Pediatric thoracic spine (lateral view)

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

Indications

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

Patient position

• the patient is erect with the left shoulder in contact with the upright detector

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

Technical factors

• lateral projection

• suspended inspiration

• centering point

  • at the level of the 7th thoracic vertebra correlating to the inferior border of the scapula

• collimation

  • anteroposteriorly to include the anterior margin of all thoracic vertebrae and the posterior column elements

  • superiorly to include the C7/T1 junction

  • inferiorly to include the T12/L1 junction

• orientation

  • portrait 

• detector size

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

• exposure ¹

  • 70-85 kVp

  • 4-12 mAs

• SID

  • 100 cm

• grid

  • no

Image technical evaluation

All thoracic vertebrae from T1 to T12 should be clearly visible. Open intervertebral joint spaces and neural foramen are demonstrated 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

The radiograph should be free from motion artifacts 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