Presented by: De Pano, Eugene

Gallego, Carl Jhodel

• The Goal of every technologist should be to take not just
a passable radiograph but rather an optimal one that can
be evaluated by a definable standard.
Evaluation Criteria Format
• The technologist should review and compare radiographs
using this standard to determine how close to an optimal
image was achieved. A systematic method of learning
how to critique radiographs is to break the evaluation into
these four parts:
 Anatomy Demonstrated-
Describes precisely what anatomic parts and structures
should be clearly visualized.
 Patient Position-
Generally Evaluates Four Issues:
 Placement of Body Part in relationship to the IR
 Positioning Factors that are Important for the Projection
 Correct Centering of Anatomy
 Collimation
 Exposure-
Describes how exposure
factors or technique can be
evaluated for optimum
exposure for that body part.
 Image Markers-
Anatomic side markers,
Right or Left, patient position
markers must be placed
correctly.
• A minimum of two types of
markers should be
imprinted on every
radiographic image. These
are:
-Patient Identification and
Date
-Anatomic Side Markers
• Additional Markers or
Identification
Time Indicators- Notes the
elapsed time in a series.
Another Important Marker on
all Decubitus Positions is a
marker or some type of
indicator to identify which
side is up.
• Routine Projections- are defined as projections commonly
taken on patients who can cooperate fully. This varies
depending on radiologist and department preference.

• Special Projections- In addition to routine projections,

These are defined as projections most commonly taken to
demonstrate better specific anatomic parts or certain
pathologic conditions or projections that may be
necessary for patients who cannot fully cooperate.
• Two General Rules or Principles are Helpful for
remembering and understanding the reasons that certain
minimum projections are performed for various
examinations.
• Minimum of Two Projections-
The first general rule suggests that a minimum of two
projections taken as near to 90 degrees from each other as
possible are required for most radiographic procedures.
 Superimposition of Anatomic Structures-
Certain Pathologic Conditions may not be visualized on
one projection only.

Localization of Lesions or Foreign Bodies-

A minimum of two projections, taken at 90 degrees or as
near right angles from each other as possible, are essential
in determining the location of any lesion or foreign body.
Foreign Bodies embedded in
tissues of the knee. Both
AP/PA and Lateral
Projections
 Determination of
Alignment of Fractures-
All fractures require a
minimum of two projections,
both to visualize fully the
fracture site and to
determine alignment of the
fractured parts.
• However there are Exceptions:
For Example- AP (Portable) Chest
- Single AP Abdomen
- AP Pelvis
 This second general rule or principle
suggests that all radiographic procedures
involving joints require a minimum of three
projections rather than only two.
These are AP or PA, Lateral, and Oblique
Projections.
 Postreduction upper and lower limbs generally require
only two projections for checking fracture alignment.
 A Pelvis study requires only a Single AP projection unless
a hip injury is suspected.
Palpation refers to the process of applying light
pressure with the fingertips directly on the
patient to locate these landmarks.
Viewing Radiographic Images
• The manner in which PA and AP
projection radiographic images are
placed for viewing depends on the
radiologists’ preference.
• In the US and Canada, and also our
practice here in the Philippines, a
common and accepted way to place
radiographic images for viewing is
to display them so that the patient is
facing the viewer, with the patient in
anatomic position.
Viewing Radiographic Images
(LATERAL POSITIONS)
• Marked R or L by the
side of the patient
closest to the IR.
• One common method is
to place the image so
that the viewer is seeing
the image from the
same perspective as the
x-ray tube.
Viewing Radiographic Images
(PA OR AP OBLIQUE (DECUBITUS CHEST AND
PROJECTIONS) ABDOMEN PROJECTION)
• Placed for viewing the • Viewed the way the x-ray
same way that a PA or AP tube “sees” them.
projection placed.
 Viewing Radiographic Images
(UPPER AND LOWER LIMB PROJECTIONS)
• The R or L lead marker
appears right-side-up.
• Images that include the
digits (hands and feet)
generally are placed with
the digits up.
• Other images of the
limbs are viewed in the
anatomic position with
the limbs hanging down.
Viewing CT or MRI Images

• The generally viewing all

CT and MRI axial images
is similar to thata used for
conventional radiographs,
even though the image
represents a thin “slice” or
sectional view of anatomic
structures.