Chest Lateral Decubitus
Position the Patient
- Patient on side (based on pathology)
- Arms raised
- Side down shows fluid
- Side up shows free air
Words That Work
“I’m going to have you lie on your [right/left] side, with the side we’re checking for fluid facing down. Gravity allows any fluid to collect along that side so we can see it more clearly. Keep your back against the plate, raise both arms above your head, and keep your shoulders and hips stacked without rolling. We’ll wait a few minutes for the fluid to settle. Then I’ll ask you to fill your lungs like two balloons and hold your breath.”
Lateral decubitus chest positioning
Set Up the Shot
- Center here
- Central ray
- T7
- Include this in the field
- Collimation
- Entire lung fields
- Set the distance
- SID
- 72"
- Check the technique
- Technique
- 110-125 kVp
- Follow facility protocols
Common Pitfalls
- •Entire lung fields not included
- •Arms not raised above head
- •Rotation (spinous processes not centered)
Evaluate the Image
What should be visible?
- Air-fluid levels
- Pleural effusion
- Pneumothorax
Does the image pass?
- ✓Air-fluid levels visible
- ✓Full lung fields included
- ✓Sharp lung markings
- ✓No rotation (equal distance from vertebral column to lateral borders of ribs)
- ✓Arms not superimposing upper lungs