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Title: "RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!"
Description: "RadPosi: Skull" focuses on the essential radiographic positioning techniques used to capture detailed images of the skull. This session covers the proper alignment and positioning for various skull views, including the lateral, anteroposterior (AP), and Townes projections, which are critical for evaluating conditions such as fractures, tumors, and other cranial abnormalities. Understanding the anatomy and positioning of the skull is vital for obtaining accurate diagnostic images while ensuring optimal image quality and minimizing radiation exposure. Mastery of skull positioning is crucial for radiographers working in neurology, trauma, and other medical specialties.

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"RadPosi: Mastering Skull
Positioning for Clear and
Accurate Cranial Imaging!”
SKULL
bony framework
2 parts
1
...
Skull cap / calvaria
b
...
Ethmoid - 1
ii
...
Temporal - 2
2
...
5 - 3 “ ABOVE THE BRIDGES OF THE NOSE
IOML + MSP PERP TO IR

OPTIC CANAL / FORAMNEN
size of the optic foramina

PARIETOORBITAL OBLIQUE PROJECTION
RHESE METHOD

3 points landing
Zygoma, nose , chin
Optic canal

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

7

Seen in lateral quadrant of the orbit
MSP: 53 DEGREES
AML PERP
CRD
PERPENDICULAR

Orbito- parieto oblique projection
ALEXANDER METHOD

rotate head away
Msp: 40 degrees
AML : perp
Inferior and lateral margin : RP

SUPERIOR ORBITAL FISSURES

is the cleft between the greater and lesser wings of the sphenoid bone

PA AXIAL PROJECTION
CALDWELL METHOD

CRD:
20- 25 DEG CAUDALLY
OML + MSP PERP
FOREHEAD AND NOSE TOUCHING
RP:
Level of inferior margin of the orbit

INFERIOR ORBITAL FISSURES
BERTEL METHOD

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

8

20- 25 degrees cephalad
Forehead + nose touching
MSP + OML perp
Demo
Inferior orbital fissure
Pterygoid process

FACIAL BONES - 14
IRREGULAR IN SHAPE

Parietoacanthial Projections

/ waters/ mahooneys/ occipitoparietals

petrous ridges
Below the maxillary sinuses
Best for facial bones
OML @ 37 degrees
Mml parallel
Nose
3/4 “ from table top
CRD: perpendicular
RP: acanthion

PA AXIAL PROJECTION
CALDWELL METHOD

OML PERP
CRD

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

9

15 deg caudal exit at nasion
Petrous ridges
Lower third of the orbit (orbital rink , orbital floor) - 15 deg caudal
OrbiTal rim
30 deg caudally
Exagerrated caldwell
Orbital floors

LATERAL PROJECTION

demo lat image the bone of the face
Rp:
Lateral surface of the zygoma
Upper mallar bone
IPL perp
IOML parallel
demo
Depressed fracture in the frontal bone

MODIFIED PARIETOACANTHIAL/ MODIFIED WATERS / SHALLOW WATERS

DEMO:
BLOW OUT FRACTURES
Petrous ridges below the inferior border of the orbits
OML angulation: 55 degrees

ACANTHIOPARIETAL PROJECTION / REVERSE WATERS

trauma patient

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

10

OML : 37 degrees
Demo
Superior facial bones
Petrous pyramids

NASAL BONES
demo
Fracture
Displacement of nasal bone and septum
Soft tissue fracture
LATERAL PROJECTION

depressed fx of the nasal bones
RP:
1/ 2 “ DISTAL TO THE NASION
3/ 4 “ DISTAL TO THE NASION

TANGENTIAL PROJECTION
SUPEROINFERIOR

Demo
Medial / lateral displacement of nasal bone
OCCLUSAL FILM
Best proj demo the linear fx of the nasal bones

PARIETO ACANTHIAL/ WATERS METHOD

demo
Displacement of bony nasal septum

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

11

Depressed fx of the nasal wings

ZYGOMATIC ARCHES
TANGENTIAL/ SMV / FULL BASAL/ SCHULLER / PFEIFFER

DEMO BILATERAL ZYGOMATIC ARCHES

TANGENTIAL / MAY METHOD

MSP: 15 degrees away from IR
DEMO
Depressed fracture in cheek bone / flat cheek bone
No SI
TOWNES METHOD

bilateral zygomatic bone

MODIFIED TITTERINGTON METHOD / PA AXIAL

bilateral zygomatic bone
23- 38 degrees caudally

MANDIBLE
PA PROJECTION

demo:
Mandibular body
CRD: PERP
FOREHEAD AND NOSE TOUCHING IR
DEMO:

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

12

Mandibular rami
30 degrees cephalad : PA AXIAL projection
Medial and lateral displacements of fracture of mandibular rami
AXIO LATERAL OBLIQUE PROJECTION

CRD:
25- 35 DEG CEPHALAD
DEMO: MANDIBULAR RAMUS
HEAD IN TRUE LATERAL POSITION
CRD: 25 DEGREES CEPHALAD
DEMO: MANDIBULAR BODY
HEAD @ 30 DEG TO IR
CRD: 25 DEGREES CEPHALAD

PA AXIAL PROJECTION

30 DEGREES CEPHALAD
DEMO: SYMPHESIS MENTI
HEAD ROTATE 45 TO IR
CRD: 25 DEGREES CEPHALAD

MANDIBULAR RAMI
PA AXIAL PROJECTION

20- 25 DEGREES CEPHALAD

DEMO
Entire mandible

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

13

TMJ trauma

PANORAMIC TOMOGRAPHY

Dental arches

TMJ
AP AXIAL PROJECTION/ TOWNES

RP:
3 “ ABOVE THE NASION
2 EXPOSURES
OPEN AND CLOSE MOUTH
TRAUMA
NO OPEN MOUTH
CRD: 35 DEG CAUDAL

LATERAL OBLIQUE/ AXIAL TRANSCRANIAL

CRD: 25- 35 DEG CAUDALLY
RP:
2” SUPERIOR TO THE EAM
1/ 2” ANTERIOR
OPEN AND CLOSE MOUTH

OBLIQUE TRANSFACIAL PROJECTION / ZANELLI METHOD

demo:
Axiolate image of mandibular jts

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

14

LATERAL TRANSCRANIAL PROJECTION

DEMO:
CONDYLES AND NECK OF THE MANDIBLE
CLOSE AND MOUTH

INFEROSUPERIOR TRANSFACIAL PROJECTION

demo
Lateral image of the TMJ
OPEN + CLOSE MOUTH

LAT TRANSFACIAL PROJECTION / ALBERS SCHONBERG METHOD

demo
Lateral image of the TMJ
2 exposures
CRD: 20 deg cephalad

EYE
demonstrate presence of radiopaque FB

VOGT BONE FREE POSITION

detects small/ low density FB particles
2 MOVEMENT
vertical movement
Horizontal movement

PARALLAX METHOD

FLOUROSCOPY

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

15

BY RICHARDS
SWEET METHOD

GEOMETRIC CALCULATION
PFEIFFER - COMBERG METHOD

leaded contact lense at the cornea
Same with Waters method

PARANASAL SINUSES

MAXILLARY SNUES
antrum / antrum of highmore
Cavity at birth
Largest
FRONTAL SINUSES
posterior to the glabella: location
2nd largest
ETHMOID SINUSES
located in the lateral masses of the labyrith of the ethmoid bone
Last sinus to developed
SPHENOID SINUES
lies in the body of the sphenoid bone directly below the sella turcica

SINUSES
demonstrate the pathology
Fluid levels : absence/ presence
Pathologic conditions

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

16

Patient Position
Erect / Upright

PARIETO ACANTHIAL PROJECTION - WATERS METHOD

37 OML
RP: ACANTHION
MML + MSP PERP
DEMONS
Maxillary sinus
Foramen rotundun
LESS THAN 37 DEG
Petrousal shadoes in the lower antra
MORE THAN 37 DEG
Forshortened Antra

PA AXIAL PROJECTION
CALDWELL METHOD

BEST TO DEMO
FRONTAL AND ANTERIOR ETHMOID SINUSES
CRD
15 DEG CAUDALLY - NASION
TRUE CALDWELL

23 DEG CAUDAL- GLABELLA
MSP + OML PERP

LATERAL PROJECTION

DEMO

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

17

ALL SINUSES
RP:
1/2 INCH POSTERIOR TO THE OUTER CANTHUS OF THE EYE

PA OBLIQUE PROJECTION

DEMO
POSTERIOR ETHMOID SINUS

WATER’S WITH OPEN MOUTH / OM W/ OPEN MOUTH

DEMO
SPHENOIDAL SINUS PROJECTED THRU OPEN MOUTH

SMV

demo
Sphenoid and ethmoid sinuses

AXIAL TRANSORAL PROJECTION
PIRIE METHOD

open mouth
Demo
Spheoidal sinuses
CRD: 30 degrees caudally

MASTOID
demo air cells
BILATERAL/ R/ L : COMPARISON
TOWNES METHOD/ 35 DEGREE FRONTO OCCIPITAL

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

18

30 DEG CAUDAL TO OML
37 DEG CAUDAL TO IOML
RP
2 “ ABOVE THE GLABELLA
2 1/2 ABOVE THE NASION
IOML PERP

SCHULLER/ AXIOLATERAL PROJECTION

25- 30 DEG CAUDALLY
RP
1 1/2 “ SUPERIOR AND POSTERIOR TO THE EAM
POSITION:
TRUE LAT
AML PERP- IR

MODIFIED LAW METHOD / AXIOLATERAL OBLIQUE
SINGLE TUBE ANGULATION
CRD
Msp: 15 deg angle towards affected side
15 deg caudal
Demons
Mastoid air cells

AP TANGENTIAL PROJECTION
MODIFIED HICKEY

DEMO

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

19

MASTOID PROCESS
HEAD ROTATE AWAY
MSP 55 DEGREE
CRD: 15 DEG CAUDAL

PETROUS TEMPORAL BONE

AXIOLATERAL OBLIQUE PROJECTION
STENVERS METHOD

POSTERIOR PROFILE POSITION
PRONE , FNZ
MSP: 45 DEG TOWARDS THE SIDE OF INTEREST
CRD
12 DEGREES CEPHALAD
PETROUS PYRAMIDS
PARALLEL TO THE FILM
DEMO:
PETROUS TEMPORAL BONE

ARCELIN METHOD

ANTERIOR PROFILE
(Reverse of stenvers)
MSP : 45 DEG : AWAY
CRD: 10 DEG CAUDALLY
DEMO
PETROUS TEMPORAL BONE

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

20

RP:
1 “ ANTERIOR
3/ 4 SUPERIOR TO THE EAM

HENSCHEN METHOD / CUSHING

CRD
15 DEG CAUDAL
DEMO
PETROUS TEMPORAL BONE
TRUE LAT POSITION

MAYER METHOD

MSP: 45 DEGREES
CRD : 45 DEGREES CAUDALLY
DEMO

LYSHOLM METHOD

DEMO
PETROUS BONE
CRD
30- 25 CAUDALLY

VALDINI METHOD / PA AXIAL PROJECTION

DEMO
ESUTACHIAN TUBE
VESTIBUOLO COCHLEAR ORGAN

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

21

PARIETOTEMPORAL PROJECTION
LOW BEER METHOD
DEMO
PETROUS TEMPORAL BONE
CRD: 33 CAUDAL ANTERIOR AND 10 DEG CEPHALAD

STYLOID PROCESS

PA AXIAL PROJECTION
CAHOON METHOD
DEMO: STYLOID PROCESS

AP OBLIQUE PROJECTION
WIGBY - TAYLOR
head rotated towatd
Pronation

HYPOGLASSAL CANAL

AXIOLATERAL OBLIQUE PROJECTION
MILLER METHOD
DEMO
DEMO HYPOGLOSSAL CANAL

JUGALAR FORAMINA

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

22

SMV SUBBSAL / KEMP HARPER METHOD
DEMO: JUGULAR FORMINA
SUPRAORBITOMEATAL LINE PARALLEL TO IR
CRD
20 DEG CAUDAL
ERASO MODIFICATION
demo
Jugular foramina

GRAVID
fetography
To determine the age, position and presenattion of the fetus
Multiple pregnancy
AP
LAT
PELVIMETRY
Size of the fetal head with maternal pelvic outlet
Cocher- Sussman Method
AP
LAT
Cocher Sussman PELVIC Meter Scale
Sandbag: prevent rotation
THOMS METHOD
torpin- thoms pelvimeter
AP
LAT

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

23

BALL METHOD
No special apparatus
UPRIGHT position

NON GRAVID PATIENT

HYSTERO
Size and shape and position of uterus / uterine tube
PELVIC PENUMOGRAPHY
VAGINOGRAPHY
RICE/ RISE WANGESTEIN TECHNIQUE
PERFORATED ANUS
Upside down
24 hrs post delivery
Stomach be filled with air using rectal thermometer
AP
LAT

🏚️ MAMMOGRAPHY

"RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!”

24


Title: "RadPosi: Mastering Skull Positioning for Clear and Accurate Cranial Imaging!"
Description: "RadPosi: Skull" focuses on the essential radiographic positioning techniques used to capture detailed images of the skull. This session covers the proper alignment and positioning for various skull views, including the lateral, anteroposterior (AP), and Townes projections, which are critical for evaluating conditions such as fractures, tumors, and other cranial abnormalities. Understanding the anatomy and positioning of the skull is vital for obtaining accurate diagnostic images while ensuring optimal image quality and minimizing radiation exposure. Mastery of skull positioning is crucial for radiographers working in neurology, trauma, and other medical specialties.