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PA abdomen X-ray positioning (erect)

An extra abdomen view, used when a routine one is not enough. The patient stands, the beam passes back to front (PA), straight on to the receptor, and the centring point is the midline, including both domes of the diaphragm.

By the ScanFlo Editorial Team · Updated

In this section · X-ray positioning

X-ray positioning/Abdomen

Still being checked: a radiographer is reviewing this guide. If your department does it differently, follow your department.

Patient position

Erect. Stand the patient facing the bucky with the abdomen pressed gently against it.

Centring & collimation

Central ray

PA

Centre: the midline, including both domes of the diaphragm.

Beam: PA, perpendicular to the receptor.

Collimate: diaphragm downwards

Distance, receptor & grid

SettingValueNotes
SID110 cm
Receptor35 × 43 cmportrait
PlacementErect (wall) buckyGrid in
AngulationNonePerpendicular to the receptor

Marker & breathing

  • Marker: R marker, labelled erect
  • Breathing: Suspend respiration.

Exposure by patient size

Treat these as a starting point. Your detector, your generator and the patient in front of you will all move the numbers.

Patient sizekVmAs (chart)mAs (DR default)
XS8083.2
S8012.55
M80166.3
L802510

These start from a classic film-screen chart (80 kV, 25 mAs at 140 cm) and are adjusted for a digital detector at 110 cm. The DR column is what ScanFlo's console suggests; each step up or down changes the mAs by about a quarter.

Image quality checklist

  • Both domes of the diaphragm included.
  • Fluid levels horizontal.
  • The anatomical side marker is visible, correct and clear of the anatomy.
  • Collimation borders are visible on all sides, no wider than the area requested.

Faults & how to fix them

FaultCauseFix
Diaphragm cut offCentring too lowCentre higher.

Common questions

Where do you centre for an abdomen PA erect X-ray?
The centring point is the midline, including both domes of the diaphragm.
What distance and beam angle does an abdomen PA erect need?
110 cm from the tube to the receptor. The beam passes back to front (PA), straight on to the receptor.
What size receptor, and do you need a grid?
Use a 35 × 43 cm receptor, portrait, in the wall bucky. A grid is needed.
What should the patient do with their breathing?
Ask them to stop breathing for the moment of the exposure.
What goes wrong most often on an abdomen PA erect?
Diaphragm cut off. Usual cause: centring too low. The fix: centre higher.

Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a abdomen pa erect in a 3D room and score your positioning. See ScanFlo XR →

Written by the ScanFlo team from everyday radiographic practice.

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