Pediatric lumbar spine (lateral view)

The lateral lumbar spine view for pediatrics is one of two views in order to examine the lumbar vertebrae.

Indications

This projection demonstrates the thoracic spine orthogonal to the AP lumbar spine view. It is useful in diagnosing fractures in pediatric patients.

Patient position

• the patient is erect with the left side of their body in contact with the upright detector

• arms are raised to remove them from the lumbar region, ideally with the elbows flexed and forearms parallel to the thorax

Technical factors

• lateral projection

• suspended expiration

• centering point

  • at the level of the iliac crests

• collimation

  • anteroposteriorly to include the anterior border of the lumbar vertebral bodies and the posterior column elements

  • superiorly to include the T12/L1 junction

  • inferiorly to include the sacral region

• orientation

  • portrait 

• detector size

  • 24 cm x 30 cm or 35cm x 43 cm depending on the patient's size

• exposure ¹

  • 65-80 kVp

  • 2-12 mAs

• SID

  • 100 cm

• grid

  • no

Image technical evaluation

All lumbar vertebrae should be clearly visible. Greater sciatic notches and superior and inferior endplates of articulating facets are seen superimposed ². A physical metal marker is ideal for pediatric imaging. 

Practical points

Preparing the room beforehand (setting up the detector, exposure and preparing lead gowns) is important as pediatric patients may not remain still.

Immobilization techniques

It is important for the radiograph to be free from motion artifact and rotation to avoid repeated x-rays.

• it may be necessary for the parent or radiographer to hold the patient in position

• ideally the parent should be in the child's direct line of sight

• techniques will vary based on the department

• distraction techniques can be utilized to avoid scattered radiation to parents and staff ³