The Abdominal Radiograph

The abdominal radiograph (AXR) is performed almost exclusively in the supine position and in the AP (anteroposterior) projection, i.e. the x-ray beam passes through the patient from front to back. Historically the abdominal radiograph was performed in both supine and erect postures, but this practice has been discontinued due to concerns over often excessive radiation dose. The Royal College of Radiologists recommends that when a patient presents with an acute abdomen, a single supine abdominal radiograph is performed. If there is the clinical suspicion of an associated intra-abdominal perforation, then an erect chest radiograph should also be performed. These guidelines and many others can be found on the Royal College’s latest edition of iRefer1.