• Patient erect, standing or seated, facing the bucky
• Arms relaxed at the sides
• Centre the midsaggital plane of the patient to the midline of the IR
• Have the patient relax their shoulders and rolled forward to touch the bucky
• Adjust the height of the bucky so that the upper border of the IR is 5cm (2 inches) above the shoulders
• Raise the chin and rest on or above the bucky
• Clear the scapulae off the lung fields by getting the patient to either

A. "Hug" the bucky by bringing the forearms behind the bucky (some buckys have purpose built handles for the patients to hold)
OR
B. Place the back of their hands against their lower hips

• PACEMAN

• No rotation as evidenced by
  
  • the medial ends of the clavicles equidistant from the spine
  • the clavicles are in the same horizontal plane
• The lungs fields are clear of the scapulae

• The 10th posterior ribs will be visualised above the diaphragm on full inspiration
  

• Lungs fields, apices, costophrenic angles, heart
  

• Centre: T7 Thoracic vertebra
  
• Shutter A: Open to show the lung apices superiorly and the costophrenic angles inferiorly
• Shutter B: Open to show the lung fields laterally
  

• There should be adequate exposure so that
  
  
  1. the ribs and thoracic vertebrae are seen faintly through the heart
  2. vascular lungs markings are shown

• Lung fields are shortened
• the heart is magnified
• the ribs may appear more horizontal
• air-fluid levels are not seen
• the clavicles are projected higher up