Anatomy Demonstrated; Thoracic vertebral bodies, intervertebral joint spaces, spinous and transverse processes, posterior ribs, and costovertebral articulations. The spinal column from C7-L1 included, no rotation demonstrated by SC joints equidistant from the spine.

Patient Positioning; Patient should be supine (preferred) with arms at side and head on table or pillow. The patient may also be erect with arms at side and weight evenly distributed on both feet. 

IR: 14x17 (portrait)

SID: 40"

CR: Perpendicular to IR, directed to T7 (3-4 inches below jugular notch)

Clinical indications: Pathology involving the thoracic spine, such as compression fractures, subluxation, or kyphosis

Anatomy Demonstrated: Thoracic vertebral bodies, intervertebral joint spaces, and intervertebral foramina. 

Patient Positioning: Postion patient in the lateral recumbent position, with head on pillow, arms raised, and knees flexed. May need to add proper waist support to keep the thoracic spine aligned, For the erect position, place the arms outstretched, with weight evenly distributed on both feet. Align and center midaxillary plane to midline of table or IR. Ensure top of IR is at least 1 1/2 inches above the shoulders and ensure no rotation. 

IR: Grid/bucky, 14 x 17 inches, portrait. 

SID: 40 inches (100 cm)

CR: CR perpendicular to long axis of thoracic spine. Direct CR to T7 (3-4 inches below the jugular notch or 7-8 inches below the vertebral prominens.) A patient with broad shoulders may require a 10–15-degree cephalic CR angle if waist is not supported. 

Clinical indications: Pathology involving the thoracic spine, such as compression fractures, subluxation, or kyphosis. 

Anatomy Demonstrated: Vertebral bodies and intervertebral disk spaces of C5 to T3 are shown. 

Patient Positioning: Patient should be erect (sitting or standing); align C-spine to CR. Place the patient's arm and shoulder closest to the IR up, flexing the elbow and resting forearm on head for support. Position arm and shoulder farthest from the IR down and rotate slightly posterior to place the remote humeral head posterior to vertebrae. Ensure there is no rotation of thorax or head. The radiograph may be performed in the recumbent position if the patient's condition requires, 

IR: Grid/bucky, 10 x 12 inches, portrait. 

SID:  60-72 inches (150-180 cm)

CR: CR perpendicular to IR and centered to T1 (approximately 1 inch above the level of the jugular notch). Optional 3–5-degree caudad CR angle to separate the two shoulders for patient with limited flexibility. 

Clinical indications: Pathology involving the inferior cervical spine, superior thoracic spine, and adjacent soft tissue structures. Various fractures and subluxation. This is a good projection when C7 to T1 is not visualized on the lateral cervical spine, or when the upper thoracic vertebrae are of special interest on a lateral thoracic spine. 

Thoracic Vertebrae

• Morgan Matousek

Lateral Thoracic Vertebrae

• Morgan Matousek