It is desirable to see both sides of the patient's body on the film in any given
projection of a decubitus position. The affected side MUST be shown with no cut-off.
Accordingly, a firm pad, folded blanket or folded sheets should be placed between the
table surface and the patient to elevate the dependent side of the patient. If the
condition of the patient or other factors makes this elevation inadvisable, the Bucky tray,
partially out, may be used as a support for the vertical film holder and a standard
wheeled hospital litter with pad used as a table. Allow the patient to remain in position
approximately five minutes so the free air rises and/or free fluid moves downward.
a. The essential position, the reference point for placement of the part, and the
technique factors used for a decubitus position should be in keeping with those used for
a normal projection of the same area. If an AP projection of the abdomen in a left
lateral decubitus position is requested, the crest of the ilia should be centered and the
horizontal CR should be directed to the center of the film. In the examination of those
parts calling for a grid or Bucky, a portable Bucky or grid cassette should be used.
b. A vertical x-ray table with Bucky used in combination with the standard
wheeled hospital litter with pad is an effective combination for decubitus positions. It
permits easy handling of the patient and equipment and is usually comfortable for the
patient. If a patient is brought to the x-ray department on the wheeled hospital litter, it is
often possible to accomplish all necessary film exposures without moving him to the
x-ray table and with a radiographic quality close to that possible with table-positioning.
This possibility should be kept in mind not only for decubitus positions, but also for
emergency and hard-to-work with patients.
a. The identification data are usually placed along the lateral border of the
cassette corresponding to the side of the body that is uppermost. The letter marked (R
or L) indicates the side nearest the film in lateral projections and indicates the side with
which it is placed in AP (anteroposterior) or PA projections. In addition to the regular
identification data, the following facts should be included:
The type of decubitus position.
The designation of the projection.
The identity of the surface that is up.
b. These added data identify the film unquestionably as a decubitus-type
position, making the details on the film more readily recognizable to any film interpreter.