Lateral thoracolumbar spine X-ray positioning
An extra T-spine view, used when a routine one is not enough. The patient lies on their side, the beam passes from side to side, straight on to the receptor, and the centring point is T12.
By the ScanFlo Editorial Team · Updated
In this section · X-ray positioning
- X-ray positioning guides
- Skull positioning
- Face & sinuses positioning
- Soft tissue neck positioning
- C-spine positioning
- Chest positioning
- Shoulder positioning
- Humerus positioning
- Elbow positioning
- Forearm positioning
- Wrist positioning
- Hand positioning
- T-spine positioning
- Abdomen positioning
- L-spine positioning
- Sacrum & SI joints positioning
- Pelvis positioning
- Hip positioning
- Femur positioning
- Knee positioning
- Tibia & fibula positioning
- Ankle positioning
- Foot positioning
Still being checked: a radiographer is reviewing this guide. If your department does it differently, follow your department.
Patient position
Lateral recumbent. Lateral with knees flexed and the spine horizontal.
Centring & collimation
Central ray
lateralCentre: T12.
Beam: lateral, perpendicular to the receptor.
Collimate: T10 to L2
Distance, receptor & grid
| Setting | Value | Notes |
|---|---|---|
| SID | 100 cm | |
| Receptor | 35 × 43 cm | portrait |
| Placement | Table bucky | Grid in |
| Angulation | None | Perpendicular to the receptor |
Marker & breathing
- Marker: R or L marker on the side nearest the detector
- Breathing: Breathe out and hold.
Exposure by patient size
Treat these as a starting point. Your detector, your generator and the patient in front of you will all move the numbers.
| Patient size | kV | mAs (chart) | mAs (DR default) |
|---|---|---|---|
| XS | 80 | 25 | 10 |
| S | 80 | 40 | 16 |
| M | 80 | 50 | 20 |
| L | 80 | 80 | 32 |
These start from a classic film-screen chart (80 kV, 80 mAs at 140 cm) and are adjusted for a digital detector at 100 cm. The DR column is what ScanFlo's console suggests; each step up or down changes the mAs by about a quarter.
Image quality checklist
- Posterior margins superimposed at the junction.
- The anatomical side marker is visible, correct and clear of the anatomy.
- Collimation borders are visible on all sides, no wider than the area requested.
Faults & how to fix them
| Fault | Cause | Fix |
|---|---|---|
| Rotation | Pelvis rolled | Square the hips and shoulders. |
Common questions
- Where do you centre for a thoracolumbar spine lateral X-ray?
- The centring point is T12.
- What distance and beam angle does a thoracolumbar spine lateral need?
- 100 cm from the tube to the receptor. The beam passes from side to side, straight on to the receptor.
- What size receptor, and do you need a grid?
- Use a 35 × 43 cm receptor, portrait, in the table bucky. A grid is needed.
- What should the patient do with their breathing?
- Ask them to breathe out and hold it while you expose.
- What goes wrong most often on a thoracolumbar spine lateral?
- Rotation. Usual cause: pelvis rolled. The fix: square the hips and shoulders.
Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a thoracolumbar spine lateral in a 3D room and score your positioning. See ScanFlo XR →
Written by the ScanFlo team from everyday radiographic practice.