CAMRT Radiography Practice Exam

How can you determine if a patient was over-rotated during an AP Oblique L Spine projection?

1. The pedicles are visible far from the midline

2. The zygapophyseal joints are well-separated

3. The superior and inferior articular processes are not in profile and the corresponding joints are closed

4. The patient exhibits no spine curvature

The correct answer is: The superior and inferior articular processes are not in profile and the corresponding joints are closed

In an AP Oblique L Spine projection, over-rotation can be determined by evaluating the visibility of the superior and inferior articular processes in relation to the corresponding zygapophyseal joints. When a patient is over-rotated, these articular processes will not be well-defined or in profile, and the joint spaces between them will appear closed. This is tells us that the spine has been too far rotated, causing the articular processes to not be clearly visible, which is a direct indication that the correct positioning was not achieved. The positions of the pedicles are also important; they should ideally be seen within the vertebral body midline when the patient is appropriately positioned. If the pedicles appear too far to the side, it indicates excessive rotation in one direction, but specifically looking at the articular processes gives more definite evidence of over-rotation in the context of this projection. Other choices may indicate various positioning issues but do not specifically confirm over-rotation. For instance, visible pedicles far from the midline could suggest under-rotation as well, and well-separated zygapophyseal joints typically indicate optimal rotation. A lack of spine curvature may suggest an entirely different issue unrelated to the specific technique of rotational positioning.