What degree and direction of angulation is used for the CR of a PA axial Caldwell projection of the skull?

• A. 15 degrees caudad
• B. 15 degrees cephalad
• C. 0 degrees
• D. 25 degrees caudad

Answer: (A)

For the PA axial Caldwell projection, the central ray is directed through the nasion with a 15-degree tilt toward the feet (caudad). This specific angulation positions the frontal bone and the orbital rims so they are well demonstrated, while driving the petrous pyramids lower into the orbits. The result is an axial view that reduces overlap from the facial bones and gives a clearer image of the frontal bone and anterior sinuses. Using no angle or angling in the opposite direction would not achieve the desired axial projection and would distort the anatomy, while a larger caudad angle would over-project structures and alter their relationships.