Chest - Left Lateral (Erect)

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Chest - Left Lateral (Erect)
Area Covered	Lung fields, apices, costophrenic angles
Pathology shown	Pathology posterior to the heart, great vessels and sternum
Radiographic Anatomy	Chest Radiographic Anatomy
IR Size & Orientation	35 x 43 cm Portrait
Film / Screen Combination	Regular (CR and DR as recommended by manufacturer)
Bucky / Grid	Moving or Stationary Grid
Filter	No
Exposure	110 kVp 8 mAs
FFD / SID	180 cm
Central Ray	Directed to the mid coronal plane at the level of T7 Perpendicular to the IR
Collimation	Centre: The mid coronal plane at the level of T7 Shutter A: Open to include the skin margins anteriorly and posteriorly Shutter B: Open to include lung apices superiorly (this is at the C7 level) and to include the diaphragm inferiorly
Markers	Use a left "L" marker to indicate the side closest to the IR Superior and Anterior Marker orientation AP
Shielding	Gonadal (check your department's policy guidelines)
Respiration	On suspended inspiration, (gives full lung aeration)
Positioning	Patient erect, standing or seated, their left side touching the bucky Ensure the midsaggital plane is parallel to the IR, that is, the patient does not lean towards the IR Ensure the mid coronal plane is perpendicular to the IR, to avoid rotation of the thorax To prevent the humeri from superimposing over the lung fields either; raise the arms above the patient's head,getting them to grasp the opposite elbow with each hand, or have the patient place their hands on their head, with their elbows pointing forward, or use the purpose built support arm that attaches to the bucky being used and have the patient hold to the bar Ensure that the chin is up away from the patient's chest
Critique PACEMAN	Positioning A lateral position is achieved as evidenced by the sternum is shown in profile the costophrenic angles are included the intervertebral foramina are open the left and right anterior ribs are superimposed on each other the posterior ribs are superimposed on each other the bones and soft tissue of the arms are not superimposed over the lung fields Area Covered Lung fields, apices, costophrenic angles are shown Collimation Centre: The mid coronal plane at the level of T7 Shutter A: Open to include the skin margins anteriorly and posteriorly Shutter B: Open to include lung apices superiorly (this is at the C7 level) and to include the diaphragm inferiorly Exposure Sufficient contrast and density to show lung markings, the ribs through the heart , and sharp outlines of the hemi diaphragms.
Special Notes	Patient rotation vs scoliosis When the patient is rotated, the posterior ribs will not be superimposed. The posterior ribs may also be not superimposed in a patient who has been correctly positioned for the Lateral Chest. This will occur if the patient has scoliosis of the thoracic spine. In these cases, adjusting the positioning will not correct this. Differences between a left and right lateral chest x-ray Left Lateral Chest - The heart is less magnified Right Lateral Chest - The heart is more magnified The left hemidiaphragm projects lower than the right hemidiphragm