Principles of Radiographic

Interpretation
SUBMITTED BY:- SAIKAT KUMAR KUNDU
MVSC 2ND YEAR
ID-54187
 INTRODUCTION
• The interpretation of radiographs is based on the recognition and
analysis of structures with different relative radiopacities on a
radiograph.

• Radiographic imaging is possible because some x-rays striking the

patient are absorbed while others penetrate through and strike a cassette
or imaging plate.

• The radiograph is therefore an image of the pattern of x-ray emergence

from a patient.
• There are three basic steps to radiographic interpretation:
1. evaluating the film and quality of the examination
2. reading the radiograph, and
3. Formulating a radiographic impression, diagnosis, and/or prognosis.

• Film quality should be evaluated by checking film exposure, labeling,

collimation, and positioning. This is an important step because poor-quality
radiographs result in missed or improperly diagnosed conditions. A properly
exposed radiograph should have enough film contrast latitude to allow
observation of bone and soft tissue outlines, and the film detail should be
sufficient to demonstrate bone trabeculae.

• Exposure becomes a less critical factor when using digital radiography

systems due to the greater contrast latitude.
• The second step in radiographic interpretation is reading the radiograph. If the
clinician is in a hurry to make a diagnosis, this step may be overlooked or cut
short, resulting in interpretational errors. A systematic thorough inspection of
the entire film should be done so that nothing is missed.

• The third step is formulating a radiographic impression, diagnosis, or

differential diagnosis. Knowledge of disease pathophysiology and its
relationship to radiographic signs is necessary for this step. Finally, the
radiographic diagnosis should be integrated with other diagnostic information,
such as history, physical examinations, and perineural anesthesia results, to
arrive at a final diagnosis.
 RADIOGRAPHIC OPACITIES
• The ability of a radiograph, whether analog or digital, to display
differences in x-ray absorption between various tissues or organs is
termed contrast resolution.
• The relative difference in radiopacities (from radiolucent to
radiopaque) of various objects and tissues makes their differentiation
possible.
 BASIC RADIOGRAPHIC OPACITIES
• The basic radiographic OpaciIties are a spectrum from radiopaque
(white) to radiolucent (black).
• The order of most radiopaque to most radiolucent is: metal, bone,
soft tissue, fluid, fat, and gas. For example, fat is more radiolucent
than soft tissue and bone, but more radiopaque than gas.
• BONE OPACITY:-
• A normal variation in bone radiopacity exists within the same bone and
between separate bones because of:
a. Different ratios of compact bone to spongy bone
b. Different ratios of trabecular bone to intertrabecular spaces
c. Different ratios of cortex to medullary canal

• Bone is assessed radiographically as being more or less radiopaque than

normal.
Sclerotic bone is more radiopaque (less radiolucent) than normal.
Porotic bone is less radiopaque (more radiolucent) than normal.
• SOFT TISSUE OPACITY:-

Is also referred to as water opacity.

Includes the radiographic opacities of normal soft tissue such as

muscle, and solid and/or fluid-filled organs such as heart, liver, spleen,
kidneys, and urinary bladder.

Variations in volume, thickness, and degree of compactness of soft

tissue radiopacities create a spectrum of varying summation opacities
on the radiograph.
• Soft tissue changes may be primary pathologic changes, secondary to more
serious bone changes, or incidental fi ndings of no clinical signifi cance. A
bright light is helpful for evaluating soft tissue structures when using
conventional (screen-fi lm) radiographic systems.

(A) Soft Tissue Thickening:-

• Soft tissue thickening in the equine extremity is usually caused by swelling
secondary to inflammation from infection or trauma. However, non-clinically
signify cant soft tissue thickening can also be identified radiographically such as
in cases of elbow or carpal hygroma where the thickening originates from
chronic trauma but is simply a cosmetic blemish.
Lateromedial (LM) projection of a normal carpus Lateromedial (LM) projection of carpal effusion.
showing the fat pads (adipose tissue bodies) Note the soft tissue thickening on the dorsal aspect of the
as lucent structures within the dorsal soft tissues carpus
(arrows).
• The soft tissue thickening may be localized or diffuse. Localized thickening
may be identified radiographically within or around joints, tendons, or
muscles.
• Radiographic signs of soft tissue thickening include an increased soft tissue
prominence, displacement of fat bodies (adipose tissue) around the joint
capsule or tendon sheaths, and mottling or obliteration of adipose tissue in
fascial planes around muscles, joint capsules, or tendons.
(B) Mineralization:-
• Soft tissue mineralization in equine limbs may be dystrophic or metastatic.
Radiographic signs of soft tissue mineralization include an amorphous
radiopacity within soft tissue structures, absence of trabecular or cortical
bone within the radiopacity, indistinct borders with dystrophic mineralization,
and well-defi ned and distinct borders. A round “cauliflower-shaped”
appearance is usually present with calcinosis circumpscripta.
Lateromedial (LM) projection of the metacarpo-phalangeal
joint. Amorphous soft tissue mineralization is present just
palmar to the distal MCIII and proximal to the sesamoid
bones, consistent with dystrophic mineralization of the
palmar joint capsule.
• GAS OPACITY:-
Gas or air is the most radiolucent opacity within the body and is easily
recognized. Gas provides good contrast between other radiographic
opacities.
The radiolucency of air provides contrast to visualize the more
radiopaque structures-
1. In the chest, structures of soft tissue opacity, such as the heart,
aorta, and pulmonary vessels, are visible because the contrast is
provided by the air-filled alveoli and airways of the lung.
2. In the intestine, the bowel wall (of water opacity) is visible because
of the gas within its lumen and the mesenteric fat adjacent to the
outer wall
In some contrast radiographic procedures, certain gases are
introduced into structures/organs to enhance radiographic contrast
(e.g., urinary bladder, peritoneal cavity) .
• Gas may be present in the soft tissue structures of equine limbs as a result of
traumatic lacerations, puncture wounds, needle centesis, or gas-producing
bacterial organisms.

• Radiographic signs of soft tissue emphysema include radiolucent regions

within soft tissue structures (the radiolucencies should be differentiated from
fat) and a focal accumulation of gas with an air-fluid level that occurs with
abscesses. The radiographic evidence of gas within the soft tissues in addition
to an irregular skin surface should prompt the diagnosis of skin laceration.
Dorsopalmar (DP) projection of the metacarpus.
Surrounding the mid third metacarpal bone, the skin
margins are irregular and there is gas within the thickened
soft tissue secondary to a skin laceration (arrows).
 PROCESS OF EXAMINING THE
RADIOGRAPHS
• To assist in developing a consistent mental picture of normal
radiographic anatomy, and also to facilitate the detection of
abnormalities, radiographic images should always be oriented in a
standard manner for viewing.
• Lateral views of any part should be oriented with the cranial (rostral)
aspect of the animal to the interpreter’s left.
• Ventrodorsal or dorsoventral radiographs of the head, neck, or trunk
should be oriented with the cranial (rostral) part of the animal
pointing up and with the left side of the animal to the interpreter’s
right.
• When viewing lateromedial or mediolateral radiographs of the
extremities, including oblique projections, the radiograph should be
oriented with the proximal aspect of the limb pointing up and the
cranial or dorsal aspect of the limb to the interpreter’s left.

• Caudocranial (plantarodorsal, palmarodorsal) or craniocaudal

(dorsopalmar, dorsoplantar) radiographs of the extremities should be
oriented with the proximal end of the extremity at the top. No
convention exists regarding whether the medial or lateral side of the
extremity is oriented to the interpreter’s right or left. However,
consistency is important, so a suggested format is that the lateral aspect
of the limb (craniocaudal or dorsopalmar or dorsoplantar radiograph) be
on the interpreter’s left.
 Changes in Position of an
Organ or Structure
1. The organ may be either pushed, pulled or displaced away from its
normal position.
2. The organ may become twisted or rotated on its axis.
3. The organ may have an ectopic position.
 Variations in Size of an
Organ or Structure
An organ may increase in size because of:
• a. Hypertrophy
• b. Hyperplasia
• c. Inflammation
• d. Neoplasia
• e. Edema
• f. Congestion
An organ may decrease in size because of:
• a. Atrophy
• b. Hypoplasia
• c. Congenital anoma
 Increased Radiolucency of an Organ or Structure
1. The presence of gas in abnormal sites such as:
a. Subcutaneous emphysema
b. Mediastinal emphysema (pneumomediastinum)
c. Cavitation of an abscess or tumor
d. Gas forming infection in a hollow viscus:
1) Emphysematous cystitis
2) Emphysematous cholecystitis
3) Emphysematous metritis
2. Bone that is more radiolucent than normal, as may occur in:
a. Osteoporosis or osteomalacia
b. Osteomyelitis
c. Neoplasia
d. Rickets
 Increased Radiopacity In an
Organ or Structure
• Increased radiopacity within an air-containing space (e.g., fluid-filled
tympanic bulla, pulmonary mass)

• Soft tissue mineralization (e.g., dystrophic mineralization)

a. Calcified hematoma
b. Chronic inflammation associated with abscess, tumor, or granuloma
c. Chronic pancreatitis
d. Fat saponification
e. Tumor/Growth
• Precipitated calcium deposition
a. Gallbladder (cholelithiasis)
b. Kidney (nephrolithiasis)
c. Urinary bladder (cyctic calculi)
d. Salivary gland (sialolithiasis)
e. Prostate gland (prostatic calculi)

• Metastatic mineralization in normal tissue caused by a calcium

phosphorus disturbance.
 GENERAL PRINCIPLES OF SMALL
ANIMAL
RADIOGRAPHIC POSITIONING
• Positioning of small animal patients for radiography requires
knowledge of normal anatomy of the species and descriptive
directional terminology.
• When patients are not properly positioned, inaccurate interpretation of
the radiograph and subsequent incorrect diagnosis of the patient can
occur.
• Proper patient positioning usually requires that the patient be
immobilized, either using chemical restraint (administration of
sedatives and anesthetics) or mechanical restraint (use of radiology
positioning aids).
 PATIENT PREPARATION
• The veterinary technician should ensure that all animals being radiographed
have a clean, dry haircoat. Wet hair and debris can cause confusing artifacts on
radiographs. If possible, remove all collars and leashes, topical medications,
bandages, and splints.
• Animals undergoing radiographic study must be properly restrained. Ideally,
chemical restraint with sedatives or anesthetics will be used so a handler does
not have to remain in the room.
• When manual restraint is necessary, it should be accompanied by the use of
positioning aids and the proper use of lead shielding to minimize exposure of
the technician to radiation. The comfort of the patient must also be considered.
 DIRECTIONAL TERMINOLOGY
• A basic knowledge of directional terminology is required for proper patient
positioning and for use when describing radiographic projections.

• The American College of Veterinary Radiology (ACVR) determines standard

nomenclature for radiographic projections. These are as follows:-

• Dorsoventral (DV): This term describes a radiograph produced when the

primary x-ray beam enters the dorsal (topline or spinal) surface and exits the
ventral (sternal or thorax and abdomen) surface of the patient.
• Ventrodorsal (VD): This term describes a radiograph produced when the
primary x-ray beam enters the ventral surface and exits the dorsal surface of
the patient.
• Medial (M): This term refers to the direction toward an animal’s midline. The
term is usually used in combination with other directional terms to describe
oblique projections. For example, dorsomedial refers to the direction of the x-
ray beam from the dorsal surface toward the midline. Radiographs of the limbs
taken with the primary x-ray beam entering the medial surface of the limb and
exiting the lateral may be referred to as mediolateral, although this is normally
shortened to simply L.

• Lateral: The term describes a radiograph produced when the primary x-ray
beam enters from the side, away from the medial plane or midline of the
patient’s body. In the strictest use of ACVR nomenclature, a lateral projection
taken with an animal lying on its right side would be referred to as left to right
lateral. However, by convention, this is usually shortened to simply right
lateral, meaning that the patient is positioned in right lateral recumbency,
indicating that the patient’s right side is closest to the x-ray cassette.
• Proximal (Pr): This is a relative directional term that indicates a structure
located closer to a point of attachment or origin from another structure or
closer to the midline of the animal.
• Distal (Di): This is a relative directional term that indicates a structure located
farther from the point of attachment or origin of another structure or away from
the midline of the animal.
• Rostral: This relative directional term indicates a structure located closer to
the nares from any point on the head.
• Cranial (Cr): This relative directional term indicates a structure located closer
to the animal’s head from any part of the body.
• Caudal (Cd): This relative directional term indicates a structure located closer
to the animal’s tail from any part of the body.
• Plantar: This term is used to describe the caudal (posterior) surface of the
hindlimb distal to the tarsus; the correct term for the surface proximal to the
tarsus is caudal.
• Palmar: This term is used to describe the caudal (posterior) surface of the
forelimb distal to the carpus; the correct term for the surface proximal to the
carpus is caudal.
• Craniocaudal (CrCd): This term describes a radiographic projection
obtained by passing the primary xray beam from the cranial surface to the
caudal surface of a structure. It is most commonly used for radiographs
involving the extremities proximal to the carpus or tarsus.
• Caudocranial (CdCr): This term describes a radiographic projection
obtained by passing the primary xray beam from the caudal surface to the
cranial surface of a structure. It is most commonly used for radiographs
involving the extremities proximal to the carpus or tarsus.
• Dorsopalmar (Dpa): This term is used to describe radiographic views distal to
the carpus obtained by passing the primary x-ray beam from the dorsal direction
to the palmar surface of the forelimb.
• Palmar dorsal (PaD): This term is used to describe radiographic views distal
to the carpus obtained by passing the primary x-ray beam from the palmar
surface of the forelimb toward the dorsal surface of the body.
• Dorsoplantar (Dpl): This term is used to describe radiographic views distal to
the tarsus obtained by passing the primary x-ray beam from the dorsal direction
to the plantar surface of the hindlimb.
• Plantardorsal (PlD): This term is used to describe radiographic views distal to
the tarsus obtained by passing the primary x-ray beam from the plantar surface
of the forelimb toward the dorsal surface of the body.
• Oblique (O): This term refers to radiographic projections taken with the
primary beam entering at an angle other than 90 degrees to the anatomical area
of interest. Oblique projections are sometimes used to obtain images of
structures that might be superimposed over other structures with standard 90-
degree views. Nearly all dental radiographs are obtained using oblique angles.
For example, a D60LMPaO indicates that the x-ray beam entered the dorsal
surface at a 60-degree angle and exited at the medial area of the palmar aspect
of the hindlimb.
 POSITIONING AIDS
• Radiology positioning aids are used to increase the patient’s comfort as well as
ensure proper positioning for the radiographic evaluation. When manual restraint
is needed, positioning aids will assist the handler in maintaining the animal in
the correct position.
• Positioning aids should be small and lightweight to allow ease of use and
storage. Positioning aids made of plastic are radiolucent, meaning x-rays can
pass through the object. Reusable positioning aids must be waterproof,
washable, and stain resistant.
• Reusable positioning devices include sandbags, foam pads and wedges,
beanbags, troughs, and ropes.
Sandbags used for radiographic positioning. Foam wedges.

Vinyl-covered V-trough
 RADIOGRAPHIC POSITIONING OF
THORAX
• Thoracic radiographs are primarily utilized for evaluation of the soft
tissues of the thoracic cavity (i.e., lungs, heart). Thoracic radiographs
are usually exposed at peak inspiration. In patients with suspected
pneumothorax, exposures are usually made during the expiratory
pause.
• For all thoracic projections, the forelimbs must be extended cranially
to avoid overlap of the shoulder muscles on the thoracic structures.
For the DV and VD projections, the sternum appears superimposed on
the thoracic vertebrae.
 Lateral Projection of the Thorax
• Positioning:
Right lateral recumbency is preferred.
• Forelimbs are extended cranially; hindlimbs caudally.
• Place a foam pad under the sternum to avoid rotation and to maintain
horizontal alignment of the sternum and spine.
• Neck is in natural position.

Proper positioning for lateral projection of the thorax.

• Field of view should be extended from caudal border of scapula to
the 13th rib.
Cranial border: thoracic inlet.
 Dorsal border: spinous processes of spinal column.
 Ventral border: xiphoid
Caudal border: 13th rib
 Differences in the views b/w left lateral &
right lateral radiography
• In the left lateral view, the two dorsal crura of the diaphragm deviate
from each other, whereas in the right lateral view they are more
parallel .
 L R

Left (L) and right (R) lateral radiographs of the caudal thorax of a dog. In the left lateral view,
the crura at the dorsal aspect of the diaphragm diverge more than in the right lateral view.
• In general, the heart will appear slightly more round and the apex may be
slightly elevated from the sternum in the left lateral view compared with the
right lateral view.

Left lateral (A) and right lateral (B) thoracic radiographs of the cardiac region. Generally, in the left lateral view, the heart will
appear more round, and there will be some slight separation of the cardiac apex from the sternum (white arrows in A).
• In the right lateral view, the dependent right diaphragmatic crus will be cranial
to the left crus because of pressure from abdominal contents, and therefore
the caudal vena cava will silhouette, or merge, with the more cranial right crus
that contains the caval hiatus. In the left lateral view, the left crus will be
cranial to the right crus, and the caudal vena cava will be superimposed on the
left crus before silhouetting, or merging, with the more caudally located right
crus that contains the caval hiatus
 A B

Left (A) and right (B) lateral radiographs of the region of the junction of the caudal vena cava with the diaphragm. In the left
lateral view (A), the left crus is more cranial, and the caudal vena cava is superimposed on it before joining the right crus that
contains the caval hiatus. In the right lateral view (B), the right crus of the diaphragm that contains the caval hiatus is more
cranial, and the caudal vena cava joins this more cranial crus.
 VD Projection of the Thorax
• Positioning:
Dorsal recumbency
Forelimbs are extended cranially with nose between forelimbs.
Hindlimbs are extended caudally.
Use a V-trough to superimpose the sternum and spine.
VD projection of the thorax.
 DV Projection of the Thorax
• Positioning:
Sternal recumbency
Forelimbs are extended slightly cranial with carpus at level of ears.
Hindlimbs are in natural flexed position
Superimpose sternum and spine.
DV projection of the thorax.
Appearance of Cardiac Silhouette in DV vs
VD Radiograph-

• There is a major difference in the appearance of the cardiac silhouette

in VD versus DV radiographs. In ventral recumbency for the DV
radiograph, the ventral aspect of the diaphragm is displaced cranially
where it contacts the heart and displaces it, typically to the left. The
heart is also more upright in the thoracic cavity when the patient is in
ventral recumbency, making it appear more round .
Ventrodorsal (VD; A) and dorsoventral (DV; B) thoracic radiographs. In the DV radiograph, the diaphragm is displaced cranially
where it contacts the heart and pushes it into the left hemithorax. The cardiac silhouette is also smaller and more round,
because it is more upright in the thoracic cavity due to the displacement. The overall size of the thoracic cavity is reduced in
the DV radiograph. The cranial excursion of the diaphragm also impinges on the accessory lung lobe region and compromises
the evaluation of that region of the thorax. The appearance of a normal heart in the DV radiograph is often misinterpreted as
cardiomegaly with an apex shift to the left.
 RADIOGRAPHIC POSITIONING OF
HEAD
• Radiographic positioning varies greatly between the different skull types owing
to anatomic variations of different breeds.
1. Standard Projections:-
a) Lateral projection
b) DV or VD projection. A symmetrical view is usually easier to obtain in the DV
position, in which the animal is resting on the horizontal rami of the mandible.
2. Supplimental Projections:-
c) Additional projections are frequently necessary, depending on the suspected
site and/or type of disease problem.
d) Oblique projections of both the abnormal and the normal sides are frequently
helpful.
 AREA OF SKULL RADIOGRAPHIC PROJECTIONS
Routine Skull Lateral, DV
Mandible Lateral ,DV
Zygomatic bone & Orbit Lateral, DV, open mouth VD, frontal, lateral oblique
Temperomandibular Joint DV
Foramen Magnum Rostro caudal
Nasal cavities & Sinuses Lateral recumbent, DV, occlusal DV, open mouth VD, frontal
Maxillary teeth Open mouth lateral oblique, open mouth VD
Mandibular teeth Open mouth lateral oblique
Incison teeth Occlusal DV, Occlusal VD, Bisecting Parallel
Lateral Position DV Position
Lateral Position
VD Position
Frontal Position Open Mouth Rostro-caudal
Open mouth VD projection Open mouth lateral oblique
for nasal caviety projection for maxilla
Occlusal VD projection for Rostrocaudal projection
rostral mandible for foramen magnum

Occlusal DV Open mouth lateral oblique

projection projection
 Lateral Projection of the Skull
• Positioning:
Right or left lateral recumbency with the affected side toward the cassette.
Foam pads placed under the mandible to maintain the sagittal plane of the
skull in a position parallel to the x-ray cassette.

• Area of View:
Should be extended from Occipital protuberance to the tip of the nose.
Centering should be done on Lateral canthus of the eye socket.
Proper positioning for lateral projection of the skull. Field of view extended
from Occipital protuberance to the tip of the nose. Centering is done on
Lateral canthus of the eye socket.
Lateral projection of the skull.
 DV Projection of the Skull
• Positioning:
Sternal recumbency.
• Sandbag placed across the cervical region to maintain placement of the
head against the x-ray cassette.
• Tape can be used across the maxilla to maintain vertical alignment of the
head on the x-ray cassette
• Area of view:-
Occipital protuberance to the tip of the nose. Zygomatic arches fully within
collimated area. Centering to be done Midway between the tip of the nose to
just caudal to the occipital protuberance at the base.

Proper positioning for DV projection of the skull.

DV projection of the skull.
 VD Projection of the Skull
• Positioning:
Dorsal recumbency.
• Foam pad or sandbag is positioned under neck to maintain hard palate in
parallel alignment with x-ray cassette.
• A V-trough can be used to aid in maintaining vertical alignment.
• Forelimbs are secured caudally.
• Foam pad under head or tape across mandibles to avoid rotation of head.
• Field of View:-
Occipital protuberance to the tip of the nose.
Zygomatic arches fully within collimated area.
Centring to be done Midway between the tip of the nose to just caudal to
the occipital protuberance at the base.

Proper positioning for VD projection of the skull.

VD projection of the skull.
Rostrocaudal Sinuses Closed Mouth
Projection
• Positioning:
Dorsal recumbency.
Foam pad or sandbag is positioned under neck.
A V-trough can be used to aid in maintaining vertical alignment
Forelimbs are secured caudally.
Tape or gauze to direct nose caudally to maintain hard palate
perpendicular to the x-ray cassette and parallel to the x-ray beam.
Proper positioning for rostrocaudal sinuses closed mouth
projection.
Rostrocaudal sinuses closed mouth projection.
 Rostrocaudal for Foramen Magnum
• Positioning:
Projection
Dorsal recumbency. Foam pad or sandbag is positioned under neck. A V-trough
can be used to aid in maintaining vertical alignment. Forelimbs are secured
caudally. Tape or gauze to direct nose caudally approximately 30 degrees with
the mandible close to the chest.
• Field Of View:- Include all of occipital crest to tympanic bullae. Centering to be
done between the eyes.
 RADIOGRAPHIC POSITIONING OF
PELVIS
• Pelvic radiographs are primarily utilized for visualization of the bones
and joints that comprise the hip. In patients with suspected hip
dysplasia, a variety of specialized procedures are used. The most
common of these is the ventrodorsal (VD)-extended hip view utilized
for certifi cation by the Orthopedic Foundation of America.

• For all pelvic projections, the hip joints and sacroiliac joints are mirror
images of each other. In addition to the VD-extended view, commonly
performed projections of the pelvis include the VD frog leg position
and lateral.
 VD-Extended Hip Projection
• Positioning:-
• Dorsal recumbency. Forelimbs extended cranially and evenly with nose
between forelimbs. Hindlimbs extended caudally and evenly into full
Extension. Femurs are rotated medially so they are parallel to one another and
the x-ray table, and the patella is centered within the patellar groove over the
stifle and taped in place.

• Centering:
• Midline between the left and right ischial tuberosity.
• Field of View:-
• Cranial border: Extended from caudal to the wing of ilium and distal to the
patella.
• Lateral borders: It is taken as lateral to the ischium.
VD-extended hip projection.
 VD Frog Leg Projection
• Positioning:
• Dorsal recumbency. Forelimbs are extended cranially. Hindlimbs are in
natural flexed position; in most normal patients, the femurs naturally
assume an angle of approximately 45 degrees to the spine. In some
large dogs, the femurs may naturally assume a 90-degree angle to the
spine. Use a V-trough with foam pads on lateral aspect of body wall to
superimpose sternum and spine.
• Centering to be made Midline between the left and right ischial
tuberosity.
 Lateral Projection of the Pelvis
• Positioning:
• Right or left lateral recumbency (side of interest closest to the cassette).
Bottom leg extended cranially, top leg extended caudally (scissor position).
• Centering: Greater trochanter of femur.
• Field of View:- Cranial edge of ilium to caudal border of ischium.

Proper positioning for lateral pelvis projection.

 RADIOGRAPHIC POSITIONING OF
SPINE
• Radiographs of the vertebral column are used to detect bony lesions as well as
evaluate intervertebral disc space. Careful positioning is necessary to maintain
the vertebral column parallel to the x-ray cassette and to allow the vertebral
column to be placed as near to the x-ray cassette as possible.
• Positioning aids are used as supportive devices to maintain the spine parallel to
the tabletop. Placing a piece of tape along the spinal column before moving the
patient onto the x-ray table may aid in maintaining proper alignment.

Use of tape to maintain proper alignment.

 VD Cervical Spine Projection
• Positioning:
• Dorsal recumbency. Foam pad is placed under neck to maintain spinal column
parallel to x-ray cassette. Forelimbs are secured evenly and caudally.
• Centering:
• To be done on C4--C5 intervertebral space.
• Field of View: Extended from Base of the skull to the spine of the scapula.

Proper position for VD cervical spine projection.

VD cervical spine projection.
 Lateral Cervical Spine Projection
• Positioning: animal should be placed on right or left lateral recumbency. Foam
pad is placed under mandible to maintain spinal column parallel to x-ray
cassette and secured with a sandbag. Forelimbs are secured evenly and
caudally.
• Centering: C4--C5 intervertebral space.
• Field of View: Base of the skull to the spine of the scapula.
 Lateral Cervical Spine Extended
Projection
• Positioning: Right or left lateral recumbency. Foam pad is placed under
mandible to maintain spinal column parallel to x-ray cassette and secured
with a sandbag. Forelimbs are secured evenly and caudally. The neck is
extended or pushed dorsally.
• Centering: C4--C5 intervertebral space.
• Field of View: Base of the skull to the spine of the scapula.
 Lateral Cervical Spine Flexed Projection
• Positioning: Right or left lateral recumbency. Head is directed ventrally and
caudally toward the humeri and can be secured with a sandbag to maintain
flexion on the dorsal part of the skull.
• Centering: C4--C5 intervertebral space.
• Field of View: Base of the skull to the spine of the scapula.
 VD Thoracic Spine Projection
• Positioning: Dorsal recumbency. Forelimbs extended evenly and cranially. V-
trough or sandbags to maintain vertical alignment.
• Centering: Caudal border of scapula at approximately the sixth or seventh
thoracic vertebra.
• Field of View: Halfway between xiphoid and last rib to spine of the scapula.
Must include C7--L1.
 Lateral Thoracic Spine Projection
• Positioning: Right or left lateral recumbency. Forelimbs are extended evenly
and slightly cranially. Hindlimbs are extended evenly and slightly caudally.
• Centering: Caudal border of scapula at approximately the sixth or seventh
thoracic vertebra.
• Field of View: Halfway between xiphoid and last rib to spine of the scapula.
 VD Lumbar Spine Projection
• Positioning: Dorsal recumbency. Forelimbs are extended evenly and slightly
cranially. Hindlimbs are extended evenly and slightly caudally.
• Centering: Palpate xiphoid and the wing of the ilium, and place the center
halfway between these two points.
• Field of View: Xiphoid to acetabulum.
 Lateral Lumbar Spine Projection
• Positioning: Right or left lateral recumbency.
• Centering: L3--4.
• Field of View: Xiphoid to acetabulum.
 VD Lumbosacral Spine Projection
• Positioning: Dorsal recumbency in V-trough. Forelimbs are extended evenly
and slightly cranially. Hindlimbs are extended evenly and slightly caudally.
• Field of View: Sixth lumbar vertebra to iliac crest.
 RADIOGRAPHIC POSITIONING OF
ABDOMEN
• Abdominal radiographs are primarily utilized for evaluation of the soft tissues
of the abdomen (kidneys, bladder, liver, intestinal tract Abdominal radiographs
are exposed after full exhalation and before initiation of inspiration (expiratory
pause). Lateral and ventrodorsal (VD) views are commonly performed.

• Some radiographic studies must be performed after the patient has been
fasted for 12 hours unless medical conditions contraindicate fasting. If
necessary, a cathartic or enema may be given 3–4 hours before radiography to
clear the intestinal tract of fecal matter. This will enhance visualization of
structures within the abdominal cavity.
 Lateral Projection of the Abdomen
• Positioning: Right lateral recumbency. Forelimbs are extended cranially;
hindlimbs extended caudally.
• Centering: Slightly caudal to last rib.
• Field of View:
Cranial border: halfway between the caudal border of scapula and the
xiphoid.
• Dorsal border: spinous processes of vertebral column.
• Ventral border: sternum.
• Extension of hindlimbs is crucial to avoid superimposing of abdominal
muscles, but hyperextension must be avoided because this may reduce
visibility of abdominal organs.
 VD Projection of the Abdomen
• Positioning: Dorsal recumbency. Forelimbs extended cranially with nose
between forelimbs. Hindlimbs extended caudally. Use a V-trough to
superimpose the sternum and spine.
• Field of View: on midline halfway between the caudal border of scapula and the
xiphoid.