Proper positioning is not only required for diagnostic value, but it is also required for patient protection. In order to repeat images several times, it is important to see if something if wrong in the image, that the technologist can recognize that and repeat only one (or not at all).
If a patient is poorly positioned, even the slightest rotation could make anatomy appear differently. This could lead to wrong diagnostic interpretation.
For example, when the chest is positioned with rotation, the heart could appear bigger than it actually is. The radiologist might see this as cardiomegaly.
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