chest · AP (posterior ribs) / Oblique
Ribs AP / PA & Oblique
Erect or supine; AP for posterior ribs, PA for anterior ribs; 45 deg oblique with injured side toward/away.
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How to perform this view
- 01
Ask patient to localise point of pain; place small marker.
- 02
For upper ribs (above diaphragm) use erect, expose on inspiration.
- 03
For lower ribs (below diaphragm) use supine, expose on expiration.
- 04
Rotate 45 deg for axillary ribs (affected side to IR for posterior injury).
- 05
Centre CR midway between MSP and lateral border at T7 (upper) or T10 (lower).
- 06
Collimate and mark side.
Anatomical & patient position
Patient: Erect or supine; AP for posterior ribs, PA for anterior ribs; 45 deg oblique with injured side toward/away.
Part: MSP centred to IR for AP; body rotated 45 deg for oblique with affected axillary portion parallel to IR.
Central ray & centring point
Perpendicular to IR; above diaphragm at T7, below diaphragm midway xiphoid & lower costal margin.
Exposure factors
kVp
Above diaphragm 70-80 kVp; below 75-85 kVp
mAs
10-20 mAs
SID
100-180 cm
IR size
35 x 43 cm
Grid
Yes
Respiration
Above diaphragm: inspiration; below: expiration
Clinical indications
- Rib fracture after trauma
- Metastatic rib lesions
- Osteomyelitis
Contraindications & precautions
- Pregnancy (relative) - confirm LMP / 10-day rule, justify exposure and shield where possible
- Suspected pneumothorax with flail chest - prioritise chest PA/AP
Structures shown & evaluation criteria
- Ribs 1-10 above or 8-12 below diaphragm
- Axillary portions free of superimposition (oblique)