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What adjustment should be made if the downside pedicle appears posterior to the vertebral body during a lumbar spine radiograph?

  1. Decrease rotation of the body

  2. Increase the patient's height

  3. Use a higher mA setting

  4. Position the patient supine

The correct answer is: Decrease rotation of the body

When interpreting lumbar spine radiographs, proper alignment of the vertebral structures is crucial for accurate assessment. If the downside pedicle appears posterior to the vertebral body, this indicates that the patient is likely over-rotated towards the imaging receptor. To correct this positioning artifact, decreasing the rotation of the body is necessary. This adjustment allows the pedicle to be visualized more centrally in relation to the vertebral body. The alignment of the pedicle should ideally be symmetrical; when the pedicle is posterior, this signifies excess rotation that distorts the anatomical relationships seen in the radiograph. Other adjustments, such as increasing the patient's height, using a higher mA setting, or positioning the patient supine, do not directly address the alignment issue caused by over-rotation. Decreasing the rotation results in improved visualization of the lumbar structures and aids in achieving an accurate representation of the anatomy, which is essential for diagnosis and treatment planning.