AP Thoracic

Spine positioning

AP Thoracic is a radiography positioning projection of the Spine. Supine, arms at sides, CR perpendicular to T7. Grid required. The centering point is located t7 vertebra (mid-chest), 3-4 inches below the jugular notch.. The central ray is perpendicular to ir at t7 level.. Image-quality criteria include all thoracic vertebrae t1-t12 visualized., intervertebral disc spaces symmetrically open.. Standard exposure ranges from 75 to 85 kVp, 25 to 40 mAs, at an SID of 40 inches (102 cm).

Anatomy demonstrated

  • Thoracic vertebral bodies T1-T12.
  • Intervertebral disc spaces.
  • Spinous processes in profile.
  • Lateral processes and facet joints.
  • Thoracic kyphotic curve.

Patient preparation

  • Verify patient identity using two identifiers.
  • Remove jewelry, bra with metal fasteners, and objects.
  • Supine on table in neutral alignment.
  • Arms at sides or folded across chest.
  • Shoulders relaxed away from neck.

Position & centering point

T7 vertebra (mid-chest), 3-4 inches below the jugular notch.

Central ray

Perpendicular to IR at T7 level.

Exposure / technique

kVp
75–85
mAs
25–40
SID
40" (102 cm)
Notes
Grid required. Supine position at end of full expiration.

Image-quality criteria

  • All thoracic vertebrae T1-T12 visualized.
  • Intervertebral disc spaces symmetrically open.
  • Spinous processes aligned vertically.
  • No rotation evidenced by symmetric lateral processes.
  • Entire chest field included.

Common errors / ARRT traps

  1. 1 Body rotation shifts lateral processes off symmetry.
  2. 2 Shoulder elevation obscures upper thoracic vertebrae.
  3. 3 CR misalignment off T7 misses mid-thoracic region.
  4. 4 Inspiration distorts disc spaces and vertebral height.

Clinical indications

  • Thoracic spine trauma survey in supine patient.
  • Evaluation of spondylosis or arthrosis.
  • Suspected compression fracture assessment.
  • Post-operative thoracic fusion follow-up.

Aligned to the 2025 ARRT Content Specifications.

Practice this projection live.

The interactive positioning viewer in the app lets you rotate the patient, see the centering point in 3D, and study the central ray angle. Start free.

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