The cervicothoracic junction and/or the thoracolumbar 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 right or left paravertebral line is widened.

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 exaggeration, reversal, or straightening of the normal kyphosis or there is scoliosis of the thoracic spine.

There are more or less than the expected 12 rib-bearing vertebral bodies.

There are cervical ribs at the cervicothoracic junction, or hypoplastic or rudimentary ribs at the thoracolumbar junction.

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

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

There is an endplate avulsion, compression, or other fracture.

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

There is a lytic, sclerotic, or blastic lesion or erosion of a pedicle or other posterior element.

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

There is focal or diffuse abnormal mineralization of the thoracic 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, lateral, 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 abnormality of the soft tissues and bones of the included neck other than from degenerative change.

There is abnormality of the soft tissues and included bones of the upper extremities, clavicles, and sternum other than from degenerative change.

There is abnormality of the included lungs, mediastinum other than the previously evaluated paravertebral soft tissues, trachea and more distal airways, diaphragm, stomach, bowel, or bowel gas pattern.

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

There are vascular calcifications or other soft tissue calcifications present.

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

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.