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Lateral nasal bones X-ray positioning

One of the routine face & sinuses views. The patient stands side-on, the beam passes from side to side, straight on to the receptor, and the centring point is the nasal bones.

By the ScanFlo Editorial Team · Updated

In this section · X-ray positioning

X-ray positioning/Face & sinuses

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

Patient position

Lateral, erect. Remove dentures, earrings, hair clips and anything in the hair. Seat the patient with the side of the face against the bucky.

Centring & collimation

Central ray

lateral

Centre: the nasal bones.

Beam: lateral, perpendicular to the receptor.

Collimate: tightly to the nose

Distance, receptor & grid

SettingValueNotes
SID100 cm
Receptor18 × 24 cmportrait
PlacementErect (wall) buckyGrid in
AngulationNonePerpendicular to the receptor

Marker & breathing

  • Marker: R or L marker on the side nearest the detector
  • Breathing: No breathing instruction needed.

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)
XS530.50.5
S530.50.5
M530.630.5
L5310.5

These start from a classic film-screen chart (53 kV, 8 mAs at 140 cm) and are adjusted for a digital detector at 100 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

  • Nasal bones in profile.
  • Soft tissue of the nose visible.
  • 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
Nasal bones burnt outFacial technique usedUse the low-kV nasal technique and collimate tightly.

Common questions

Where do you centre for a nasal bones lateral X-ray?
The centring point is the nasal bones.
What distance and beam angle does a nasal bones lateral need?
100 cm from the tube to the receptor. The beam passes from side to side, straight on to the receptor.
What size receptor, and do you need a grid?
Use an 18 × 24 cm receptor, portrait, in the wall bucky. A grid is needed.
Where does the lead marker go?
R or L marker on the side nearest the detector.
What goes wrong most often on a nasal bones lateral?
Nasal bones burnt out. Usual cause: facial technique used. The fix: use the low-kV nasal technique and collimate tightly.

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

Written by the ScanFlo team from everyday radiographic practice.

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