The supine view is used in unconscious patients, those immobilised due to trauma and the critically ill and intubated. In addition to the disadvantages of the erect AP film, there can be difficulty detecting pneumothorax which will collect anteriorly, and haemothorax or other effusions which pool in the recesses posteriorly.
Fig 1: AP supine view | Fig 2: PA erect view |
These films are of the same patient. The image on the left shows the appearance when the patient is lying supine, the image on the right when the patient is sitting up. Note the difference in the appearance of the heart and the mediastinum.