Skull - Lateral

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Radiographic Positioning

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Name of projection Skull - Lateral (Erect)
Area Covered Entire skull
Pathology shown Fractures and pathologies of the skull
Radiographic Anatomy Skull Radiographic Anatomy
IR Size & Orientation 24 x 30 cm
Film / Screen Combination Regular
(CR and DR as recommended by manufacturer)
Bucky / Grid Moving or Stationary Grid
Filter No
Exposure 70 kVp
16 mAs
FFD / SID 100 cm
Central Ray Directed to 5 cm superior to the EAM (External Auditory Meatus)
Perpendicular to the bucky
Collimation Outer skin margins of the skull
Markers Inferior and Anterior
Marker orientation AP, indicating the side of the skull closest to the bucky
Shielding Gonadal (check your department's policy guidelines)
Respiration Suspended
  • Patient standing or sitting facing the bucky
  • Place the side of interest of the skull closest to the bucky
  • Oblique the body slightly to assist with positioning and patient comfort
  • The interpupillary line is parallel to the floor
  • The radiographic baseline (OrbitoMeatal Line) is also parallel to the floor
  • The midsaggital plane is parallel to the bucky

  • No rotation is evidenced by
    • The greater wings of sphenoid are superimposed (see notes below)
  • No tilt is evidenced by
    • There is superimposition of the superior orbital plates of the frontal bone
Area Covered
  • Entire skull
  • Centre: 5 cm (2 inches) superior to the EAM
  • Shutter A: Open to include the skin margins of the top of skull superiorly, and the base of the occiput inferiorly
  • Shutter B: Open to include the skin margins of the anterior and posterior skull
  • Assess for adequate penetration of the thickest part of the skull seen on the lateral view
  • Bony trabecular patterns and cortical outlines are sharply defined
  • Soft tissues are visualised
Special Notes Determining the direction of head rotation
Identify the greater wing of sphenoid which is closer to the bucky. Compared to the other greater wing of sphenoid it will appear sharper and less magnified. Look at the position of the one furthest from the bucky to decide how to reposition the patient.
For instance, in the case of a left lateral skull view, the greater wing of sphenoid which is less sharp and more magnified will be on the right side of the patient. If this is more anterior than the one on the left, it means the patient is looking towards the bucky, so bring the midsaggital plane parallel to the bucky to rectify this.