Which of the following are required to produce a radiograph using a decubitus position?

This site uses cookies to improve performance. If your browser does not accept cookies, you cannot view this site.

Setting Your Browser to Accept Cookies

There are many reasons why a cookie could not be set correctly. Below are the most common reasons:

• You have cookies disabled in your browser. You need to reset your browser to accept cookies or to ask you if you want to accept cookies.
• Your browser asks you whether you want to accept cookies and you declined. To accept cookies from this site, use the Back button and accept the cookie.
• Your browser does not support cookies. Try a different browser if you suspect this.
• The date on your computer is in the past. If your computer's clock shows a date before 1 Jan 1970, the browser will automatically forget the cookie. To fix this, set the correct time and date on your computer.
• You have installed an application that monitors or blocks cookies from being set. You must disable the application while logging in or check with your system administrator.

Why Does this Site Require Cookies?

This site uses cookies to improve performance by remembering that you are logged in when you go from page to page. To provide access without cookies would require the site to create a new session for every page you visit, which slows the system down to an unacceptable level.

What Gets Stored in a Cookie?

This site stores nothing other than an automatically generated session ID in the cookie; no other information is captured.

In general, only the information that you provide, or the choices you make while visiting a web site, can be stored in a cookie. For example, the site cannot determine your email name unless you choose to type it. Allowing a website to create a cookie does not give that or any other site access to the rest of your computer, and only the site that created the cookie can read it.

Citation, DOI & article data

Citation:

Murphy A, Bell D, Bickle I, et al. Chest (lateral decubitus view). Reference article, Radiopaedia.org (Accessed on 24 Nov 2022) https://doi.org/10.53347/rID-53650

The lateral decubitus view of the chest is a specialized projection that is now rarely used due to the ubiquity of CT.  It is chiefly used in the pediatric population.

On this page:

Undertaken to demonstrate small pleural effusions, or for the investigation of pneumothorax and air trapping due to inhaled foreign bodies.

• the patient is lying either left lateral or right lateral on a trolley on top of a radiolucent sponge
  • note: when investigating pneumothorax the side of interest should be up; when investigating pleural effusions the side of interest should be down
• the detector is placed landscape posterior to the patient running parallel with the long axis of the thorax 
• patient's hands should be raised to avoid superimposing on the region of interest, legs may be flexed for balance
• rotation of shoulders or pelvis should be minimized
• patients should be changed into a hospital gown, with radiopaque items (e.g. belts, zippers) removed
• x-ray is taken in full inspiration

• lateral decubitus
• centering point
  • midsagittal place (xiphisternum) at the level of T7
• collimation
  • laterally to include both lungs 
  • superior to the apex
  • inferior to the costodiaphragmatic recess
• orientation
  • portrait (relative to the patient)
• detector size
  • 35 cm x 43 cm
• exposure
  • 100 - 125 kVp
  • 3 - 10 mAs
• SID
  • 100 cm
• grid
  • yes

A marker annotating 'horizontal beam decubitus" should always be present, with the side of interest clearly labeled.

The entire lungs should be visible from the apices down to the lateral costophrenic angles. 

• the chin should not be superimposing any structures
• minimal to no superimposition of the scapulae borders on the lung fields
• sternoclavicular joints are equal distant apart
• the clavicle is in the same horizontal plane
• a minimum of ten posterior ribs is visualized above the diaphragm
• the ribs and thoracic cage are seen only faintly over the heart
• clear vascular markings of the lungs should be visible

• in the context of inhaled foreign bodies, bilateral decubitus lateral views should be performed, allowing for adequate assessment of any air trapping
  • patients with obstructive foreign bodies will not have a collapsed lung, however, will manifest hyperlucency of the dependent lung
• ensure the patient is carefully rested against the wall detector and at no risk of falling 
• rotation of a chest radiograph can simulate common pathology processes and make it hard to produce an appropriate diagnosis
  • the sternoclavicular joints are a sound indicator for positional rotation, if one sternoclavicular joint is notably wider than the other, that respected side needs to be rotated toward the image receptor to correct rotation  
• patients with a longstanding history of emphysema or COPD will have abnormally long lungs compared to the general population, remember this when collimating superior to inferior
• side marker placement is imperative; patients can have congenital conditions that mimic a mirrored image
• remember to explain to your patient what you are about to do; that is ask them to take a breath in and hold it; many times this gives the patient time to prepare and results in a better breath hold and therefore a higher quality radiograph
  • always remember to tell your patient to breathe again

References

Related articles: Imaging in practice

Promoted articles (advertising)

Which two conditions must be met for a decubitus position?

What is the general purpose for using a lateral decubitus position?

Which of the following will be observed on a supine AP chest image?

What is the most optimal position of the patient for examinations of the heart and lungs?