Thoracic Spine, Chest, and Bony Thorax Radiography

The bony thorax is a region of the body where one generally places the film to a landmark and then centers the tube to the film. This brings use to one of the old rules from radiographic physics. When radiographs of the thoracic spine are taken, one must deal with variation of tissue density and the effects of air in the lungs. The A-P view has the air-filled lung, aorta, and heart muscle superimposed on the spine. One needs to adjust the exposure to adequately visualize the thoracic spine behind the heart without burning out the upper thoracic spine. Patient measurements are different for the thoracic spine and the rest of the thoracic views. The A-P measurement is taken over the shoulder with the calipers in contact with the sternum and thoracic spine. The lateral thoracic spine measurements are taken just under the axilla, while the chest measurements are taken laterally at the middle of the chest.