In AP lumbar radiography, which finding indicates minimal rotation and proper alignment?

• A. Pedicles appear symmetric.
• B. Pedicles appear magnified.
• C. Spinous processes displaced laterally.
• D. Iliac crests are not symmetrical.

Answer: (A)

Symmetry of the pedicles on an AP lumbar radiograph shows there is little to no rotation and the spine is aligned with the beam. When the patient is not rotated, the vertebral structures face the detector evenly, so the pedicles on both sides appear at equal size and position relative to the vertebral body. If rotation occurs, one pedicle becomes more prominent or displaced, the spinous processes shift away from the midline, and the iliac crests can look asymmetrical. Magnified pedicles can result from distance or positioning issues rather than proper alignment, so they do not indicate correct rotation. Thus, symmetric pedicles reflect minimal rotation and proper alignment.