Abstract: Making an Ortho image is an important method to diagnose spinal and leg lesions in clinic. As the whole process requires multiple exposures in different positions, and it is very complicated and time consuming, it leads to low efficiency and it’s hard to obtain ideal stitching result from image quality. The optimization of the workflow can not only reduce the workload of the operator, improve the work efficiency, but also improve the comfort of the patient in the process, finally to ensure the quality of the stitching image. This paper firstly introduces the background and workflow of making an Ortho image. Then, each optimization solutions are elaborated, including the encountered difficulties and the countermeasures. It provides a detailed reference about how to realize the Ortho function in DR system.