The Caldwell View (Occipitofrontal Projection)
1. Clinical Definition
The Caldwell view is a radiographic projection where the patient’s nose and forehead are placed against the image receptor. The central ray is angled caudally (usually 15°) to project the petrous ridges into the lower third of the orbits.
2. High-Yield Indications
- Frontal Sinuses: Excellent for visualizing the frontal sinuses, which are obscured in other views.
- Anterior Ethmoid Sinuses: Superior visualization compared to the Water view.
- Orbital Bone Evaluation: Used to assess the orbital rims, particularly the medial and lateral margins.
3. Comparison: Caldwell vs. Water
| View | Primary Sinus Utility | Petrous Ridge Position |
|---|---|---|
| Caldwell | Frontal & Anterior Ethmoid | Lower 1/3 of orbits. |
| Water | Maxillary | Below the maxillary sinuses. |
4. Examination Pearls
- Diagnostic Use: Frequently requested to rule out pathology such as fluid levels, mucosal thickening, or opacification of the frontal sinuses.
- Orbital Pathology: By projecting the petrous ridges lower, the view provides a clearer look at the upper orbital rim and medial wall, helping to identify subtle fractures.