Radiographic evaluation of the pelvis and spine often starts with plain radiographs, most commonly ordered after a traumatic injury. Patients with non-traumatic back pain do not routinely need radiographs. Indications for plain films in these patients include age older than 55 years, or back pain lasting longer than 4 weeks. Thoracolumbar radiology is capable of diagnosing fractures of the vertebral bodies, such as burst or compression fractures, or transverse fractures due to distraction injuries. Ligamentous injuries can be identified by widening or rotation of the spinous processes, or by dislocation of one vertebral body relative to another. Osteomyelitis, tumors, and Paget disease may be diagnosed if thoracolumbar involvement is present. In the thoracolumbar spine, a burst fracture may be mistaken for a less serious compression fracture. Computed tomography (CT) of the abdomen and pelvis, performed on many trauma patients, may be more accurate in diagnosing injuries of the thoracolumbar spine.