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skull · PA Axial (Parietoacanthial)
Paranasal Sinuses Occipitomental (Water's)
Patient erect facing IR, chin resting on IR.
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AI Patient · KV Sir
How to perform this view
- 01
Seat patient ERECT (to show air-fluid levels).
- 02
Rest chin on vertical IR; extend neck.
- 03
OML at 37 deg to IR; mentomeatal line perpendicular.
- 04
Ensure no rotation.
- 05
Horizontal CR exits at acanthion.
- 06
Open-mouth variant shows sphenoid sinus.
Anatomical & patient position
Patient: Patient erect facing IR, chin resting on IR.
Part: Head extended so OML forms 37 deg with IR; MML perpendicular.
Central ray & centring point
Horizontal, perpendicular to IR, exiting at acanthion.
Exposure factors
kVp
70-80 kVp
mAs
15-25 mAs
SID
100 cm
IR size
24 x 30 cm portrait
Grid
Yes
Respiration
Suspended
Clinical indications
- Maxillary sinusitis
- Facial bone fractures (orbit floor, zygoma)
- Sinus polyps/tumours
Contraindications & precautions
- Pregnancy (relative) - confirm LMP / 10-day rule, justify exposure and shield where possible
- Suspected unstable spinal injury - do NOT move neck/spine; use cross-table lateral first and keep collar - do not extend neck
Structures shown & evaluation criteria
- Maxillary sinuses free of petrous ridges
- Petrous ridges just below maxillary sinuses
- Orbits, zygomatic arches