Basic Principles and Techniques

The standard views of the skull are the posteroanterior (PA), lateral, anteroposterior (AP), half-axial (Towne), and base. The PA view demonstrates the frontal and ethmoidal sinuses, frontal bones, nasal cavity, superior orbital rims, and mandible. The frontal, parietal, temporal, and occipital bones, the sella turcica, the orbital roofs, the mastoid region, and the lateral aspect of the facial bones are demonstrated on the lateral view. The Towne view shows the zygomatic arches, the foramen magnum, the occipital bone, and the mastoid region. The base view demonstrates the basal structures of the skull. To evaluate the facial bones and sinuses, the occipitomental (Waters) view is often used.

Conventional radiographic examination of the spine plays a critical role in the initial evaluation of the trauma patient. Because the cervical cord is prone to damage from unnecessary manipulation, the initial radiographic examination is usually limited to two or three projections that provide the optimum amount of clinically pertinent information. Plain film examination of the spine is also an invaluable tool in the screening of patients for degenerative, inflammatory, and neoplastic conditions and serves as an excellent imaging modality by alerting the physician to the presence and degree of abnormalities. Of all the spine examinations involving radiation, plain film radiography gives the lowest dose, averaging 0.2 rad to the ovaries for a four-view lumbar examination. The testicular dose is 10 to 50 percent of the ovarian dose.

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