primaMED Training Institute

PA Axial Projection (Caldwell Method) – Facial Bones

Clinical Indications:- facial bone fractures
Inflammatory or neoplastic lesions
Evaluation of frontal and ethmoid sinuses
Assessment of orbital fractures

Patient Position:- Patient erect or prone facing the image receptor (erect preferred)
Rest forehead and nose against the detector
MSP perpendicular to the IR
OML perpendicular to the IR
Ensure no head rotation or tilt

Central Ray (CR):- 15° caudal to the OML
Center at the nasion.Exit at the nasion.

Collimation:-Collimate to include the facial bones/orbits.

Evaluation Criteria:- Petrous ridges projected into the lower one-third of the orbits.

Symmetrical orbital margins:- Frontal, ethmoid, nasal bones, zygomatic bones, maxillae, and anterior nasal spine well demonstrated

Important Viva Points:- Beam angle: 15° caudal

Purpose of 15° caudal angle: Projects the petrous ridges into the lower one-third of the orbits, allowing clear visualization of the frontal and anterior ethmoid sinuses

Oblique foot X-Ray Anatomy