RadteraXR Facial Bones
XRNo contrastHead & Neckverify
Indications
- Facial trauma (where CT unavailable)
- Suspected facial/orbital/zygomatic fracture
- Sinusitis evaluation (with sinus series)
- Foreign body in orbit
Patient prep
- Remove glasses, dentures, jewelry, hairpins from head/face
Contrast
None / non-contrast
Technique
- Parietoacanthial (Waters): chin on IR, OML 37 deg to IR, CR perpendicular exiting acanthion; demonstrates maxillae, orbits, zygomatic arches
- Lateral: true lateral, CR to zygoma/lateral canthus
- PA Caldwell (CR 15 deg caudad) for orbital rims/frontal
- SID 40 inches; grid; kVp ~75-85; erect if possible to show air-fluid levels
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | Parietoacanthial (Waters) | Frontal (angled) | OML 37 deg to IR; petrous ridges below maxillary sinuses; orbital floors and maxillae |
| 2 | Lateral | Sagittal | Superimposed facial bones; CR to outer canthus/zygoma |
| 3 | PA Caldwell | Frontal axial | CR 15 deg caudad to nasion; orbital rims and frontal sinuses |
Key points
- CT is the preferred modality for facial trauma per ACR; radiographs used when CT unavailable
- Modified (open-mouth/shallow) Waters better profiles orbital floor
- Erect positioning needed to show air-fluid levels in sinuses
- Dedicated nasal bone or zygomatic arch (SMV/tangential) views if focal concern
References
• Bontrager's Handbook - Facial Bones
• Merrill's Atlas Vol 2 - Facial Bones
• Radiopaedia: Facial bones series link
• Merrill's Atlas Vol 2 - Facial Bones
• Radiopaedia: Facial bones series link
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.