Sternum, Clavicle & Ribs

Sternum
    Projections

•  Oblique (RAO or LAO)

•  Lateral

Sternum Oblique

Oblique (RAO or LAO)
Patient position

• Stands or sits (or lying down) facing the bucky. Midsagittal plane perpendicular.

Part position

• Rotate right or left side 20-30 degrees away from the bucky.

Position of cassette

• Upper edge at 7th cervical vertebra.

• Centre of the cassette at the level of the Midsternum.

Central ray

• To enter perpendicularly at the level of the medial border of the scapula of the raised side & lateral to the spine, exiting midsternum.

Respiration

• Gentle breathing during a long exposure time to blur out the lung markings.

• Exposure :- 75kV, 50 mAs(25mA x 2 sec).

Sternum Lateral
Patient position

• Standing, seated in lateral position (or recumbent).

Part position

• Rotate shoulders  and arms posteriorly for erect position, or, place arms above head for recumbent position.

• Center sternum to bucky in true lateral position.

Position of cassette

• Upper edge 4-5 cm above sternal notch.

• Vertical Centre of the cassette at the level of the sternum.

Central ray 

• To Enter and exit perpendicularly at the lateral border   of midsternum.
• Respiration  :- Suspended deep inspiration.

 Sterno-clavicular joints  Obliques
Patient position

• Prone or seated erect facing the bucky.

 Part position

• Keeping affected side closer to bucky rotate patient’s body enough to project the vertebrae  away from the joint (45 degrees).

• Center sternoclavicular joint centred to the bucky & cassette

 Central ray

• perpendicularly to a point 5 -10cm away from the midline at the level of T2-T3  to exit at the joint.

 Respiration  :- Suspended deep inspiration.

Clavicle AP
 Patient Position

• Position patient erect or supine.

• Turn patient's head away from affected side.

Part Position

• Center clavicle to center of cassette, midway between midline of body and lateral border of shoulder.

Respiration:

• Obtain radiograph during suspended expiration.

Central Ray

• Direct perpendicular to mid-shaft of clavicle.

NOTE: If necessary to decrease part-cassette distance and improve recorded detail, obtain PA clavicle. Place patient facing grid using perpendicular central ray and position using above landmarks.

Clavicle AP axial

• Position patient erect or supine.

• Center clavicle to lower third of cassette, midway between midsagittal plane and lateral border of shoulder.

• Turn patient's head away from affected side if needed.

• Obtain radiograph during suspended inspiration.

• Direct angle 15 to 30 degrees cephalad centered to midshaft of clavicle.

• NOTE: If necessary to decrease part-cassette distance and improve recorded detail, obtain PA axial clavicle. Place patient facing grid using 15 to 20 degrees caudal central ray angulation.