Bontrager's Textbook of Radiographic Positioning and Related Anatomy - E-Book

Master radiographic positioning with this comprehensive, user-friendly text. Focusing on one projection per page, Bontrager’s Textbook of Radiographic Positioning and Related Anatomy, 9th Edition includes all of the positioning and projection information you need to know in a clear, bulleted format. Positioning photos, radiographic images, and radiographic overlays, presented side-by-side with the explanation of each procedure, show you how to visualize anatomy and produce the most accurate images. Updated to reflect the latest ARRT competencies and ASRT curriculum guidelines, it features more than 200 of the most commonly requested projections to prepare you for clinical practice. Key Features Labeled radiographs (radiographic overlays) identify key radiographic anatomy and landmarks to help you recognize anatomy and determine if you have captured the correct diagnostic information on your images. Positioning chapters, organized with one projection per page, present a manageable amount of information in an easily accessible format. Unique page layout with positioning photos, radiographic images, and radiographic overlays presented side-by-side with the text explanation of each procedure to facilitate comprehension and retention. Pathologic Indications list and define the pathologies most likely to be encountered during procedures covered in each chapter to help you understand the whole patient and improve your ability to produce radiographs that make diagnosis easy for the physician. Pathology Demonstrated sections explain why a particular projection is needed, or what pathology might be demonstrated, to give you a larger frame of reference and a better understanding of the reasoning behind each projection. Radiographic Criteria on positioning pages provide standards for evaluating the quality of each radiograph, helping you develop a routine for evaluating radiographic quality. Pediatric Applications prepare students for clinical success — and prepare technologists to deal competently with the special needs of their pediatric patients. Geriatric Applications include general information on positioning techniques and patient handling for geriatric patients, fostering an understanding of the challenges these patients present to the technologist. Critique Radiographs demonstrate positioning errors and help you avoid similar errors in clinicals. Instructor resources include an accompanying Evolve website with PowerPoint slides, an image collection, and a test bank to help instructors prepare for class. Student resources include a workbook and handbook to help you better understand and retain complicated material. Front Cover Bontrager's Textbook of Radiographic Positioning and Related Anatomy Copyright Page Acknowledgments and Dedication Contributors Contributors to Past Editions Reviewers Preface Purpose and Goal of the Ninth Edition Methodology New to This Latest Edition Ancillaries Workbook Evolve Instructor Resources Handbook Mosby’s Radiography Online How to Use the Positioning Pages Table Of Contents 1 Terminology, Positioning, and Imaging Principles Contents Part One ■ Terminology and Positioning General, Systemic, and Skeletal Anatomy and Arthrology General Anatomy Structural Organization Cells Tissues Organs System Organism Systemic Anatomy Body Systems Skeletal System Circulatory System Digestive System Respiratory System Urinary System Reproductive System Nervous System Muscular System Endocrine System Integumentary System Skeletal Anatomy Osteology Axial Skeleton Appendicular Skeleton Sesamoid Bones Classification of Bones Long Bones Composition Short Bones Flat Bones Irregular Bones Development of Bones Blood Cell Production Bone Formation Intramembranous Ossification Endochondral Ossification Primary and Secondary Centers of Endochondral Ossification (Fig. 1.21) Radiograph Demonstrating Bone Growth Arthrology (Joints) Classification of Joints Functional Structural Fibrous Joints 1. Syndesmoses1 2. Sutures 3. Gomphoses Cartilaginous Joints 1. Symphyses 2. Synchondroses Synovial Joints Movement Types of Synovial Joints 1. Plane (gliding) joints 2. Ginglymus (hinge) joints 3. Pivot (trochoid) joints 4. Ellipsoid (condylar) joints 5. Saddle (sellar) joints 6. Ball and socket (spheroidal) joints 7. Bicondylar joints3 Body Habitus Impact of Body Habitus on Radiographic Positioning Positioning Terminology General Terms Radiographic Examination or Procedure Anatomic Position Viewing Radiographs Body Planes, Sections, and Lines (Fig. 1.39) Plane: Straight Line Surface Connecting Two Points Sagittal Plane Coronal Plane Horizontal (Axial) Plane Oblique Plane Sectional Image of Body Part Longitudinal Sections—Sagittal, Coronal, and Oblique Transverse or Axial Sections (Cross-Sections) Sagittal, Coronal, and Axial Images Planes of the Skull (Fig. 1.44) Base Plane of Skull Occlusal Plane Body Surfaces and Parts Terms for the Back and Front Portions of the Body (Fig. 1.45) Posterior or Dorsal Anterior or Ventral Terms for Surfaces of the Hands and Feet Plantar Dorsal Foot Hand Palmar Radiographic Projections Common Projection Terms Posteroanterior (PA) Projection Anteroposterior (AP) Projection AP Oblique Projection PA Oblique Projection Mediolateral and Lateromedial Projections Body Positions General Body Positions Specific Body Positions Lateral Position Oblique Position5 Left and Right Posterior Oblique (LPO and RPO) Positions Right and Left Anterior Oblique (RAO and LAO) Positions Decubitus (Decub) Position Right or Left Lateral Decubitus Position—AP or PA Projection Dorsal Decubitus Position—Left or Right Lateral Ventral Decubitus Position—Right or Left Lateral Additional Special Use Projection Terms Axial Projection Inferosuperior and Superoinferior Axial Projections Tangential Projection Examples AP Axial Projection—Lordotic Position Transthoracic Lateral Projection (Right Lateral Position) Dorsoplantar and Plantodorsal Projections Parietoacanthial and Acanthioparietal Projections Submentovertical (SMV) and Verticosubmental (VSM) Projections Relationship Terms Medial Versus Lateral Examples Proximal Versus Distal Examples Cephalad Versus Caudad Interior (Internal, Inside) Versus Exterior (External, Outer) Superficial Versus Deep Example Ipsilateral Versus Contralateral Example Terms Related to Movement Flexion Versus Extension Hyperextension Abnormal Hyperextension Normal Flexion and Hyperextension of Spine Normal Hyperextension of Wrist Acute Flexion of Wrist Ulnar Deviation Versus Radial Deviation of Wrist Dorsiflexion Versus Plantar Flexion of Foot and Ankle Dorsiflexion of Foot Plantar Flexion of Foot Eversion Versus Inversion Valgus Versus Varus1 Medial (Internal) Rotation Versus Lateral (External) Rotation Abduction Versus Adduction Supination Versus Pronation Protraction Versus Retraction Example Elevation Versus Depression Example Circumduction Rotation Versus Tilt Summary of Potentially Misused Positioning Terms Position Projection View Positioning Principles Evaluation Criteria Evaluation Criteria Format Image Markers and Patient Identification Patient Identification and Date (Film-Screen Cassette [ANALOG] Systems) Digital Systems Anatomic Side Marker Additional Markers or Identification Professional Ethics and Patient Care Essential Projections Routine Projections Special Projections General Principles for Determining Positioning Routines Minimum of Two Projections (90° From Each Other) 1. Superimposition of anatomic structures 2. Localization of lesions or foreign bodies Example 3. Determination of alignment of fractures Minimum of Three Projections When Joints Are in Area of Interest Exceptions to Rules Palpation of Topographic Positioning Landmarks Palpation Image Receptor (IR) Alignment Viewing Radiographic Images Viewing CT or MRI Images Part Two ■ Imaging Principles Image Quality in Film-Screen (Analog) Radiography Analog Images Exposure Factors for Analog (Film-Screen) Imaging Image Quality Factors Density Definition Controlling Factors Adjusting Analog Image Density Density and Anode Heel Effect Compensating Filters Summary of Density Factors Contrast Definition Adjusting Analog Image Contrast Controlling Factors Grids Correct Use of Grids 1. Off-center grid Exception: decubitus—short dimension (SD)—type linear grids: 2. Off-level grid 3. Off-focus grid 4. Upside-down focused grid Summary of Contrast Factors Spatial Resolution Controlling Factors Geometric Factors Film-Screen System Motion Difference between voluntary and involuntary motion Summary of Spatial Resolution Factors Distortion X-Ray Beam Divergence Controlling Factors 1. SID Minimum 40-inch (or 102-cm) SID 2. OID 3. Object image receptor alignment Effect of improper object IR alignment 4. Central ray alignment CR angle Summary of Factors That May Affect Distortion Image Quality in Digital Radiography Digital Images Exposure Factors for Digital Imaging Image Quality Factors Brightness Controlling Factors Contrast Resolution Controlling Factors Pixels and Bit Depth Pixel Size Scatter Radiation Control Spatial Resolution Controlling Factors Distortion Controlling Factors Exposure Indicator Deviation Index Controlling Factors Noise Signal-to-Noise Ratio (SNR) High SNR Low SNR Postprocessing Postprocessing and Exposure Indicator Range Postprocessing Options Applications of Digital Technology Digital Imaging Systems Computed Radiography (CR) (Photostimulable Storage Phosphor Plate-PSP) Technologist Workstation Image Archiving Application of CR Digital Systems Collimation Accurate Centering of Part and IR Use of Lead Masks Use of Grids Exposure Factors Evaluation of Exposure Indicator Direct Radiography (DR) (Flat-Panel Detector With Thin-Film Transistor) Advantages of DR Systems Application of DR-Based Systems Image Receptor Sizes and Orientation Picture Archiving and Communication System (PACS) Advantages of PACS Digital Imaging Glossary of Terms Part Three ■ Radiation Protection Radiation Units Traditional and SI Units Dose Limits Personnel Monitoring ALARA Pregnant Technologists Radiographic Patient Dose Patient Protection in Radiography Minimum Repeat Radiographs Correct Filtration Accurate Collimation Collimation and Tissue Dose Positive Beam Limitation (PBL) Manual Collimation Collimation Rule Specific Area Shielding Shadow Shields Contact Shields Male Female Summary of Rules for Specific-Area Shielding Pregnant Patient Optimum Speed Minimize Patient Dose by Selecting Projections and Exposure Factors With Least Patient Dose Radiation Safety Practices Fluoroscopic Patient Dose Dose Area Product (DAP) Skin Injury Dose Reduction Techniques During Fluoroscopy Scattered Radiation Radiation Protection Practices During Fluoroscopy Image Wisely 2 Chest Contents Radiographic Anatomy Chest Bony Thorax Topographic Positioning Landmarks Vertebra Prominens (Seventh Cervical Vertebra) Jugular Notch (Manubrial or Suprasternal Notch) Xiphoid Process (Tip) Respiratory System Pharynx Esophagus Four Parts of the Respiratory System Larynx (Voice Box) Sectional image of larynx Trachea Thyroid gland Parathyroid glands Thymus gland Radiographs Sectional image of the trachea Branches of aortic arch Right and Left Bronchi Secondary bronchi, lobes, and alveoli Sectional image of bronchi and lungs Lungs Sectional drawing of lungs and heart Sectional image PA Chest Radiograph Parts of Lungs Lateral Chest View Mediastinum Thymus Gland Heart and Great Vessels Trachea and Esophagus Radiographic Positioning Body Habitus Breathing Movements Degree of Inspiration Positioning Considerations Radiation Protection Repeat Exposures Collimation Lead Shielding Backscatter Protection Technical Factors Kilovoltage Exposure Time and Milliamperage (mAs–Milliampere Seconds) Placement of Image Markers Pediatric Applications Supine Versus Erect Technical Factors Geriatric Applications CR Centering Technical Factors Instructions and Patient Handling Obese Patient Considerations Breathing Instructions Hold Breath on Second Inspiration Inspiration and Expiration Erect Chest Radiographs PA 72-inch (183-cm) source image receptor distance Evaluation Criteria PA Chest Positioning True PA, No Rotation Extending the Chin Minimizing Breast Shadows Lateral Chest Positioning Side Closest to IR True Lateral, No Rotation or Tilt Direction of Rotation No Tilt Arms Raised High CR Location CR Chest-Positioning Method Vertebra Prominens (PA Chest) Exceptions Jugular Notch (AP Chest) Lung Dimensions and IR Placement PA Chest AP Chest Collimation Guidelines Digital Imaging Considerations Alternative Modalities and Procedures Conventional Tomography and CT Sonography Nuclear Medicine MRI Clinical Indications Chest Pathology, Conditions, and Trauma5 Routine and Special Projections Routine and Special Projections PA Projection: Chest Ambulatory Patient Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration PA Projection: Chest On Stretcher if Patient Cannot Stand Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Lateral Position: Chest Ambulatory Patient Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Alternative Lateral Positions: Chest With Wheelchair or Cart if Patient Cannot Stand Clinical Indications Technical Factors Shielding Patient Position on Cart Patient Position in Wheelchair Part Position CR Recommended Collimation Respiration AP Projection: Chest Supine or Semierect (in Department or as Bedside Portable) Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Lateral Decubitus Position (AP Projection): Chest Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Alternative Positioning AP Lordotic Projection: Chest Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Alternative Lordotic Projection Anterior Oblique Positions—RAO and LAO: Chest Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Exception Posterior Oblique Positions—RPO and LPO: Chest Clinical Indications Technical Factors Shielding Patient Position (Erect) Patient Position (Recumbent) Part Position CR Recommended Collimation Respiration Lateral Position: Upper Airway Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Note on Centering and Exposure for Neck Region Centering and Exposure for Distal Larynx and Trachea Region AP Projection: Upper Airway Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Note on Exposure Centering for Upper Airway and Trachea Radiographs for Critique 3 Abdomen Contents Radiographic Anatomy Abdominal Radiography Acute Abdominal Series Abdominal Muscles Abdominal Organ Systems Digestive System Oral Cavity, Pharynx, and Esophagus Stomach and Small and Large Intestines Stomach Small Intestine Duodenum (A) Jejunum and ileum (B and C) Radiograph of Stomach and Small Intestine Large Intestine Spleen Accessory Digestive Organs Pancreas Liver Gallbladder Cholelithiasis CT Sectional Images Urinary System Excretory or Intravenous Urogram Sectional Image Abdominal Cavity Peritoneum Mesentery Omentum Mesocolon Greater Sac and Lesser Sac Retroperitoneal and Infraperitoneal Organs Retroperitoneal Organs Infraperitoneal Organs Intraperitoneal Organs Male Versus Female Peritoneal Enclosures Quadrants and Regions Four Abdominal Quadrants Nine Abdominal Regions Names of Regions Topographic Landmarks Seven Landmarks of the Abdomen Radiographic Positioning Patient Preparation General Positioning Considerations Breathing Instructions Image Markers Radiation Protection Repeat Exposures Close Collimation Gonadal Shielding Pregnancy Protection Exposure Factors Special Patient Considerations Pediatric Applications Geriatric Applications Obese Patient Considerations Digital Imaging Considerations Alternative Modalities CT and MRI Sonography Nuclear Medicine Clinical Indications Routine and Special Projections Routine and Special Projections AP Projection—Supine Position: Abdomen KUB Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration PA Projection—Prone Position: Abdomen Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Lateral Decubitus Position (AP Projection): Abdomen Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration AP Projection—Erect Position: Abdomen Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Dorsal Decubitus Position (Right or Left Lateral): Abdomen Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Lateral Position: Abdomen Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Acute Abdominal Series: Acute Abdomen (1) AP Supine, (2) Erect (or Lateral Decubitus) Abdomen, (3) PA Chest Departmental Routine Specific Clinical Indications for Acute Abdominal Series Positional Guidelines Patient and Part Positioning Breathing Instructions CR Radiographs for Critique 4 Upper Limb Contents Radiographic Anatomy Upper Limb Hand and Wrist Phalanges—Fingers and Thumb (Digits) Metacarpals (Palm) Joints of the Hand Thumb (First Digit) Fingers (Second Through Fifth Digits) MPJ and CMC Joints Review Exercise With Radiographs Carpals (Wrist) Proximal Row Distal Row Carpal Sulcus (Canal or Tangential Projection) Summary Chart of Carpal Terminology Review Exercise With Radiographs Forearm—Radius and Ulna Radius and Ulna Proximal Ulna Distal Humerus True Lateral Elbow Review Exercise With Radiographs Classification of Joints Hand and Wrist Interphalangeal Joints Metacarpophalangeal Joints Carpometacarpal Joints Intercarpal Joints Wrist Joint Wrist Ligaments Elbow Joint Wrist Joint Movement Terminology Ulnar Deviation Radial Deviation Forearm Rotational Movements Summary Elbow Rotational Movements Importance of Visualizing Fat Pads Wrist Joint Elbow Joint Summary Radiographic Positioning General Positioning Considerations Lead Shielding Distance Multiple Exposures per Imaging Plate Special Patient Considerations Trauma Patients Pediatric Applications Geriatric Applications Exposure Factors Image Receptors Increase Exposure With Cast Collimation, General Positioning, and Markers Correct Centering Digital Imaging Considerations Exposure Factors Alternative Modalities and Procedures Arthrography CT and MRI Nuclear Medicine Clinical Indications Malignant bone tumors Benign bone or cartilaginous tumors (chondromas) Routine and Special Projections Routine and Special Projections PA Projection: Fingers Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation PA Oblique Projection—Medial or Lateral Rotation: Fingers Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Optional Medial Oblique Lateromedial or Mediolateral Projections: Fingers Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation AP Projection: Thumb Clinical Indications Technical Factors Shielding Patient Position—AP Part Position—AP Exception—PA (Only if Patient Cannot Position for Previous AP) CR Recommended Collimation PA Oblique Projection—Medial Rotation: Thumb Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Lateral Position: Thumb Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation AP Axial Projection (Modified Robert’s Method)5: Thumb Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation PA Stress Thumb Projection Folio Method8 Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation PA Projection: Hand Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation PA Oblique Projection: Hand Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Exception “Fan” Lateral—Lateromedial Projection: Hand Clinical Indications Technical Factors Compensation Filter Shielding Patient Position Part Position CR Recommended Collimation Lateral in Extension and Flexion—Lateromedial Projections: Hand Alternatives to Fan Lateral Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation AP Oblique Bilateral Projection: Hand Norgaard Method Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation PA (AP) Projection: Wrist Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Alternative AP PA Oblique Projection—Lateral Rotation: Wrist Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Lateromedial Projection: Wrist Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation PA and PA Axial Scaphoid—With Ulnar Deviation: Wrist Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation PA Scaphoid—Hand Elevated and Ulnar Deviation: Wrist Modified Stecher Method10 Clinical Indications Technical Factors Shielding Patient Position Part Position Alternative Method CR Recommended Collimation PA Projection—Radial Deviation: Wrist Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Carpal Canal (Tunnel)—Tangential, Inferosuperior Projection: Wrist Gaynor-Hart Method Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Alternative Imaging Carpal Bridge—Tangential Projection: Wrist Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation AP Projection: Forearm Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Lateromedial Projection: Forearm Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation AP Projection: Elbow Elbow Fully Extended Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation AP Projection—Alternate Partial Flexion: Elbow When Elbow Cannot Be Fully Extended Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Acute Flexion Projections: Elbow AP Projections of Elbow in Acute Flexion Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation AP Oblique Projection—Lateral (External) Rotation: Elbow Clinical Indications Lateral (External Rotation) Oblique Technical Factors Shielding Patient Position Part Position CR Recommended Collimation AP Oblique Projection—Medial (Internal) Rotation: Elbow Clinical Indications Medial (Internal Rotation) Oblique Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Lateromedial Projection: Elbow Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Trauma Axial Lateromedial and Mediolateral Projections: Elbow Coyle Method13 Clinical Indications Technical Factors Shielding Patient Position Part Position 1—Radial Head–Axial Lateromedial Projection Part Position 2—Coronoid Process–Axial Mediolateral Projection Recommended Collimation Radial Head—Lateromedial Projections: Elbow Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Radiographs for Critique 5 Humerus and Shoulder Girdle Contents Radiographic Anatomy Upper Limb (Extremity) Humerus Proximal Humerus Anatomy of Proximal Humerus on Radiograph Shoulder Girdle Clavicle Radiograph of the Clavicle Scapula Anterior View Posterior View Lateral View Review Exercise With Radiographs AP Projection Lateral Projection Proximal Humerus and Scapula Inferosuperior Axial Projection Classification of Joints Classification Mobility Type Movement Type Radiographic Positioning Proximal Humerus Rotation Radiographs of Proximal Humerus External Rotation Internal Rotation Neutral Rotation Positioning and Exposure Considerations Technical Considerations Average Adult Humerus and Shoulder Radiation Protection Gonadal Shielding Shielding of Thyroid, Lungs, and Breasts Special Patient Considerations Pediatric Applications Geriatric Applications Obese Patient Considerations Digital Imaging Considerations Alternative Modalities and Procedures Arthrography CT and MRI Nuclear Medicine Sonography Clinical Indications Routine, Alternate, and Special Projections Routine and Special Projections AP Projection: Humerus Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Rotational Lateral—Lateromedial or Mediolateral Projections: Humerus Clinical Indications Technical Factors Shielding Patient and Part Position CR Recommended Collimation Respiration Trauma Horizontal Beam Lateral—Lateromedial Projection: Mid-to-Distal Humerus Distal Humerus Clinical Indications Technical Factors Shielding Patient and Part Position CR Recommended Collimation Respiration Transthoracic Lateral Projection: Humerus (Trauma) Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration AP Projection—External Rotation: Shoulder (Nontrauma) AP Proximal Humerus Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration AP Projection—Internal Rotation: Shoulder (Nontrauma) Lateral Proximal Humerus Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Inferosuperior Axial Projection: Shoulder (Nontrauma) Lawrence Method Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration PA Transaxillary Projection: Shoulder (Nontrauma) Hobbs Modification Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Inferosuperior Axial Projection: Shoulder (Nontrauma) Clements Modification7 Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration AP Oblique Projection—Glenoid Cavity: Shoulder (Nontrauma) Grashey Method Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Apical AP Axial Projection: Shoulder8 Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Tangential Projection—Intertubercular (Bicipital) Sulcus: Shoulder (Nontrauma) Fisk Modification Clinical Indications Technical Factors Shielding Patient and Part Position Erect (Fisk Modification) Supine CR Recommended Collimation Respiration AP Projection—Neutral Rotation: Shoulder (Trauma) Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Transthoracic Lateral Projection: Proximal Humerus (Trauma) Lawrence Method Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration PA Oblique Projection—Scapular Y Lateral: Shoulder (Trauma) Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Tangential Projection—Supraspinatus Outlet: Shoulder (Trauma) Neer Method9 Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration AP Apical Oblique Axial Projection: Shoulder (Trauma) Garth Method Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration AP and AP Axial Projections: Clavicle Clinical Indications Technical Factors Shielding Patient Position Part Position CR AP AP Axial Recommended Collimation Respiration Alternative PA AP Projection (Pearson Method): AC Joints Bilateral With and Without Weights Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Weights Alternative AP Axial Projection (Alexander Method) Alternative Supine Position AP Projection: Scapula Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Lateral Position: Scapula Patient Erect Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Lateral Position: Scapula Patient Recumbent Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Respiration Radiographs for Critique 6 Lower Limb Contents Radiographic Anatomy Distal Lower Limb Foot Phalanges—Toes (Digits) Metatarsals Joints of Phalanges (Digits) and Metatarsals Joints of digits Joints of metatarsals Sesamoid bones Tarsals Calcaneus Articulations Talus Articulations Navicular Articulations Cuneiforms Articulations Cuboid Articulations Arches of Foot Longitudinal Arch Transverse Arch Ankle Joint Frontal View Lateral View Axial View Joint Structure Review Exercise With Radiographs Lateral Left Foot (Fig. 6.13) Oblique Right Foot (Fig. 6.14) AP Mortise View Right Ankle (Fig. 6.15) Lateral Right Ankle (Fig. 6.16) Lower Leg—Tibia and Fibula Tibia Proximal Extremity Body Distal Extremity Fibula Midfemur and Distal Femur—Anterior View Midfemur and Distal Femur—Posterior View Distal Femur and Patella (Lateral View) Distal Femur and Patella (Axial View) Patella Knee Joint Proximal Tibiofibular Joint and Major Knee Ligaments Synovial Membrane and Cavity Menisci (Articular Disks) Knee Trauma Review Exercise With Radiographs AP Lower Leg (Fig. 6.29) Lateral Lower Leg (Fig. 6.30) AP Knee (Fig. 6.31) Lateral Knee (Fig. 6.32) Lateral Knee (Fig. 6.33) Tangential Projection (Patellofemoral Joint) (Fig. 6.34) Classification of Joints Surfaces and Projections of the Foot Surfaces Projections Motions of the Foot and Ankle Radiographic Positioning Positioning Considerations Distance Shielding Collimation General Positioning Correct Centering Multiple Exposures Per Imaging Plate Exposure Factors Image Receptors Grids Special Patient Considerations Pediatric Applications Geriatric Applications Obese Patient Considerations Placement of Markers and Patient Identification Information Increase Exposure With Cast Digital Imaging Considerations Alternative Modalities and Procedures Arthrography CT MRI Bone Densitometry Nuclear Medicine Clinical Indications Routine, Alternate, and Special Projections Routine and Special Projections AP Projection: Toes Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Computed Radiography or Digital Radiography AP Oblique Projection—Medial or Lateral Rotation: Toes Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Computed Radiography or Digital Radiography Lateral—Mediolateral or Lateromedial Projections: Toes Clinical Indications Technical Factors Shielding Patient and Part Position CR Recommended Collimation Computed Radiography or Digital Radiography Tangential Projection: Toes—Sesamoids Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Alternative Projection AP Projection: Foot Dorsoplantar Projection Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Computed Radiography or Digital Radiography AP Oblique Projection—Medial Rotation: Foot Clinical Indications Technical Factors Shielding Patient Position Part Position CR Recommended Collimation Optional Lateral Oblique (Fig. 6.60) Lateral—Mediolateral or Lateromedial Projections: Foot Clinical Indications Technical Fac

Master radiographic positioning with this comprehensive, user-friendly text. Focusing on one projection per page, Bontrager’s Textbook of Radiographic Positioning and Related Anatomy, 9th Edition includes all of the positioning and projection information you need to know in a clear, bulleted format. Positioning photos, radiographic images, and radiographic overlays, presented side-by-side with the explanation of each procedure, show you how to visualize anatomy and produce the most accurate images. Updated to reflect the latest ARRT competencies and ASRT curriculum guidelines, it features more than 200 of the most commonly requested projections to prepare you for clinical practice.

• Labeled radiographs (radiographic overlays) identify key radiographic anatomy and landmarks to help you recognize anatomy and determine if you have captured the correct diagnostic information on your images.
• Positioning chapters, organized with one projection per page, present a manageable amount of information in an easily accessible format.
• Unique page layout with positioning photos, radiographic images, and radiographic overlays presented side-by-side with the text explanation of each procedure to facilitate comprehension and retention.
• Pathologic Indications list and define the pathologies most likely to be encountered during procedures covered in each chapter to help you understand the whole patient and improve your ability to produce radiographs that make diagnosis easy for the physician.
• Pathology Demonstrated sections explain why a particular projection is needed, or what pathology might be demonstrated, to give you a larger frame of reference and a better understanding of the reasoning behind each projection.
• Radiographic Criteria on positioning pages provide standards for evaluating the quality of each radiograph, helping you develop a routine for evaluating radiographic quality.
• Pediatric Applications prepare students for clinical success — and prepare technologists to deal competently with the special needs of their pediatric patients.
• Geriatric Applications include general information on positioning techniques and patient handling for geriatric patients, fostering an understanding of the challenges these patients present to the technologist.
• Critique Radiographs demonstrate positioning errors and help you avoid similar errors in clinicals.
• Instructor resources include an accompanying Evolve website with PowerPoint slides, an image collection, and a test bank to help instructors prepare for class.
• Student resources include a workbook and handbook to help you better understand and retain complicated material.