SKULL:

TOWNE’S METHOD (AP Axial Projection)

“Oh, Shit! Zy’s Pussy Makes Me So Tight”

 Occipital bone (CR: 30°↓ OML, 37°↓ IOML)

 Sella Turcica (CR: 30°↓, SS: ACP & FM) (37°↓, SS: DS & PCP w/in the FM)
 Zygoma (CR: 30°↓ OML, 37°↓ IOML) (RP: 1” above Glabella)
 Petromastoid (RP: 2.5” above Glabella)
 Mandible
 Mandibular Condyles [axial view] (CR: 30°↓ OML, 37°↓ IOML) (RP:3” above Nasion)
 Skull
 TMJ [Dislocation] (CR: 30°↓ OML, 37°↓ IOML) (RP:3” above Nasion)

HAAS METHOD (PA Axial Projection) [Reverse Towne’s, alternative to Towne’s

Method]
“Oh, Shit!”

 Occipital bone (25°↑) [Nunchofrontal Projection]

 Sella Turcica (CR: 10°↑ OML, 25°↑ IOML)

VALDINI METHOD (PA Axial Projection)

 Occipital bone

CALDWELL METHOD (PA Axial Projection)

 Skull (General survey) (CR: 15°↓)

 Paranasal sinuses [SS: F, E]
 Superior Orbital Fissure (20-25°↓)
 Inferior Orbital Fissure (20-25°↑)
 Rotundum Foramina (25-30°↓)

SCHULLER METHOD
(Submentovertical Projection)

 Base of the skull

 Paranasal sinuses [SS: E, S]
 Zygoma (1.5-2” below symphysis menti
 Petromastoid
 Mandible (U-shaped/Horse shoe shaped)
 Mastoid pneumatization (CR: 25°↓)
 Organs of hearing w/in the petrosas

(Verticosubmental Projection)

 Anterior cranial base

(Axiolateral Projection)

 TMJ (CR: 25°↓)

LYSHOLM METHOD/ RUNSTROM II METHOD (Axiolateral Projection)
[Alternative to Schuller Method]

 Base of the skull (CR: 35°↓)

LATERAL PROJECTION

 Parietal bones
 Paranasal sinuses [SS: Frontal, Ethmoid, Maxillary, Sphenoid (FEMS)]
 Sella Turcica (CR: ¾ anterior & ¾ superior to EAM) [Best demo]
 Clivus
 Nasal bone
 Facial bone

WATERS METHOD (Parietoacanthial Projection)

 Paranasal sinus (High Waters) (OML 37° to IR) [SS: M]

OPEN-MOUTH WATERS METHOD (Modified Parietoacanthial Projection

 Paranasal sinus (Shallow Waters) (OML 55° to IR) [SS: S]

 Best demo blowout fx

PIRIE METHOD (Axial Transoral Projection)

 Paranasal sinus (CR: 30°↓) [SS: S]

RHE53° METHOD (Parieto-orbital Oblique Projection)

 Paranasal sinus (MSP 53° to IR) [SS: E]

 Optic Foramen (MSP 53° to IR)

REVERSE RHE53° METHOD (Orbito-Parietal Oblique Projection)

 Optic Foramen (MSP 53° to IR)

ALTSCHUL METHOD (AP Axial Projection)

 Jugular Foramina (CR: 40-60°↓) [best demo]

TITTERINGTON METHOD

 Zygoma (CR: 23-38°↓)

INFEROSUPERIOR OBLIQUE PROJECTION

 Zygoma (15°Rotate and 15°tilt head TO IR)

FUCHS METHOD

 Zygoma (45°Rotate and 15°Tilt head AWAY from IR) (CR: 35°↓)

(AP Projection)

 Styloid process [w/in the Maxillary sinuses] (CR: 13°↓

(Axiolateral Oblique Projection)

 Styloid Process [Lateral view] (CR: 10°↑, 10° anteriorly)

MAY METHOD

 Zygoma (15°Rotate and 15°tilt head AWAY from IR)

LAW METHOD (Axiolateral Projection)

Original Law Method

 Mastoid air cells (CR: 25°↓ and 15° anterior)

 TMJ [demo TMJ NEAREST to IR] (CR: 15°↓, MSP 15° to IR

Modified Law Method

 Mastoid air cells (CR: 15°↓)

STENVER’S METHOD (Post Profile Position, Axial Oblique Projection)

 Petrous bone [NEAREST to IR] (CR: 12°↑)

ARCELIN METHOD [Reverse Stenver’s] (Anterior Profile Position, Axial Oblique

Projection)

 Petrous bone [FARTHEST to IR] (CR: 10°↓) *if px can’t prone

MAYER’S METHOD (Axial Oblique Projection)

 Mastoid air cells (CR: 45°)

OWEN METHOD (Axial Oblique Projection)

 Mastoid air cells (CR: 30-40°)

HENSCHEN METHOD

 Tumors of the acoustic nerve (CR: 15°↓)

HIRTZ METHOD

 Axial view of the petrosa (CR: 5° to level of EAM)

HICKEY METHOD (AP Tangential Projection)

 Petromastoid (tangential view) (CR: 15°↓, rotate head 55° AWAY from affected side)

LOW BEER METHOD (Axiolateral Projection)

 Mastoid air cells [image similar to Stenver’s] (CR: 33° anterior, 10°↑)

ALBERS-SCHONBERG (Axiolateral Projection)

 TMJ (CR: 20°↑

ZANELLI METHOD

 TMJ (MSP 30° to IR, head tilted 30°)

ALEXANDER METHOD (Orbito-Parietal Oblique Projection)

 Optic Foramina (MSP 40° to IR)

HOUGH METHOD

 Sphenoid strut (CR: 7°↓, MSP 20° to IR)

BERTEL METHOD

 Inferior Orbital Fissure (20-25°↑)

VOGT-BONE FREE METHOD

 Orbits [foreign body, uses dental/occlusal film

PARALLAX METHOD

 Orbits (eyeball movement)

SWEET METHOD

 Orbits [Geometric calculation]

PFEIFFER-COMBERG METHOD

 Leaded contact lens

Axiolateral Oblique Projection

 Mandibular Rami & condyles (Head rotation: 0°) (CR: 25°↑)

 Mandible [General survey] (Head rotation: 10-15°) (CR: 25°↑)
 Mandibular Body (Head rotation: 30°) (CR: 25°↑)
 Symphysis Menti (Head rotation: 45°) (CR: 25°↑)

CAHOON’S METHOD (PA Axial Projection)

 Styloid process [w/in the Maxillary sinuses] (CR: 25°↑)

WIGBY-TAYLOR METHOD (AP Oblique Projection)

 Styloid Process [Oblique view] (CR: (CR: 8°↑, MSP 12° to IR)

KEMP-HARPER METHOD (SMV Axial Projection)

 Jugular Foramina (CR: 20°↓)

ERASO MODIFICATION

 Jugular Foramina (OML 25° to IR) (CR: 0°)

MILLER METHOD

 Hypoglossal Canal (CR: 12°↓, Head rotated 45° AWAY from affected side)
UPPER EXTREMITIES:

ROBERT METHOD

 1st CMC joint [Trapezometacarpal articulation] (CR: 0°)

RAFERT-LONG METHOD

 1st CMC joint (CR: 15° Proximally)

 Best demo. the Scaphoid using a four-image multi-angle CR series [Scaphoid Series] (CR: 0°,
10°↑, 20°↑, 30°↑)

LEWIS METHOD

 1st MCP joint

 Best demo. Bennett’s fx [fx at the base of the 1st MCP]
 Best demo. fx of the 5th MC (rotate hand 5° Posterior from the lateral position)

BURMAN METHOD (AP Axial Projection)

 1st CMC w/ radial shift (AP view)

 Magnified concavo aspect of the 1st CMC joint (best demo) (CR: 45°)

NORGAARD METHOD (BALL-CATCHER’S POSITION, AP Oblique Projection)

 Hand’s Rheumatoid Arthritis (STAPEZYNSKI: recommended the ball-catcher’s position for fx

of the 5th MC)

BREWERTON METHOD (AP Axial Projection)

 Best demo. BONY EROSIONS, early findings of RHEUMATOID ARTHIRITIS (CR: 45°
distally to 3rd CMC)

AP Projection

 Thumb (LEWIS suggested: extreme internal rotation of 10-15°)

 Best demo. Carpal Interspaces
 Distal ulna w/out obliquity
 Best demo. Elbow Joint Spaces
In Partial Flexion
 Alternative projection to AP Projection when the px cannot extend the elbow
(Forearm // to IR):
 Demo. the proximal forearm
 Best demo. the proximal radius and ulna
(Distal Humerus // to IR):
 Best demo. the distal humerus w/ no distortion of the humeral epicondyles
In External Rotation [Shoulder]
 (Humeral epicondyle is // to IR) (CR: ┴ to 1” ↓ coracoid process) [Hand in supination]
 Humerus is in AP Projection
 Humeral head in profile
 Best demo. Greater Tubercle in profile on the lateral aspect of the humeral head
 The TRUE AP Projection of the humerus in the anatomical position
 Profile image of the site of insertion of the SUPRASPINATUS TENDON
 In Neutral Rotation [Shoulder]
 (Humeral epicondyle is 45° to IR) (Palmar/Anterior aspect of the hand against the hip/thigh)
 Humerus in Oblique view
 Slight overlapping of humeral head to glenoid cavity
 Partial profile of the humeral head
 Demo. the GREATER TUBERCLE on anterior aspect of the humeral head
 Demo. the POSTERIOR PART of the Supraspinatus Insertion
 Demo. the SUBACROMIAL BURSA
In Internal Rotation [Shoulder]
 (Humeral epicondyle ┴ tp IR) (Dorsal/Posterior aspect of hand against hip)
 Humerus in Lateral Projection
 Greater overlapping of humeral head to glenoid cavity
 Best demo. the LESSER TUBERCLE
 Profile image of the site of the Insertion of the SUBSCAPULARIS TENDON
Shoulder Summary
ESSPT: NPSIT-SAB ISST: ENI:
External Neutral Internal External SUPRASPINATUS
Supra Posterior part Sub Neutral
Spinatus Supra spinatus Scapularis Internal -
Subscapularis
Tendon Insertion Tendon
Tendon
Sub-Acromial Bursa

PA Projection

 Thumb (there’s loss of detail bc thumb is NOT close to IR)

 2nd-5th digits (hand pronated) (CR: to affected PIP joint)
 Hand (CR: ┴ to 3rd MCP)
 Wrist
 Best demo. Scaphoid Fat Stripe & Individual Carpals
Ulnar Deviation
 Best demo. an elongated view of Scaphoid
 Best demo. Lateral Side Carpal Interspaces
Radial Deviation
 Best demo. the Lunate, Triquetrum, Pisiform, & Hamate
 Best demo. the Medial Side Carpal Interspaces

Oblique Projection

 Thumb (slight ulnar deviation)

 3rd-5th digits (laterally rotate 45°) (CR: to affected PIP joint)
 2nd digit (medially rotate 45°) (CR: to affected PIP joint)
 Hand (Laterally rotated 45°) (CR: ┴ to 3rd MCP) (Coin-sign projection)
 Severe metacarpal deformities & fx [Reverse Oblique, LANE KENNEDY & KUSCHNER
Method] (Medially rotate hand 45°)

AP Oblique Projection

 Best demo. the Pisiform, Triquetrum, & Hamate

PA Oblique Projection

 Best demo. the Scaphoid, Trapezium, & Anatomic Snuffbox

Lateral Projection

 Thumb (hand is clenched/arched)

 2nd-3rd digits (Radial/Lateral side down) (CR: to affected PIP joint)
 4th-5th digits (Ulnar/Medial side down) (CR: to affected PIP joint)
 Alignment relationship of Distal Radius w/ other carpals
 Best demo. Pronator Fat Stripe
 Best demo. widening of wrist joint due to fx or dislocation
 Demo. Elbow Fat Pads (Elbow flexed 90°; 30°-35° elbow flexion if there is soft tissue swelling)
 Best demo. the Olecranon Process
 If the Posterior Fat Pad is seen, it is an indicator of an Elbow joint pathology
In Extension
 Hand [Localizes foreign body and metacarpal(MC) fx displacement] (CR: ┴ to 2 nd MCP)
In Flexion
 Best demo. anterior & posterior displacement of MC fx (CR: ┴ to 2nd MCP)
In Fan Lateral
 Best demo. individual digits (CR: ┴ to 2nd MCP)
In Palmar Flexion (FIOLLE Method)
 Best demo. the Carpal Boss/Carpe Bossu (CR: ┴ to 2nd MCP)

AP Medial Oblique Projection - Internal Rotation

 Best demo. Coronoid process, Olecranon process Within olecranon fossa, Trochlea (COWT)

AP Lateral Oblique Projection – External Rotation

 Best demo. Radial head, neck, & tuberosity

 Capitulum
 Medial epicondyle superimposed to Olecranon process

STETCHER Method (PA Axial Projection)

 Wrist
-Hand and wrist elevated on a 20° wedge foam (CR: ┴ to Scaphoid)
-Hand is placed flat on IR (CR: 20°)
 Best demo. the Scaphoid

BRIDGEMAN METHOD (PA Axial w/ Ulnar Deviation)

 Best demo. an elongated Scaphoid (CR: 20° towards the elbow)

CLEMENTS-NAKAYAMA METHOD (PA Axial Oblique Projection)

 Best demo. the fx Trapezium (CR: 45° distally to anatomic snuffbox) (Hand rotated 45°
laterally)

GAYNOR-HART METHOD (Tangential Carpal Canal; Inferosuperior Projection)

 Best demo. the Carpal Canal, Carpal Tunnel, Hook of Hamate, Pisiform, & Trapezium
 Demo. the Median Nerve Impingement (Carpal Canal Syndrome)
MARSHALL METHOD (Superoinferior Projection)

 Alternative to Gaynor-Hart Method

 Demo. the Carpal Canal (CR: 20°-35° from long axis of forearm) (wrist in dorsiflexion)

LENTINO METHOD (Tangential Carpal Bridge)

 Best demo. Scaphoid fx, calcifications, FB in the dorsal aspect of carpals/wrist (CR: 45° to
midpoint of distal forearm chip)

COYLE METHOD (Trauma Axiolateral Projection)

 Performed if the px cannot fully extend the elbow for medial or lateral oblique elbow
 Alternative projection for both elbow oblique projection
 Radial head, neck, tuberosity (CR: 45° TOWARDS shoulder) (Elbow flexed 90°)
 Coronoid Process (CR: 45° AWAY from shoulder) (Elbow flexed 80°)

RADIAL HEAD SERIES (Lateral Projection)

 Best demo. Occult fx of the radial head at varying degree of rotation of the hand

Hand in Lateral Rotation

 Radial tuberosity superimposed on the shaft of radius

Hand in Pronation

 Radial tuberosity facing posterior

Hand in Internal Rotation

 Radial tuberosity posterior to adjacent ulna

JONES METHOD (AP Projection, Acute Flexion Method)

Humeral Epicondyle // to IR
 Best demo. the Olecranon Process

Forearm // to IR

 Best demo. the Proximal Radius & Ulna through the superimposed Distal Humerus (CR: ┴ to
the long axis of the forearm) (RP: 2” distal to the olecranon process)

Distal Humerus // to IR

 Best demo. the Olecranon Process (CR: ┴ to the long axis of humerus) (RP: 2” above the
Olecranon Process)

TRANSAXILLARY PROJECTION (Inferosuperior Axial Projection)

Lawrence Method

 (CR: horizontal if arm is abducted 90°; 15°-30° medially if arm is NOT abducted) [Hand in
supination; px in SUPINE position]
 Teres Minor
 Lesser Tubercle
Rafert Method

 (CR: 15° medially if arm is NOT abducted; horizontal if arm is abducted 90°) [Hand in
exaggerated external rotation; px in SUPINE position]
 Hill-Sachs Defect
 Teres Minor
 Lesser Tubercle

Westpoint Method

 (CR: 25° ANTERIORLY & 25° MEDIALLY if arm is abducted 90°) [Px in PRONE position]
 Demo. the Anterior-Inferior GLENOID RIM in px w/ CHRONIC SHOUDLER
INSTABILITY

Clements Method

 (CR: 5°-15° medially if arm is NOT abducted; horizontal if arm is abducted 90°) [Px in
LATERAL RECUMBENT position]
 Alternative to supine/prone Transaxillary Projection
 Transaxillary Projection w/ the least amount of CR angulation

Hobbs Modification (PA Transaxillary Projection)

 (Px is erect and rotated 5°-10° anteriorly, affected arm raised)

 Demo. fx/dislocation of the proximal humerus
 Lateral projection of Proximal Humerus