Wednesday, 25 April 2012

 Spine

Thoracic Spine Lateral

Indications for imaging
Congenital abnormalities, scoliosis, trauma, pain, metastasis's.
Anatomy  Demonstrated
Thoracic vertebra,

Thoracic Spine Lateral Anatomy
Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London
Basic Patient Position
The patient lies on one side on the table, mid-sagittal plane parallel to the table top and mid coronal plane midline aligned to the midline of the table, the hips and knees flexed 45 degrees to support the patient and minimise movement, raising the arms well above the head maximises visualisation of the upper vertebrae.


Thoracic Spine Lateral Patient Position
Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London

Radiation protection
There are many local rules for gonad protection however the following should be taken into account. The 28 day rule should be applied for female patients.
In males and females direct lead rubber gonad protection can be applied at all times, 
Central Ray
The vertical central ray is centered at the level of T7, at the level of the tip of the sixth spinous process when counting down from the prominent spinous process of C7 at the midpoint of the thoracic curve, i.e. midway between the most posterior dorsal skin surface and the anterior border of T1.
Exposure is made on suspended inspiration.
Exposure Factors
Kv mAS FFD (cm) Grid Focus AEC Cassette
85 20 100 Yes Fine Yes 30 x 40 cm
Evaluation of the Image
ID and markers must be present and correct in the appropriate area of the film
Evidence of collimation on four sides equally around the centering point.
Optimal exposure should penetrate all the bone structures and contrast should be low enough to visualise fully the bone and soft tissue structures.
Limits of the examination, superiorly the upper border of C7, inferiorly the lower border of L1, laterally the medial part of the posterior ribs.
The intervertebral joint spaces should be visible, the spinous processes should be projected over the centers of the vertebral bodies.


Thoracic Spine Lateral Radiograph
Related Projections
Thoracic spine Later
Cervical spine AP
Lumbar spine AP
Additional modalities
CT
MRI

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