Thoracic Spine

Question 1

What is part of the minimal diagnostic series of the thoracic spine?

Answer 1

AP and Lateral.

Question 2

What are the additional views of the thoracic spine?

Answer 2

Swimmer’s lateral and Oblique.

Question 3

What thoracic vertebra are visible in an AP thoracic view?

Answer 3

T1-T12.

Should be taken with close collimation.

Question 4

What are the 2 pitfalls of the AP Thoracic?

Answer 4

Upper thoracics are surrounded by lucent lung fields (high contrast body area).
Lower thoracics are surrounded by dense abdomen (low contrast body area).

Question 5

Describe the pedicles in an AP Thoracic view:

Answer 5

Oriented lengthwise in the sagittal plane (seen on end, appear as circles).
Useful in identifying rotation.

Question 6

What things make it easier to visualize the articular processes in an AP Thoracic?

Answer 6

Rotation, lateral flexion, and scoliosis.

In normal situations, they’re difficult to see b/c they are thin, overlapping structures.

Question 7

T/F: The ends of SP’s in the T-spine frequently curve to L or R; this has no clinical significance.

Answer 7

True.

Question 8

How do you determine anterior vs posterior ribs in an AP Thoracic view?

Answer 8

Posterior extends from the spine; medial to lateral slope is superior to inferior.
Anterior extends to nonvisualized costal cartilage; lateral to medial slope is superior to inferior.

Question 9

In what direction do the TP’s extend in the thoracic spine?

Answer 9

Laterally.

Question 10

What joint spaces are not consistently seen or evaluated on the AP thoracic radiograph?

Answer 10

Intervertebral, zygapophyseal/facet, costovertebral, and costotransverse joint spaces.

Question 11

What are the pitfalls of the lateral thoracic view?

Answer 11

Upper thoracics is surrounded by arms, shoulders, and scapula.
Mid thoracics surrounded by lungs.
Lower thoracics surrounded by dense abdomen.

Question 12

What structures are best visualized on a lateral thoracic view?

Answer 12

IVD’s, pedicles (in profile), IVF, venous channels of hahn, zygapophyseal/facet joints (b/c they’re in the coronal plane), and sternoclavicular joints.

Question 13

What is used to check thoracic kyphosis?

Answer 13

George’s/posterior body margin line.

Question 14

What structures are best visualized on a swimmer’s cervical/thoracic?

Answer 14

Cervicothoracic junction.

Question 15

How many views of the ribs do you need to take on a swimmer’s Cx/Tx view?

Answer 15

2 perpendicular views (90 degrees to each other).

Place the site of pain/trauma closest to the film.

Question 16

When taking an x-ray of the sternum what 3 views should be taken (swimmer’s)?

Answer 16

Lateral and PA (it places the sternum closest to the film).

RAO projects the sternum away from the heart shadow.