What that means is if one doctor measures a 50-degree scoliosis and another doctor measures it at 45 degrees without discussing how the measurement was taken, the measurements are considered to be the same because of that 5-degree error rate. In a scoliosis X-ray, there’s an acceptable error rate of up to 5 degrees from one doctor to another. If someone else looks and thinks that T9 is the most tilted vertebra and measures from L4 to T9 instead, they’ll get a completely different measurement. Let’s say a patient’s most tilted vertebra is from L4 to T11 and the angle measurement is 50 degrees. However, the most tilted vertebra is a little subjective. Comparing this tilt to a horizontal level is what gives you the Cobb angle: the most standard measurement for scoliosis.įor example, if L4 is tilted 15 degrees to the left and L1 is tilted 20 degrees to the right, adding those will give you a 35-degree Cobb angle. How Scoliosis X-Ray Measurements are TakenĪ lot of times, when you’re trained to take a scoliosis X-ray, you’re trained to take the most tilted vertebra of the lowest part of the spine and compare it to the most tilted vertebra as you go up the spine. Typically, scoliosis X-rays should be taken while the patient is in a standing position and from a variety of angles. If the X-ray technician changes the position to make the patient more comfortable, this can alter the presentation of the film. This can occur when a patient’s experiencing some type of pain. I’ve seen scoliosis X-rays that are taken while the patient is lying down this is horrible for scoliosis X-rays because curves typically reduce when lying down, so X-rays taken from this position won’t give accurate measurements.Īnother error can occur if the patient’s arms are not relaxed, or even worse, if they’re purposely positioned symmetrically. When a patient leans back, it creates a turn and rotation, and that can lead to a bad X-ray. Patients with scoliosis often have rib issues where some are farther back on one side and more forward on the other. This is not an appropriate position, as it can alter the scoliosis. Sometimes, X-rays are taken while a patient is leaning back against the machine. Body PositioningĪnother common issue that can alter scoliosis X-ray results is the position the patient is in while the X-ray is being taken. The main issue is that shoes can be worn improperly, throwing things off balance, and this can skew the results. While it might not seem important whether or not a patient getting a scoliosis X-ray wears shoes, I can assure you it is. That stitching process can create an error, which can be very damaging in terms of accuracy. These images are then stitched together to make a single X-ray image out of the separate images. There would be one taken of the cervical spine (upper back), another of the thoracic spine (middle back), and one taken of the lumbar spine (lower back). Stitching ImagesĪ lot of times, machines aren’t big enough to take the entire spine, so the images are taken sectionally. Common Scoliosis X-Ray ErrorsĪlthough X-rays continue to be the most reliable, noninvasive, accessible, and cost-effective method for diagnosing and monitoring scoliosis, there are some common mistakes that can be made. Ultimately, the X-ray should be taking an image of the entire spine all at the same time. Thirdly, the patient should be standing, with arms relaxed, and no shoes on. Secondarily, scoliosis X-rays should include the entire spine, meaning from the neck to the pelvis this is necessary for getting the most accurate images of the spine. If the X-ray machine is closer than 72 inches, what can happen is the scoliosis is magnified, making the curve appear slightly larger. Typically, a scoliosis x-ray should be taken from a certain distance the machine should be 72 inches away from the patient’s body. While many people still have concerns regarding side effects of frequent X-rays, those concerns are unfounded. Once any underlying pathology or conditions are ruled out, X-rays can tel l us what we need to know about a patient’s condition. The Scoliosis X-ray is the most common method of diagnosing and monitoring a patient’s scoliosis.
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