Citation, DOI & article data
Citation:
McWilliam, R., Murphy, A. Thoracic spine (AP view). Reference article, Radiopaedia.org. (accessed on 13 Sep 2022) //doi.org/10.53347/rID-49207
The thoracic spine anteroposterior (AP) view images the thoracic spine, which consists of twelve vertebrae.
On this page:
This projection is utilized in many imaging contexts including trauma, postoperatively, and for chronic conditions. It can help to visualize any compression fractures, subluxation or kyphosis.
- the patient is erect or supine, depending on clinical history
- ideally, spinal imaging should be taken erect in the setting of non-trauma to give a functional overview of the thoracic spine
- all imaging of patients with a suspected spinal injury must occur in the supine position without moving the patient
- hands are placed by the patient's side
- anteroposterior projection
- arrested inspiration (to push the diaphragm downwards over the upper lumbar vertebra)
- centering point
- the level of the 7th thoracic vertebra at the MSP
- the central ray is perpendicular to the image receptor
- collimation
- superiorly to include the C7/T1 junction
- inferiorly to include the T12/L1 junction
- lateral to include the costotransverse joints and left and right paraspinal lines
- orientation
- portrait
- detector size
- 35 cm x 43 cm
- exposure
- 70-80 kVp
- 25-40 mAs
- SID
- 110 cm
- grid
- yes (ensure the correct grid is selected if using focused grids)
The entire thoracic spine should be visible from T1 to T12:
- no patient rotation as evident by central spinous processes with sternoclavicular joints appearing equidistant
- intervertebral joints are seen in profile
- adequate image penetration and image contrast is evident by clear visualization of thoracic vertebral bodies, with both trabecular and cortical bone demonstrated
- the three-column concept of thoracolumbar spinal fractures is of particular importance when assessing this image for pathology
- take particular care when imaging patient on a trauma trolley that the image receptor is aligned to the central ray to prevent anatomy exclusion and grid cut-off
- flexing the patient's legs or providing a pillow under the knees may improve patient comfort, whilst reducing spinal lordosis
References
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