RadteraXR Skull
XRNo contrastHead & Neckverify
Indications
- Suspected skull fracture (where CT unavailable)
- Shunt/ventricular catheter survey ('shunt series')
- Suspected non-accidental injury (part of skeletal survey)
- Metabolic/bone lesions
- Foreign body localization
Patient prep
- Remove glasses, dentures, earrings, hairpins, hearing aids and other radiopaque objects from head
Contrast
None / non-contrast
Technique
- PA (or PA Caldwell, CR 15 deg caudad to nasion): forehead and nose on IR, orbitomeatal line perpendicular to IR
- AP Towne (CR 30 deg caudad to OML / 37 deg to IOML through foramen magnum): for occipital bone
- Lateral: head true lateral, midsagittal plane parallel to IR, interpupillary line perpendicular, CR ~2 inches above EAM
- SID 40 inches; grid; kVp ~75-85
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | PA (or PA Caldwell) | Frontal | OML perpendicular; Caldwell uses 15 deg caudad CR for frontal bone/orbits |
| 2 | AP axial (Towne) | Frontal axial | CR 30 deg caudad to OML; demonstrates occipital bone, dorsum sellae in foramen magnum |
| 3 | Lateral | Sagittal | True lateral; demonstrates sella turcica, vault; often both laterals for trauma |
Key points
- CT is the modality of choice for acute head trauma per ACR; plain skull mainly for shunt surveys, foreign body, or skeletal survey
- Submentovertical (SMV) for skull base when indicated
- Shunt series = AP/lateral skull plus AP chest and abdomen to trace catheter
References
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.