The thoracolumbar junction and/or the lumbosacral junction is/are not entirely included on the exam.

The exam is over or under penetrated.

The exam is limited by overlying structures, bones or soft tissues, patient positioning, support devices, or motion.

The prevertebral or paravertebral soft tissues are abnormal.

The vertebral bodies are abnormally aligned.

The anterior and posterior vertebral body lines are abnormal or interrupted.

The visualized spinous processes are malaligned or distracted on the AP and/or lateral view(s).

There is reversal or straightening of the normal lordosis or scoliosis of the lumbar spine.

There are more or less than the expected 5 non rib-bearing vertebral bodies.

There is a transitional motion segment at the lumbosacral junction (sacralization of L5 or lumbarization of S1).

There is a fracture or distraction of a vertebral body, transverse or spinous process, or other posterior element.

There is anterior wedging and/or compression of a vertebral body or end plate.

There is an end plate avulsion or other fracture.

There is displacement of a fracture fragment into the soft tissues or spinal canal.

There is lucency or defect of the pars interarticularis from spondylolysis.

There is an abnormality of a pedicle or lamina on the frontal or lateral view.

There is a fracture, erosion, sclerosis, lytic, or blastic lesion of a pedicle or lamina.

There is evidence of a lytic or sclerotic lesion, or disruption of the trabecular pattern of a vertebral body, end plate, or sacrum.

There is a fracture or interruption of the arcuate lines of the sacrum.

There is erosion, sclerosis, narrowing, or other abnormality of a sacral foramen or the SI joints.

There is focal or diffuse abnormal mineralization of the lumbosacral spine.

There is distraction or focal widening of a disc space.

There is disc space narrowing with or without erosive or sclerotic changes of the end plates or subchondral bone other than from degenerative change.

There is anterior or posterior spondylolisthesis, subluxation, or rotational abnormality at a disc space.

There is widening, rotational abnormality, or displacement of facets at any motion segment.

There is facet joint narrowing or sclerosis other than from degenerative change.

There is narrowing or encroachment of a neural foramen other than from degenerative change.

There are degenerative changes present that might explain the patient’s symptoms.

There is abnormal bowel or bowel gas pattern.

There are gallstones, vascular, renal, pelvic, or other soft tissue calcifications present.

There is free intraperitoneal or retroperitoneal air or other abnormal air in the included chest, abdomen, or pelvis.

The included thoracic spine, ribs, and remainder of the bony pelvis are abnormal.

There is abnormality of the lower chest and/or diaphragm.

There is a foreign body or there are post surgical changes of the bones or soft tissues of the included lower thorax, abdomen, and pelvis.

There is an abnormality or complication of post surgical hardware/device.

There are support lines or tubes in an abnormal position.

There are other existing conditions that might be contributing to symptoms which can or should be further evaluated non-emergently.