The scoliosis erect lateral view is performed to visualize the thoracic and lumbar vertebrae of interest in profile.
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Indications
This projection is done in cases of scoliosis and often done upon first presentation as a useful examination in identifying spondylolisthesis and the degree of kyphosis and/or lordosis 1,2.
Patient position
patient in an erect lateral position
arms elevated away from the spine
convex side (identified from PA/AP view) or side of largest convexity placed closest to the image receptor
ensure rotation of hips and shoulders is reduced as much as possible (some rotation inherent to scoliosis may be inevitable)
ensure at least 3-5 cm of iliac crests are present on the radiograph
Technical Factors
lateral projection
suspended expiration
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centering point
dependent on area of interest, patient height and detector size
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collimation
superiorly to include all vertebrae of interest
inferiorly to include sacral region
anteriorly to include all vertebrae (with/without lordosis)
posteriorly evidence of spinous processes in their entirety
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orientation
portrait
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detector size
most likely a stiched series
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exposure
95-100 kVp (digital) 1
60-80 mAs
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SID
100-150 cm
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grid
yes
Image technical evaluation
area of scoliosis should be visible with evidence of iliac crests inferiorly
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no patient rotation indicated by superimposed vertebral bodies
it is expected that some rotation would be present, inherent to scoliosis and the associated twisting of the vertebrae
bony margins and trabecular patterns should both be clearly visible in thoracic and lumbar vertebrae
Practical points
a compensatory wedge filter may be appropriate to achieve an even density throughout the image 1