Category Archives: Spine Imaging

Sacrum Coccyx Lateral
4
Feb

Overview

The lateral sacrum and coccyx radiograph profiles the lower spine to assess alignment and fractures. The patient lies in true lateral with the detector centered to the sacrum. This view is useful for evaluating coccygeal angulation and sacral fractures.

Technique

Position the patient in true lateral and center the detector to include the sacrum and coccyx. Use appropriate exposure and immobilize the patient to minimize motion. Include adjacent pelvic structures when indicated.

Clinical Indications

Lateral sacrum and coccyx are indicated for trauma tailbone pain and suspected fracture or dislocation. They complement AP views for comprehensive assessment. CT or MRI may be required for detailed evaluation of complex injuries.

Image Assessment

Evaluate coccygeal angulation sacral body integrity and posterior element alignment. Inspect for cortical disruption and callus formation on follow up. Report findings relevant to pain management and surgical planning.

SI Joint AP Oblique
4
Feb

Overview

AP oblique views of the sacroiliac joints profile the joint space and sacral ala for inflammatory and traumatic changes. The patient is rotated to place the SI joint of interest perpendicular to the detector. These views aid in detecting erosions sclerosis and joint space narrowing.

Technique

Rotate the patient approximately 25 to 30 degrees to the side of interest and center the detector to the sacroiliac joint. Use appropriate exposure and immobilize the patient to reduce motion. Obtain bilateral obliques for comparison when indicated.

Clinical Indications

SI joint obliques are indicated for suspected sacroiliitis trauma and pelvic pain. They help detect erosive changes and joint space irregularity. MRI provides superior soft tissue and early inflammatory detection when needed.

Image Assessment

Assess joint space symmetry erosions and subchondral sclerosis. Evaluate for sacral fractures and adjacent pelvic pathology. Report findings relevant to rheumatologic or orthopedic management.

Whole Spine Lateral
4
Feb

Overview

Whole spine lateral radiographs evaluate sagittal alignment from cervical to sacral regions under physiologic load. They are used to assess global balance and plan corrective spinal surgery. Proper positioning ensures inclusion of all spinal segments.

Technique

Obtain a full length lateral radiograph with the patient standing and arms positioned to avoid obscuring the spine. Use consistent posture and include a calibration marker for measurements. Immobilize and instruct the patient to maintain natural stance.

Clinical Indications

Whole spine lateral views are indicated for deformity assessment adult spinal deformity and preoperative planning. They quantify sagittal vertical axis pelvic parameters and lumbar lordosis. Serial imaging monitors progression and postoperative outcomes.

Image Assessment

Measure sagittal vertical axis pelvic tilt pelvic incidence and lumbar lordosis. Assess for compensatory mechanisms and vertebral deformity. Report findings to guide surgical planning and alignment goals.

Pelvis Outlet View
4
Feb

Overview

The outlet view projects the sacrum and pubic rami to evaluate vertical displacement of the pelvic ring. The beam is angled cephalad to visualize the sacral foramina and pubic symphysis. This projection is useful in trauma to assess vertical shear injuries.

Technique

Angle the tube cephalad typically 40 degrees and center to the pubic symphysis. Keep the patient supine and immobilized to avoid motion. Use appropriate exposure to penetrate pelvic structures.

Clinical Indications

Outlet views are indicated for suspected vertical pelvic displacement and sacral fractures. They complement inlet and AP views for comprehensive pelvic trauma evaluation. CT provides detailed assessment for surgical planning.

Image Assessment

Evaluate sacral alignment pubic symphysis height and vertical displacement of hemipelvis. Inspect for sacral fractures and sacroiliac widening. Document measurements and recommend advanced imaging when indicated.

Pelvis Judet Views
4
Feb

Overview

Judet views are oblique pelvic radiographs that profile the anterior and posterior acetabular columns. They are obtained in two oblique positions to assess column integrity and fracture patterns. These views aid in initial assessment of acetabular trauma.

Technique

Rotate the patient 45 degrees to obtain iliac oblique and obturator oblique projections. Center the detector to the acetabulum and use appropriate exposure. Immobilize the patient and document positioning for comparison.

Clinical Indications

Judet views are indicated for suspected acetabular fractures and complex pelvic trauma. They help differentiate column involvement and guide surgical planning. CT is often used for definitive fracture mapping.

Image Assessment

Assess anterior and posterior column continuity acetabular roof and joint congruity. Look for intra articular fragments and displacement. Report findings to inform orthopedic management and operative approach.