Facial Bones PA Axial (Caldwell)

• Frontal sinuses above orbital rims.
• Ethmoid air cells within orbits, between orbits.
• Orbital rims and orbital cavities bilaterally.
• Nasal bones and nasal septum.
• Maxillary, lacrimal, and frontal bones.
• Zygomatic bones and zygomatic processes.

• Verify patient identity.
• Remove glasses, earrings, dentures, hairpins.
• Position patient prone or upright.
• Forehead and nose against IR; OML perpendicular to IR.
• No rotation: shoulders and head symmetrical.
• Hands at sides or folded over chest.
• Suspend respiration during exposure.

CR exits at nasion. Forehead and nose against IR.

CR angled 15° caudad. Exits at nasion.

kVp

75–85

mAs

25–40

SID

40" (102 cm)

Notes

CR angle critical: 15 degrees ensures proper sinus projection.

• Frontal sinuses projected clearly above orbital rims.
• Ethmoid sinuses visualized within orbits.
• Minimal distortion of forehead.
• No rotation: equal distance from midline to orbit.
• No tilt: orbital rims appear symmetrical.
• Nasal bones and nasal septum visible without tilt.
• Facial bones centered on IR with margin.

1. 1 CR not angled 15 degrees: petrous ridges project over sinuses.
2. 2 Rotation: orbits appear unequal distance from midline.
3. 3 Tilt: orbital rims at different vertical levels.
4. 4 Forehead not against IR: magnification and distortion.
5. 5 Nose not touching IR: off-center positioning.

• Frontal sinusitis evaluation.
• Ethmoid sinus disease assessment.
• Trauma evaluation of facial and orbital bones.
• Foreign body localization.
• Pre- or post-operative sinus follow-up.