Lateral thoracic radiograph (step-by-step guide)

1. Select exposure settings on the x-ray machine, and place the grid on the plate (where the depth is over 10cm).

2. Position patient in lateral recumbency (right side to the plate for right lateral, left side to plate for left lateral).

Figure 1 — A dog positioned in left-lateral
Figure 1 — A dog positioned in left-lateral

3. Position a foam wedge under the sternum to minimise rotation and ensure the patient’s ribs are in line with the spine.

Figure 2 — Patient in left-lateral with foam wedge placed under sternum
Figure 2 — Patient in left-lateral with foam wedge placed under sternum

4. Put a sandbag over the patient’s neck to keep it in position; ensure breathing is not obstructed

Figure 3 — Sandbag placed over patient’s neck
Figure 3 — Sandbag placed over patient’s neck

5. Pull forelimbs cranially and hindlimbs caudally to remove them from the x-ray field, and secure them in place with rope ties or sandbags.

Figure 4 — Sandbags placed on patient’s limbs to secure their position
Figure 4 — Sandbags placed on patient’s limbs to secure their position

6. Place right/left marker within collimation of the beam, right marker present for right lateral and vice versa.

7. Centre the primary beam over the mid-thorax and collimate cranially to the thoracic inlet, caudally to the last rib, and dorsally and ventrally to the skin edges.

Figure 5 — Collimation of the left lateral thoracic radiograph
Figure 5 — Collimation of the left lateral thoracic radiograph

8. Ensure staff stand behind the lead shield and take the radiograph.

Figure 6 — A right lateral thoracic radiograph
Figure 6 — A right lateral thoracic radiograph
General considerations for thoracic radiographyVentrodorsal thoracic radiograph (step-by-step)