X Ray Sternum Lateral View

The lateral sternum is obtained with the patient in a true lateral position (commonly left lateral), standing or seated. The arms are raised and hands placed behind the head with shoulders rolled posteriorly to clear the sternum. The image receptor is centered at the midsternum and the central ray is perpendicular to it. Suspend respiration (inspiration) for the exposure.

A lateral view X‑ray is a side-to-side projection where the X‑ray beam passes from one side of the body to the other, producing an image of anatomy in profile. It complements front (AP/PA) views, shows depth and spatial relationships, reveals anterior or posterior structures, and helps localize lesions, assess alignment, effusions, fractures, or foreign bodies—commonly used for chest, spine, skull, and joints.

Stand upright for an RAO sternum: rotate the body 15–20° to a right anterior oblique so the sternum projects over the heart; center the image receptor on the mid‑sternum (around T7) and direct the central ray perpendicular to it; suspend respiration on deep inspiration. For a lateral sternum, use a true lateral, arms back, center on mid‑sternum, perpendicular ray, suspend on inspiration. Shield appropriately.

The sternum is generally not well visualized on a standard posterior–anterior (PA) chest x‑ray because it overlaps the mediastinum and heart. A lateral chest x‑ray or dedicated oblique sternum views can show the bone and detect fractures. CT is the most sensitive modality for sternum abnormalities, detailed bone assessment, and associated mediastinal injuries; choose imaging based on clinical suspicion.

The primary reason for using a lateral projection of the sternum is to clearly visualize the entire sternum without overlapping cardiac and mediastinal structures. This view separates the sternum from the ribs and spine, improving detection of fractures, displacements, congenital anomalies, infections, or tumors, and assists preoperative or follow-up assessments by providing a direct lateral profile of sternal alignment and cortical integrity.

A lateral chest X‑ray complements frontal views by showing structures in profile, helping localize abnormalities seen on PA/AP films. It improves detection of small pleural effusions, posterior lung consolidation, lobar collapse, and mediastinal or retrocardiac lesions. It also assesses heart size and contours, vertebral bodies, and chest wall; useful for confirming or monitoring infections, fluid, masses, or suspected pneumothorax.