Thoracic Spine - AP
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Radiographic Positioning
Adult | Other related pages of interest |
Name of projection | Thoracic Spine - AP |
Area Covered | C7 to L1 |
Pathology shown | Fractures, scoliosis/kyphosis, tumour, infection, congenital abnormality |
Radiographic Anatomy | Thoracic Spine Radiographic Anatomy |
IR Size & Orientation | 35 x 43 cm Portrait |
Film / Screen Combination | Regular (CR and DR as recommended by manufacturer) |
Bucky / Grid | Moving or Stationary Grid |
Filter | Decubitus filter over the superior thoracic spine when using film, not required with DR CR |
Exposure | 66 kVp 20 mAs or 66 kVp 20mA 1sec for breathing technique |
FFD / SID | 100 cm |
Central Ray | Directed to T7 (to the midsaggital plane, midway between the jugular notch and the xiphoid process) Perpendicular to the IR |
Collimation | Centre: To the midsaggital plane, midway between the jugular notch and the xiphoid process Shutter A: Open to include the hyoid bone Shutter B: Open approximately 10 - 12 cm to include the paraspinal soft tisues (this may need to be open wider in the case of scoliosis) |
Markers | Superior and LateralMarker orientation AP |
Shielding | Gonadal (check your department's policy guidelines) |
Respiration | On suspended deep inspiration or gentle breathing for breathing technique |
Positioning |
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Critique | Positioning
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Special Notes | Determining the direction of rotation Using spinous process alignment: When the spinous processes are not seen in the midline of the vertebral bodies this usually indicates rotation of that part of the cervical spine. As the head is rotated in a particular direction, the spinous process tip will move in the opposite direction. For example, if the spinous process tip is closer to the left vertebral body edge, then the patient's neck is rotated so they are looking towards the right side. Using pedicle alignment: In an AP view the pedicles are seen laterally in the area between the transverse process and the vertebral body. With correct positioning the pedicles should be equidistant from the vertebral body edges. Example: If the right pedicle is more towards the midline of the vertebral body (it is rolled under/behind the vertebral body), indicating the patient is rotated so they are looking towards the right side. Demonstrating intervertebral disc spaces Successful demonstration of the intervertebral disc spaces is largely dependent on correct central ray angulation. Generally, the central ray is perpendicular to the film. |