WATERS METHOD
Pathology Demonstrated:
Fractures (particularly tripod and Le Forte fractures) and neoplastic/inflammatory are shown. Foreign bodies in the eye also may be demonstrated on the image.
Facial bone fracture
Facial bone fracture
Technical Factors:
IR size - 24 x 30 cm (10 x 12 inches), lengthwise or 18 x 14 cm (8 x 10 inches)
Moving or stationary grid
70 to 80 kV range
Small focal spot
mAs 18
Moving or stationary grid
70 to 80 kV range
Small focal spot
mAs 18
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| Parietoacantial Projection, Modified Waters View for orbital foreign body localization |
Patient Position:
Remove all metallic or plastic objects from head and neck. Patient position is erect or prone (erect is preferred is patient's condition allows).
Part Position:
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| Supine Position Facial Bone X-ray |
Extent neck, resting chin against table/upright Bucky surface.
Adjust head until MML is perpendicular to the plane of the image receptor. The OML will form a 37 degrees angle with the table Bucky surface.
Adjust head until MML is perpendicular to the plane of the image receptor. The OML will form a 37 degrees angle with the table Bucky surface.
Table Radiography
Position the MSP perpendicular to the midline of the grid or the table / bucky surface, preventing rotation and / or tilting of head. (One way to check for rotation is to palpate the mastoid processes on each side and the lateral orbital margins with the thumbs and fingertips to ensure that these line are equidistant from the tabletop.)
Central Ray:
Align CR perpendicular to IR, to exit at acanthion.
Center IR to CR
Minimum SID is 40 inches (100 cm).
Center IR to CR
Minimum SID is 40 inches (100 cm).
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| Upright Position |
Collimation:
Collimate to outer margins of skull on all sides.
Respiration:
Suspend respiration.
Radiographic Criteria:
Structure Shown:
Inferior orbital rim, maxillae, nasal septum, zygomatic bones, zygomatic arches, and anterior nasal spine.
Inferior orbital rim, maxillae, nasal septum, zygomatic bones, zygomatic arches, and anterior nasal spine.
Correct Positioning:
Correct neck extension demonstrates petrous ridges just inferior to the maxillary sinuses.
No patient rotation exist, as indicated by equal distance from the midlateral orbital margin to the outer skull margin on each side.
No patient rotation exist, as indicated by equal distance from the midlateral orbital margin to the outer skull margin on each side.
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| Parietoacantial Projection (Waters View Facial Bone) |
Collimation and CR:
Entire skull included on the image, with the acanthion in the center.
Collimation borders to the outer margins of the skull.
Collimation borders to the outer margins of the skull.
Exposure Criteria:
Contrast and Density are sufficient to visualize maxillary region.
Sharp bony margins indicate no motion.
Sharp bony margins indicate no motion.
