Comprehensive Osteopathic Medical Licensing Examination (COMLEX USA) Practice

Which X-ray view is best for diagnosing a stress fracture in the spine?

1. Lateral

2. Anteroposterior

3. Oblique

4. Decubitus

The correct answer is: Oblique

The best X-ray view for diagnosing a stress fracture in the spine is the oblique view. This view provides a unique angle that allows for better visualization of the vertebrae and intervertebral foramen, which can reveal subtle changes or abnormalities not easily seen in other views. Stress fractures are often more difficult to detect than acute fractures because they may not show significant changes on standard X-rays until a healing process has begun. In the context of spinal stress fractures, the oblique view can better demonstrate the alignment and potential deficiencies along the pars interarticularis area, where these fractures commonly occur. By capturing this angle, clinicians can assess for cortical disruptions or other signs indicative of a stress fracture, facilitating a more accurate diagnosis. Other views have their respective uses but do not provide the same level of detail for identifying stress fractures. The lateral view is effective for visualizing the height of the vertebrae and alignment but may miss fractures that do not displace vertebral structures. The anteroposterior view is helpful for overall assessment of spinal alignment but lacks the specificity for detecting pars interarticularis stress fractures. The decubitus view is typically used for assessing certain types of fluid levels or masses within the thorax and would not