Today’s topic will focus on the various positions we encounter in X-rays over the years, which involve different views to view anatomy accurately. The specific positions I would like to discuss today involve the ribs, most commonly due to their review as the right posterior oblique, left posterior oblique, right anterior oblique, and left anterior oblique. These are most often shortened to RAO, LAO, LPO, and RPO. While these terms can be somewhat confusing, it is simple to understand that they describe the position the patient is in versus the projection of an X-ray taken. So when we look at this compared to rib ex rays most often they want either one or two of likes depending what facility you are at and then usually an AP or PA so driving deeper into what it takes for a rib series typically your pan is placed closest to the board so if your pain is in your back your backs against the board if it’s in your front your fronts against the board that helps to dictate your PA or AP position from then it tells you, you’re obliques if you’re going to do both obliques you do if you are in a PA position you would do both RAO and LAO positions thus putting your left front shoulder against the board turning to a 45 and then doing the same thing by placing your right front shoulder against the board period however it does get a little bit more interesting if you only do one of like then it is essential to remember the clever trick of PA away period this means that if you are in a PA position for your ribs you will turn the area of pain away from the board when taking the oblique images. By remembering this helpful hint, you will be able to tell for sure which side of the old image you need to do to get it correctly. This does not mean that when you take an AP position, you would turn to the side of paying it towards the board, thus being the opposite of the PA away strategy.
Lastly, a helpful hint with ribs is that the breathing is different if it is an upper rib or a lower rib. A helpful analogy to remember this quickly is to think of it as going down and out. By thinking this down and out strategy, it refers to the lower ribs, specifically the lower part of the ribs. You have them exhale and hold their breath out. Going along those same lines, you can think in terms of up and in, that is, your upper ribs, kind of towards the top, you are going to have them take that breath in and hold it. Either one of those things helps to remember the breathing and being able to apply it to the other easily