Scoliosis (lateral bending view)
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Scoliosis lateral bending views are additional projections accompanying the standard PA/AP views with the aim of assessing the patient’s lateral spinal range of spinal motion 1.
Patient position
- patient erect or supine
- patient bending their upper body laterally (right and left) from the hips as much as possible
- ensure patient aligned centrally to the IR
- ensure rotation of hips and shoulders is reduced as much as possible (some rotation inherent to scoliosis may be inevitable)
- ensure at least 3
- 5-5 cm of iliac crests are present on the radiograph
Technical Factorsfactors
- anteroposterior or posteroanterior projection
- suspended expiration
-
centering point
- dependent
oon the area of interest, patient height and detector size
- dependent
-
collimation
- dependent on orthopaedic preference and imaging modality
- superiorly to include all vertebrae of interest (may be C7)
- inferiorly to include the sacral region (may be S1 or level of femoral heads)
- lateral collimation sufficient to include all of spinal curvature
-
orientation
- portrait
-
detector size
- 35 cm
Xx 43 cm - 35 cm
Xx 90 cm (if available)
- 35 cm
-
exposure
- 80-95 kVp (digital)
- 40-60 mAs
-
SID
- 100 cm - 150 cm
-
grid
- yes
Image technical evaluation
- area of scoliosis should be visible with evidence of iliac crests inferiorly
- no patient rotation
- rotated vertebrae may be distinguished from scoliotic vertebrae in that:
- rotated vertebral bodies will have their long axes straight and
- scoliotic vertebral bodies will have a lateral deviation
- rotated vertebrae may be distinguished from scoliotic vertebrae in that:
- bony margins and trabecular patterns should both be clearly visible in thoracic and lumbar vertebrae
Practical points
- PA projections should be considered over the AP projection for the reduced dose to
radio-sensitiveradiosensitive organs situated anteriorly- although the PA projection may
bebe difficult to achieve if the patient is in a prone position
- although the PA projection may
- a compensatory wedge filter may be appropriate to achieve
an even densityisodensity throughout the image 1.
-<![endif]--><!--StartFragment--></p><p><strong>Scoliosis lateral bending views</strong> are additional projections accompanying the standard PA/AP views with the aim of assessing the patient’s lateral spinal range of motion <sup>1</sup>.</p><p><!--EndFragment--></p><h4>Patient position</h4><ul>- +<![endif]--><!--StartFragment--></p><p><strong>Scoliosis lateral bending views</strong> are additional projections accompanying the standard PA/AP views with the aim of assessing the patient’s lateral range of spinal motion <sup>1</sup>.</p><p><!--EndFragment--></p><h4>Patient position</h4><ul>
-<li>ensure at least 3 - 5 cm of iliac crests are present on the radiograph</li>-</ul><h4>Technical Factors</h4><ul>- +<li>ensure at least 3-5 cm of iliac crests are present on the radiograph</li>
- +</ul><h4>Technical factors</h4><ul>
-<strong>centering point</strong><ul><li>dependent o the area of interest, patient height and detector size</li></ul>- +<strong>centering point</strong><ul><li>dependent on the area of interest, patient height and detector size</li></ul>
-<li>35 cm X 43 cm</li>-<li>35 cm X 90 cm (if available)</li>- +<li>35 cm x 43 cm</li>
- +<li>35 cm x 90 cm (if available)</li>
-<li>PA projections should be considered over the AP projection for the reduced dose to radio-sensitive organs situated anteriorly<ul><li>although the PA projection may be be difficult to achieve if the patient is in a prone position</li></ul>- +<li>PA projections should be considered over the AP projection for the reduced dose to radiosensitive organs situated anteriorly<ul><li>although the PA projection may be difficult to achieve if the patient is in a prone position</li></ul>
- +</li>
- +<li>a compensatory wedge filter may be appropriate to achieve isodensity throughout the image <sup>1</sup>
-<li>a compensatory wedge filter may be appropriate to achieve an even density throughout the image <sup>1</sup>.</li>
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