The spine

Question 1

what are some common clinical indications for the spine?

Answer 1

u Blunt trauma
u Axial loading
u Hyper-extension, hyper-flexion
u Degenerative change
u OA/RA
u Congenital cause

Question 2

what are clinical indications for lumbar spine?

Answer 2

u Trauma
u Pain (sudden onset or longstanding & increasing)
u ?osteoporotic collapse
u ? Bone primary/hot spot
u ? Osteomyelitis
u SI joint lesion

Question 3

Patient position for L-Spine AP

Answer 3

• Patient supine on x-ray table
• M-S plane in midline at right angles to the cassette
• Patient’s head on pillow, arms by side
• ASIS equidistant from table top
• Shoulders equidistant from table top
• Hips and knees flexed

Question 4

what is the centring point for an L-Spine AP?

Answer 4

• Central ray vertical to the image receptor
• Midline at level of lower costal margin
• Expose on arrested expiration

Question 5

what are some essential image charactersitcis of an AP L-spine

Answer 5

u Bony cortex and trabeculae seen - kVp
u Intervertebral disk spaces demonstrated.
u T12-Sacroiliac joints demonstrated.
u Sacroiliac joints are equidistant from the spine.

Question 6

Whats the patient position for a Lateral l-spine

Answer 6

• SUPINE: Lay patient on table in the lateral position
• M-S plane parallel and middle of axilla coincident with midline of table.
• Arms raised and folded over head
• Vertebral column parallel to cassette
• ASIS superimposed
• Shoulders superimposed
• Can be done standing/erect too
• Almost always a left lateral

Question 7

whats the centirn gpoint for L-SPINE LATERAL?

Answer 7

• Central ray vertical to the image receptor
• 8-10cm anterior to spinous processes at level of lower costal margin (L3)
• Expose on arrested expiration

Question 8

Imaging criteria for l spine lateral

Answer 8

• Bony cortex and trabeculae seen.
• Intervertebral disk spaces demonstrated.
• Bodies of T12-L5/S1 demonstrated.
• Vertebral endplates superimposed.
• Cortices at the posterior and anterior margins of the vertebral body should also be superimposed. (No double edges)
• The imaging factors selected must produce an image density sufficient for diagnosis from T12 to L5/S1, including the spinous processes.

Question 9

what are some L-SPINE additional spinal projections.

Answer 9

-AP L5/S1 Projection
-PA Sacrum
-Lateral sacrum
-Posterior/ anterior obliques.
-HBL
-Sacro-iliac joints (prone and posterior obliques).
-Lateral flexion and lateral extension.
-Side-bending APs.
-Erect spine.

Question 10

Lumbar spine clinical indications.

Answer 10

u Trauma
u Pain (sudden onset or longstanding & increasing)
u ?osteoporotic collapse
u ? Bone primary/hot spot
u ? Osteomyelitis
u SI joint lesion

Question 11

L spine AP patient position

Answer 11

• Patient supine on x-ray table
• M-S plane in midline at right angles to the cassette
• Patient’s head on pillow, arms by side
• ASIS equidistant from table top
• Shoulders equidistant from table top
• Hips and knees flexed

Question 12

what is the centring point for L-SPINE AP

Answer 12

• Central ray vertical to the image receptor
• Midline at level of lower costal margin
• Expose on arrested expiration