CAMRT Radiography Practice Exam

What indicates under rotation of an oblique L-spine?

1. Pedicle anterior

2. Pedicle posterior

3. Inferior articulating process

4. Lamina

The correct answer is: Pedicle anterior

Under-rotation of an oblique lumbar spine image indicates that the patient has not been turned sufficiently towards the imaging receptor. This misalignment can be assessed by examining the position of the pedicles on the vertebrae. When viewing images of the lumbar spine, ideally, the pedicles should appear as symmetrical, with their centers reflecting the correct relationship to the vertebral body. If the pedicles are found to be more anteriorly positioned relative to the midline of the vertebral body, this signifies under-rotation. This appearance results because the structures have not been sufficiently rotated to achieve the ideal lateral position, causing the left or right pedicle to move forward and appear more anterior. Recognizing this pattern is crucial for radiographers to ensure proper positioning for accurate diagnostic assessment. In contrast, if the pedicle is positioned more posteriorly, it suggests over-rotation. Observing the inferior articulating process or the lamina would not provide as direct a visual cue as the pedicle positioning would in assessing oblique alignment; thus, they are not the best indicators for under-rotation.