Why should lumbar spine radiographs be obtained with the patient in the standing position whenever possible

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Lumbar spine pathology (e.g. spondylolisthesis) tends to be exacerbated in the upright position and relieved with recumbency. Most other spinal imaging procedures are performed in the supine position (e.g. CT, magnetic resonance imaging). Standing radiographs provide the opportunity to obtain valuable information about spinal alignment in the erect weight-bearing position.

Figure 10-6. Anteroposterior (A) and lateral (B) view of the lumbar spine. S, Spinous process; P, pedicle; T, transverse process; L, lamina; A, articular facet joint; B, body; I, intervertebral foramen. (From Mercier L. Practical Orthopedics. 6th ed. Philadelphia: Mosby; 2008.)

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