Abdomen & Pelvis X-Ray Positioning Master Guide

Comprehensive Clinical Reference for Routine Abdomen, Acute Series, Pelvis, Hips, and Special Views

Routine & Acute Abdomen Views

1. AP Abdomen (KUB / Supine)Standard

Patient PositionSupine position with arms folded across chest or down by sides, knees supported at knees to relax abdominal muscles.

Beam DirectionPerpendicular to the level of iliac crests (included from symphysis pubis up to diaphragm).

Clinical IndicationEvaluating KUB structures, renal calculi, calcifications, bowel gas patterns, and ascites.

2. AP Abdomen (Upright / Erect)Standard

Patient PositionPatient standing erect with back against vertical grid device, weight evenly distributed.

Beam DirectionHorizontal central ray directed 5 cm above the level of iliac crests to include diaphragm.

Clinical IndicationDemonstrating free intraperitoneal air (pneumoperitoneum) and air-fluid levels in bowel obstruction.

3. Left Lateral Decubitus AbdomenAcute

Patient PositionPatient lies on left side for 10–20 mins prior to exposure to allow free air to rise against liver edge.

Beam DirectionHorizontal cross-table beam centered to level of iliac crests.

Clinical IndicationAlternative to upright abdomen for detecting free intraperitoneal air in non-ambulatory patients.

4. Right Lateral Decubitus AbdomenSpecial

Patient PositionPatient lies on their right side on a radiolucent platform, arms up, knees bent.

Beam DirectionHorizontal cross-table beam centered to upper abdomen / diaphragm level.

Clinical IndicationComplementary view to assess right-sided fluid collections or differential air distribution.

5. Lateral Abdomen (Supine/Recumbent)Special

Patient PositionTrue lateral recumbent position with knees flexed, arms raised overhead.

Beam DirectionPerpendicular to mid-coronal plane at level of iliac crests.

Clinical IndicationAssessment of prevertebral calcifications, aortic aneurysms, or foreign bodies in the abdomen.

Routine & Trauma Pelvis Views

6. AP Pelvis ViewStandard

Patient PositionSupine with legs internally rotated 15° to 25° (brings femoral necks parallel to receptor), toes taped.

Beam DirectionPerpendicular to midpoint between ASIS and pubic symphysis.

Clinical IndicationEvaluation of pelvic ring fractures, hip joints, sacrum, and pubic symphysis alignment.

7. Pelvic Outlet (Taylor) ViewTrauma

Patient PositionSupine position with legs extended or slightly supported.

Beam DirectionAngled 20° to 35° cephalic for males (30° to 45° for females), centered to pubic symphysis.

Clinical IndicationAssessing vertical displacement of the pelvic ring and superior/inferior pubic rami fractures.

8. Pelvic Inlet ViewTrauma

Patient PositionSupine position on the radiographic table.

Beam DirectionAngled 40° caudad, centered to level of greater trochanters / pubic symphysis.

Clinical IndicationEvaluating pelvic ring anterior/posterior compression fractures and SI joint subluxation.

9. Judet View (Acetabulum Obliques)Special

Patient PositionPatient rotated 45° in both Internal Oblique (downside hip) and External Oblique (upside hip).

Beam DirectionPerpendicular to 5 cm distal to affected ASIS.

Clinical IndicationDetailed visualization of acetabular fractures, anterior/posterior columns, and hip stability.

Hip Joint & Specialized Pelvis Views

10. AP Hip Joint ViewStandard

Patient PositionSupine with leg internally rotated 15° to 25° to true anatomical alignment.

Beam DirectionPerpendicular to femoral neck (located 5 cm distal along perpendicular line from midpoint of ASIS and pubic symphysis).

Clinical IndicationEvaluating proximal femur, femoral neck fractures, hip joint space, and degenerative changes.

11. Lateral Hip (Frog-Leg / Cleaves)Standard

Patient PositionSupine with hips and knees flexed, soles of feet placed together and thighs abducted laterally.

Beam DirectionPerpendicular to femoral neck (or angled 45° if unilateral).

Clinical IndicationAssessing non-traumatic hip pathologies, developmental dysplasia of hip (DDH), and femoral head status.

12. Cross-Table Lateral Hip (Danelius-Miller)Trauma

Patient PositionSupine position, unaffected leg lifted/moved out of beam path, cassette placed vertically against lateral hip.

Beam DirectionHorizontal cross-table ray directed perpendicular to femoral neck and cassette.

Clinical IndicationTrauma assessment of suspected femoral neck or intertrochanteric fractures without moving injured limb.

13. Pubic Symphysis Stress ViewsSpecial

Patient PositionStanding upright (Flamingo view) or supine, alternately bearing full weight on one leg and then the other.

Beam DirectionPerpendicular centered directly at the pubic symphysis.

Clinical IndicationEvaluating pelvic instability, pubic symphysis diastasis, and ligamentous disruption.

📌 Quick Jump Directory (Abdomen & Pelvis Views)

1. AP Abdomen (Supine) 2. AP Abdomen (Upright) 3. Left Lateral Decub. 4. Right Lateral Decub. 5. Lateral Abdomen 6. AP Pelvis 7. Pelvic Outlet 8. Pelvic Inlet 9. Judet View 10. AP Hip Joint 11. Frog-Leg Hip 12. Cross-Table Hip 13. Pubic Symphysis Stress

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