Chest Lordotic is a radiography positioning projection of the Chest. AP axial / lordotic. Projects clavicles above lung apices. SID 72". The centering point is located mid-sternum (~3" inferior to the jugular notch). with patient leaning back and cr horizontal, the central ray exits superior to the apices.. The central ray is horizontal, perpendicular to ir. patient leaned back ~30° to project the clavicles above the lung apices.. Image-quality criteria include clavicles superimposed at or above the lung apices (key criterion)., sternum and ribs project foreshortened (expected for the angle).. Standard exposure ranges from 110 to 125 kVp, 3 to 6 mAs, at an SID of 72 inches (180 cm).
Patient preparation
- Verify patient identity using two identifiers.
- Remove radiopaque objects from the chest area.
- Position patient ~1 foot in front of the upright Bucky.
- Patient leans backward so shoulders touch the IR; hands on hips, palms out, elbows forward.
- Instruct full inspiration; hold.
Position & centering point
Mid-sternum (~3" inferior to the jugular notch). With patient leaning back and CR horizontal, the central ray exits superior to the apices.
Central ray
Horizontal, perpendicular to IR. Patient leaned back ~30° to project the clavicles above the lung apices.
Exposure / technique
- kVp
- 110–125
- mAs
- 3–6
- SID
- 72" (180 cm)
- Notes
- High-kVp technique. If patient cannot lean back, use AP upright with CR 15-20° cephalad, the angled CR achieves the same projection geometry.
Image-quality criteria
- Clavicles superimposed at or above the lung apices (key criterion).
- Sternum and ribs project foreshortened (expected for the angle).
- Apices clearly visible without clavicular overlap.
- No rotation: equal density bilaterally.
- Posterior ribs appear horizontal; anterior ribs angle steeply upward.
Clinical indications
- Suspected apical disease, TB, apical consolidation, mass, or scarring.
- Pancoast tumor evaluation (superior sulcus tumor).
- Differentiating calcified granuloma vs nodule when overlap obscures view on PA.
- Apical pneumothorax follow-up when clavicles obscure the apex on routine views.
Aligned to the 2025 ARRT Content Specifications.