Sternum Lateral is a radiography positioning projection of the Thorax. Lateral sternum, erect. SID 60-72". Shoulders and arms drawn back. The centering point is located mid-sternum, midway between the jugular notch and the xiphoid process. The central ray is horizontal, perpendicular to IR. Centered to the sternum. Image-quality criteria include sternum visualized in profile, free from superimposition, manubrium, body, and xiphoid process all clearly visible. A sample technique is 81 kVp with DR 10 or CR 20 mAs, at the chart's 40 in SID. The working SID is 72 inches (183 cm).
Anatomy demonstrated
- Manubrium in profile.
- Sternal body.
- Xiphoid process.
- Sternal angle.
- Clavicular articulations.
Patient preparation
- Verify patient identity using two identifiers.
- Remove all radiopaque objects from the chest.
- Position patient erect, lateral surface of chest against IR.
- If the patient's condition warrants, take the lateral with a horizontal beam, patient supine (Bontrager).
- Draw both shoulders and arms back, hands clasped behind the back.
- Ensure the body is not rotated; shoulders aligned.
Position & centering point
Mid-sternum, midway between the jugular notch and the xiphoid process.
Central ray
Horizontal, perpendicular to IR. Centered to the sternum.
Exposure / technique
- kVp
- 81
- mAs
- DR 10 / CR 20
- Chart row
- kVp and mAs at the chart's 40 in SID
- Working SID
- 72" (183 cm)
- Notes
- Grid required. Bontrager: 40 in minimum, 60-72 in recommended to reduce magnification of the sternum. Sample technique: DR 10 / CR 20 mAs at 81 kVp, 40 in SID, for a 29 cm part (Merrill's sample chart). Adjust for your equipment. Bontrager prints digital 80 +/- 5 kV.
kVp and mAs are sample values. Use caution when applying them in your department.
Image-quality criteria
- Sternum visualized in profile, free from superimposition.
- Manubrium, body, and xiphoid process all clearly visible.
- Sternal articulations and angle clearly demonstrated.
- Anterior and posterior borders of the sternum sharp.
- No superimposition of humeri, shoulders or soft tissue on the sternum.
- No rib superimposition on the sternum.
Common errors
- 1 Rotation forward or backward superimposes ribs on the sternum.
- 2 Shoulders not drawn back far enough superimposes them on the sternum.
- 3 Breathing motion blurs the bony margins.
- 4 Off-centered CR clips the sternum from the field.
Clinical indications
- Evaluation of sternal fractures, including depressed fractures.
- Assessment of sternal deformity (pectus carinatum or excavatum).
- Detection of sternal metastases or infection.
- Post-operative evaluation after cardiac or thoracic surgery.