Describe the standard radiographic evaluation of a patient with suspected Scheuermanns disease

Standing long cassette posteroanterior (PA) and lateral views of the spine are examined for excessive thoracic kyphosis, vertebral wedging, endplate changes, narrowing of the disc spaces, and scoliosis. The PA view should include the iliac apophyses and triradiate cartilages for evaluation of skeletal maturity. The patient should stand with his or her hips and knees fully extended. The elbows are flexed and the hands supported in the supraclavicular fossa so the arms neither flex nor extend the spine. PA radiographs decrease the radiation exposure to the breasts and heart compared with anteroposterior views. A hyperextension lateral view taken with the patient supine over a radiolucent wedge placed just caudal to the apex of the kyphosis is used to assess flexibility of the kyphotic deformity.

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