An adequate thoracic spine x-ray should incorporate the 1st lumbar vertebra. It is frequently difficult to visualise the upper thoracic vertebrae on the lateral film however due to overlying bone and soft tissue.

An adequate lumbar spine x-ray should include the upper part of the sacrum however a ‘pelvis’ x-ray is best to examine the sacrum

Fig 1: Markedly displaced fracture of T3, not well visualised on lateral view Fig 2: Markedly displaced fracture of T3, clearly visible on AP view