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XR Scoliosis Series

XRNo contrastSpine
Indications
  • Evaluation and monitoring of scoliosis/spinal curvature
  • Cobb angle measurement
  • Pre-operative/post-operative spinal deformity assessment
  • Skeletal maturity (Risser) assessment
Patient prep
  • Remove radiopaque objects over torso; gown
Contrast
None / non-contrast
Technique
  • Erect/weight-bearing PA (preferred over AP to reduce breast/gonadal dose) of full spine on long (14x36 inch / 36-inch) IR or stitched DR
  • CR perpendicular to center of full spine (~T9-T10)
  • SID 72 inches; grid
  • Include from external acoustic meatus / C7 through iliac crests (Risser)
  • Use breast shielding/compensating filters; suspended respiration
Series / Sequences
#Series / SequencePlaneNotes
1PA erect full spineFrontalStanding/weight-bearing; full spine on long IR; for Cobb angle and curve magnitude
2Lateral erect full spineSagittalStanding; evaluates sagittal alignment/kyphosis-lordosis and spondylolisthesis
Key points
  • PA projection preferred to lower breast and thyroid dose in (often young female) patients
  • Right and left lateral bending (supine) views assess curve flexibility for surgical planning
  • Include iliac crests to assess Risser sign of skeletal maturity
  • Compensating filters even out density between thoracic and lumbar regions
References
• Lampignano JP, Kendrick LE. Bontrager's Handbook of Radiographic Positioning and Techniques. 11th ed. Elsevier; 2024 — scoliosis series projections.
• Merrill's Atlas Vol 1 - Vertebral Column (Scoliosis)
• Radiopaedia: Scoliosis radiography link
• Knott P, et al. SOSORT 2012 consensus paper: reducing x-ray exposure in pediatric patients with scoliosis. Scoliosis 2014;9:4. link
Source: Researched — verify against your institution
‹ PreviousXR Lumbar Spine
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.