Nasal bones (lateral view)

The lateral nasal bones view is a nonangled lateral radiograph showcasing two small oblong bones situated side by side, together forming the nasal ridge.

Indications

This view is often primarily used in assessing various nasal bone fractures in the trauma setting. Depending on the department, this view may be done bilaterally (for comparison of affected versus unaffected side) or unilaterally (only affected side).

Patient position

• rest the lateral aspect of the patient's head (with the side of interest) against the image detector
• adjust the head into a true lateral position, with the midsagittal plane (Figure 1) parallel to the image detector
• for patient's comfort, adjust the patient's body into an oblique position

Technical factors

• lateral projection
• centering point
  • 1.25 cm inferior to nasion
• collimation
  • within 5 cm of the nasal bones on all sides
• orientation  
  • for unilateral side: portrait
  • for bilateral side: landscape
• detector size
  • 24 cm x 18 cm
• exposure
  • 60-70 kVp
  • 5-10 mAs
• SID
  • 100 cm
• grid
  • no

Image technical evaluation

• nasal bones with soft tissue nasal structure, frontonasal suture (superior) and anterior nasal spine should be demonstrated
• nasal bones should be seen with no rotation

Practical points

• remove glasses and nose piercings to avoid artefact obscuring important pathology
• this view should not replace a lateral facial bones x-ray
  • as this projection is often requested together with a facial bones series , there may be the temptation to combine the request and only image a lateral facial bones x-ray as per ALARA. However, nasal bones and their soft tissue nasal structures are less dense compared to the denser facial bones and should hence be imaged separately to prevent over exposure of the less dense region