Abdomen - Erect

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Abdomen - Erect
Area Covered	From the diaphragm downwards
Pathology shown	Air-fluid levels, air under the diaphragm
Radiographic Anatomy	Abdomen Radiographic Anatomy
IR Size & Orientation	35 x 43 cm Portrait D.R. may cover 43 x 43 cm
Film / Screen Combination	Regular (CR and DR as recommended by manufacturer)
Bucky / Grid	Moving or Stationary Grid
Filter	No
Exposure	80 kVp 40 mAs
FFD / SID	100 cm
Central Ray	Directed to the midsaggital plane, 5cm superior to the level of the iliac crests Perpendicular to the IR
Collimation	Centre: To the midsaggital plane, 5cm superior to the level of the iliac crests Shutter A: Open to IR size inferiorly and superiorly to include the diaphragm and as much of the abdomen as possible Shutter B: Open to include the lateral skin margins if possible
Markers	Inferior and Lateral Marker orientation AP
Shielding	Gonadal on males, if possible (check your department's policy guidelines)
Respiration	On suspended expiration or inspiration - check your department's technique protocol
Positioning	If possible, the patient should be in the AP erect position for at least 10 minutes prior to the image being taken so that any intraperitoneal free air can be demonstrated under the diaphragm. (AP/PA chest radiography is more sensitive for pneumoperitoneum) Patient is erect with their back to the wall bucky There is no rotation of the torso Ensure there are no artefacts, such as zips or buttons over the area being imaged Centre the midsaggital plane of the patient to the midline of the IR Arms slightly abducted from the torso
Critique PACEMAN	Positioning No rotation as evidenced by symmetrical iliac wings the sacrum is centred in the pelvic inlet the pedicles of the vertebrae are the same distance from the spinous processes on each side Area Covered The diaphragm, abdomen, flanks Collimation Centre: L3 Lumbar vertebra, which is approximately 5cm (2 inches) superior to the level of the iliac crests Shutter A: Open to include the entire diaphragm superiorly Shutter B: Open to include the lateral skin margins if possible Exposure There should be adequate exposure and no patient motion so that the following anatomy is shown the outline of the psoas muscles the outline of the kidneys skeletal structures such as the posterior ribs, vertebrae and pelvis
Special Notes	Can be performed PA, especially applicable in the case of unsteady patients.