Image Assessment

Assess the orbital floor maxillary sinus and zygomatic arch for fractures and fluid levels. Evaluate for orbital emphysema and foreign bodies. Report findings and recommend CT when detailed anatomic delineation is required.

Skull Lateral
4
Feb

Overview

The lateral skull radiograph profiles the cranial vault and facial bones to assess fractures and soft tissue calcifications. The patient is positioned true lateral with the orbitomeatal line parallel to the detector. This view complements AP imaging for comprehensive skull assessment.

Technique

Position the head in true lateral and center the detector to include the entire skull from the frontal sinus to the occiput. Use appropriate exposure and immobilize the head to minimize motion. Collimate to the skull to reduce dose.

Clinical Indications

Lateral skull is indicated for trauma suspected fracture and evaluation of sinus disease or calcifications. CT is preferred for detailed assessment of fractures and intracranial pathology. Radiographs may be used for screening or when CT is not available.

Image Assessment

Evaluate cranial vault contour suture lines and paranasal sinus aeration. Inspect for depressed fractures and soft tissue emphysema. Recommend CT for definitive assessment of suspected intracranial injury.

Skull AP
4
Feb

Overview

The AP skull radiograph evaluates cranial vault symmetry and gross osseous lesions. The patient is positioned upright or supine with the detector centered to the skull. This view is used for initial assessment in trauma and suspected skull pathology.

Technique

Center the detector to include the entire skull and ensure the orbitomeatal line is perpendicular to the detector for standard AP projection. Use appropriate exposure and immobilize the head to reduce motion. Collimate to the skull to minimize dose.

Clinical Indications

AP skull is indicated for trauma suspected fracture and evaluation of lytic or sclerotic lesions. CT is preferred for detailed assessment of skull fractures and intracranial injury. Radiographs may be used when CT is unavailable.

Image Assessment

Inspect cranial vault for fractures lytic lesions and calcifications. Evaluate sutures and skull base when visible. Recommend CT for detailed evaluation of suspected intracranial or complex skull pathology.

SI Joint AP Oblique
4
Feb

Overview

AP oblique views of the sacroiliac joints profile the joint space and sacral ala for inflammatory and traumatic changes. The patient is rotated to place the SI joint of interest perpendicular to the detector. These views aid in detecting erosions sclerosis and joint space narrowing.

Technique

Rotate the patient approximately 25 to 30 degrees to the side of interest and center the detector to the sacroiliac joint. Use appropriate exposure and immobilize the patient to reduce motion. Obtain bilateral obliques for comparison when indicated.

Clinical Indications

SI joint obliques are indicated for suspected sacroiliitis trauma and pelvic pain. They help detect erosive changes and joint space irregularity. MRI provides superior soft tissue and early inflammatory detection when needed.

Image Assessment

Assess joint space symmetry erosions and subchondral sclerosis. Evaluate for sacral fractures and adjacent pelvic pathology. Report findings relevant to rheumatologic or orthopedic management.

Sacrum Coccyx Lateral
4
Feb

Overview

The lateral sacrum and coccyx radiograph profiles the lower spine to assess alignment and fractures. The patient lies in true lateral with the detector centered to the sacrum. This view is useful for evaluating coccygeal angulation and sacral fractures.

Technique

Position the patient in true lateral and center the detector to include the sacrum and coccyx. Use appropriate exposure and immobilize the patient to minimize motion. Include adjacent pelvic structures when indicated.

Clinical Indications

Lateral sacrum and coccyx are indicated for trauma tailbone pain and suspected fracture or dislocation. They complement AP views for comprehensive assessment. CT or MRI may be required for detailed evaluation of complex injuries.

Image Assessment

Evaluate coccygeal angulation sacral body integrity and posterior element alignment. Inspect for cortical disruption and callus formation on follow up. Report findings relevant to pain management and surgical planning.

Sacrum Coccyx AP
4
Feb

Overview

The AP sacrum and coccyx radiograph evaluates the lower spine and pelvic ring for fractures and degenerative change. The patient is positioned supine with the detector centered to the sacrum. This view is used for trauma and chronic tailbone pain assessment.

Technique

Center the detector to include the sacrum and coccyx and use appropriate tube angulation if needed to project the sacrum free of pelvic superimposition. Ensure patient comfort and immobilize to reduce motion. Collimate tightly to reduce dose.

Clinical Indications

AP sacrum and coccyx are indicated for trauma tailbone pain and suspected fracture or infection. They help detect sacral insufficiency fractures and coccygeal dislocation. CT or MRI may be required for detailed evaluation.

Image Assessment

Assess sacral alar integrity coccygeal alignment and look for cortical disruption. Evaluate adjacent pelvic structures for associated injury. Report findings and recommend advanced imaging when clinical concern persists.

Lumbar Spine Lateral
4
Feb

Overview

The lateral lumbar spine radiograph profiles vertebral bodies intervertebral disc spaces and posterior elements to detect spondylolisthesis and compression fractures. The patient is positioned true lateral with knees flexed for comfort. This view is essential for evaluating sagittal balance and neural foramina indirectly.

Technique

Center the detector to include L1 to S1 and ensure true lateral alignment with minimal rotation. Use appropriate exposure and immobilize the patient to reduce motion. Flex knees to reduce lumbar lordosis when needed for better visualization.

Clinical Indications

Lateral lumbar spine is indicated for low back pain trauma and suspected compression fractures. It helps assess disc height spondylolisthesis and vertebral collapse. MRI is preferred for direct neural element and disc pathology evaluation.

Image Assessment

Measure disc heights and vertebral body alignment and assess for anterior or posterior displacement. Evaluate for compression fractures and osteophyte formation. Report findings relevant to surgical planning and conservative management.