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PostureRay Update – What’s New? Features and Change Log Update

What’s New in Version 26  November 2023 Update

Lateral Thoracic Computer Vision Now Available!

Video of all three Computer Vision Modules:

Lateral Lumbar Computer Vision

Video Tutorial:

What’s New in Version 26 of PostureRay?

PostureRay version 26 includes “Computer Vision Artificial Intelligence” for automated digitization of the lateral cervical, flexion and extension X-Rays along with neutral lateral Lumbar xray (Novemeber 2022). Please review the tutorial page for details. Always remember, as demonstrated in the tutorial videos and one to one trainings, you always as the doctor must always validated the digitization using computer vision no different then if you had another associated doctor manually mark the xrays. The computer vision only saves time, it is in no means a replacement for your clinical decision making and you the doctor must always validate all markings regardless if utilizing the computer vision modules or with associate doctors, when and iff you see any mis marked segments, it is your job to correct the anatomical location. Again this is not a replacement for clinical decision making. You must always validate the anatomical digitizations in all cases prior to making these part of your health care records for your patient.

Video Tutorial:

The computer vision module requires a valid technical support maintenance agreement and is only available in the CBP Technique version. Currently only the lateral cervical, lateral cervical flexion, lateral cervical extension, and neutral lateral lumbar (November 2022) xrays have computer vision option, but more x-rays to be added as research projects move forward. This computer vision artificial intelligence module interfaces with our proprietary patent pending cloud software when your x-rays are analyzed by our server, and as such, an internet connection is always required along with technical support maintenance. If a client cancels their technical support maintenance agreement, or it expires at any time, the customer will lose access to this module as well as PostureRay database online backups and the online browser based Virtual ViewBox. PostureRay can still be used in a manual mode like it always has prior to version 25 and version 26 without these value added features.

What’s New in Version 25 of PostureRay?

While under a technical support plan, in version 25, you will have ability now to view your x-rays online through any supported browser, making a ROF possible from nearly any computer! Additionally, while under technical support plan, we will securely back up your PostureRay images and database. Note access to both backups as well online viewbox is only available while under a technical support plan. NOTE: Virtual Viewbox only support CBP Technique versions at this time. If you decline technical support agreement, you will lose access to the virtual viewbox and features related to the cloud browser based module.

Video Tutorial:

What’s New in Version 24 of PostureRay?

DICOM X-Ray Receive
This new feature allows for x-rays to be pushed directly to PostureRay from compliant x-ray acquisition software or PACS software allowing the doctor to save time during import x-ray phase. After PostureRay learns how the images are named, it will automatically set up the patient case when x-rays are sent to PostureRay with the patient information from the x-ray software system as well as “pre-map” them to the correct x-ray assignment.  This is one of the most time consuming aspects of importing x-rays on earlier versions of PostureRay.

Video tutorial:

Added optional points for digitizing for stitching purposes

  • LCN:     added optional T2 to T10
  • LLN:      added optional T8 to T11

Added Stitching variables:

  • First step: controls to select which X-ray is behind and which is in front.
  • Thoracic Scoliosis with modified Fergusson non-scoliosis
  • AP Cervical with Thoracic Scoliosis with modified Fergusson non-scoliosis
  • APOM with Thoracic Scoliosis with modified Fergusson non-scoliosis
  • Thoracic Scoliosis with AP Lumbar
  • Lateral Cervical with Lateral Lumbar
  • Stitching Lateral sectionals: if concatenated comments exceed maximum length, truncate the Lat. Fullspine comment to fit.
  • Stitching with Lateral Lumbar ext./flex. problems fixed. This was sometimes interfering with the Lateral Lumbar Neutral.
  • Stitching with duplicate scoliosis start, apex or end vertebrae was causing multiple error messages.
  • On extremely narrow portrait monitors, the left part of the stitching dialog box wasn’t visible

DICOM listen: listen for DICOMs posted from a PACS system.
DICOM Image Processing:

  • The last Method B DICOM loaded in an Evaluation had problems saving touch-ups.
  • DICOM JPEG2000 header case with “E07F”, “1000” and OW instead of OB
  • Added apostrophe to DICOM search
  • Search DICOM: Patient Name and ID tags were much further in the DICOM header for a few DICOMs to be found.
  • Extract special characters like é, ç, ï from the DICOM header’s Patient Name and permit searching on these characters
  • DICOM JPEG2000 auto-invert from negative
  • Split Image button 2.5 times bigger to facilitate it’s use

Quick Draw:

  • Lateral Fullspine Quick Draw: results were 0mm and curve missing on reports and Viewbox.
  • AP Thoracic non QD mixed with AP Lumbar QD caused an error message “Apex must have a value. Reset to first entry. This message wouldn’t go away.
  • Changes to Lateral Cervical, Thoracic, Lumbar and Full calculations to skip all non-QD calculations.

Patient Comparative Report:

  • CBP LCN global % change (it was showing the first two segmental analysis values)
  • When LF or AP Full are very wide vs high, the assessment text was overwriting the X-rays at the top of the page.
  • added LF stitched

Impression Comparative Report:

  • Left Lateral Posture page wasn’t showing if all four postures were present
  • Right Lateral Posture images weren’t showing if the Back Posture wasn’t present.


  • When we have a scoliosis view, show checkbox to show/hide the centroids (blue Xs) on the Impression lines 
  • Added next to View button, Order Select and Compare radio buttons
  • Processing of comparisons with Postures and Marking views. Other views not available yet.
  • Hiding/showing of applicable checkboxes/radio buttons based on displayed view types

SQL Express 2017:

  • Installation of SQL Express 2017 with PostureRayNet
  • Upgrade and conversion of PostureRay from SQL Express 2012 to SQL Express 2017


  • Patient age: Instead of calculating the age with rounding up, for example age 17.6 is 18, we round down so age 17.6 would be 17.
  • Scoliosis Impression lines: made red actual line like the Patient line
  • LL ext/flex angle signs were absent.
  • AP Thoracic and AP Fullspine follow-up X-ray. If saved before finishing digitization, the apex list box button had apices side by side instead of a vertical list and there was an error about drawing actual lines after digitization. This released fixes the problem.
  • Patient Report: Lateral Fullspine line description had low back instead of Lateral Fullspine.
  • C0-C1 instability LC, LCE and LCF: calculation of line angle to horizontal difference replaced with law of sines calculation.
  • Optional setting to export Patient Name, Birth date and X-ray date on X-ray
  • Reports with optional separate files per view: have continuous page numbering within a report file:
    • Impression report
    • Instability report
    • Comparative impression report
    • Comparative instability report
  • Travel Sheet: in some cases 9 X-rays/page had overflowed text in the Results section.
  • PostureScreen push: initially in Evaluation form, female patients were appearing as male. This was just a setting issue because the data was good.
  • APOM bending C1-C2 overhang in Impression report summary table: cut-off is 3.0 rounded to one digit, degree changed to mm for < 3.0 mm
  • E.H.R. export form opened from View Evaluation form or Report form, the AP Full view wasn’t being shown in the list and so couldn’t be exported.
  • Modified Fergusson case when digitizing started at L4: the LD and Translation were appearing at the same location in the Viewbox overlay.
  • Evaluation change practitioner: added on View Evaluation form for admin user.
  • DMX form, step backwards one frame with note below the seconds radio button.
  • Save DMX Magnification setting between PostureRay sessions.
  • APOM neutral and bending C2 Axial Rotation direction added to calculations, reports and Viewbox.
  • Permit loading AP Full with other AP sectionals after the initial load of X-rays.
  • Annotations: show two decimal digits on measurements. For example 23.15mm.
  • Select X-rays for view form: Loaded checkbox is no longer displayed.
  • Patient report scoliosis notes: sectional name is mentioned only in the original sentence instead of also appearing before each vertebra in the paragraph.

What’s New in Version 23 of PostureRay?

  • Lateral Stitching:
    • Lateral Cervical + Lateral Thoracic + Lateral Lumbar
    • Lateral Thoracic + Lateral Lumbar
  • Anterior Stitching:
    • Anterior Cervical + Anterior Thoracic + Anterior Lumbar
    • Anterior Cervical + Anterior Thoracic + Modified Fergusson
    • APOM+ Anterior Thoracic + Anterior Lumbar
    • APOM + Anterior Thoracic + Modified Fergusson
    • Anterior Cervical + Anterior Lumbar
    • Anterior Cervical + Modified Fergusson
    • Anterior Thoracic + Anterior Lumbar
    • Anterior Thoracic + Modified Fergusson
  • Scoliosis Stitching:
    • Cervical Scoliosis+ Thoracic Scoliosis + Lumbar Scoliosis
    • Cervical Scoliosis + Thoracic Scoliosis + Modified Fergusson Scoliosis
    • Cervical Scoliosis + Lumbar Scoliosis
    • Cervical Scoliosis + Modified Fergusson Scoliosis
    • Thoracic Scoliosis + Lumbar Scoliosis
    • Thoracic Scoliosis + Modified Fergusson Scoliosis
  • Mixed Anterior/Scoliosis Stitching:
    • Anterior Cervical + Thoracic Scoliosis + Lumbar Scoliosis
    • Anterior Cervical + Thoracic Scoliosis + Modified Fergusson Scoliosis
    • APOM+ Thoracic Scoliosis + Lumbar Scoliosis
    • APOM + Thoracic Scoliosis + Modified Fergusson Scoliosis
    • Anterior Cervical + Lumbar Scoliosis
    • Anterior Cervical + Modified Fergusson Scoliosis
  • Stitching module is only currently available for the CBP technique Module
  • Currently you can not stitch a 2 view Lateral Cervico-Thoracic + Thoraco-Lumbar, but will be added in a future version.
  • Video link:

Multiple fixes and improvements:

Added S1 post-tangent option for line-drawing in System Setup form

Evaluation form:

  • Touch-up saving exception fixed
  • Touch-up button tool-tips hidden after leaving button
  • LCN SK default not checked in setup form will leave SK unchecked initially.
  • AP Thoracic and Fullspine: apex list box: made background red when no apices so that new users will notice it more.
  • L6 checked and S1 digitization started. Display message: “L6 has been added for digitization. However, S1 has been digitized. Please make sure that S1 markers aren’t on the L6 vertebra.”
  • Scoliosis pane: more messages to help user
  • Lateral Fullspine digitization: SK may be checked only if C1 is checked.
  • Gender label in the Client Pane was black instead of blue.
  • Some views such as AP Cervical apex wasn’t being changed.

Patient Report: for Lateral fullspine with the three lateral sectionals present, if from stitching, still show the Lateral Fullspine page
Impression report:

  • For AP Full non-scoliosis with four curves or more: the assessment was overflowing the bottom of the assessment text box.
  • Lateral Lumbar new table layout for assessment.
  • If Lateral Fullspine is stitched and we have the Lateral Sectionals, show a separate Lateral Fullspine page with the three tables.
  • added an option for Lateral Full line-drawing

Instability Lumbar Report: assessment introduction typos fixed
Patient Comparative Report:

  • AP Full non-scoliosis different apices: the two side-by-side tables were sometimes over-written at the bottom by the global table.
  • Assessment text fixed for better fitting of 2 and 3 curve assessments.
  • Cover page now has Evaluation and X-ray dates for Initial and Follow-up studies.

Impression comparative Report: 
– Lateral Lumbar to Lateral Fullspine: If one was L5-S1 and the other was L5-L6 and L6-S1, there was a problem in the instability summary table.
Travel Sheet:

  • Text for AP Full: fixed text for apex 5 and 6.
  • Don’t exceed the 25 lines of text with wrap-around
  • : last name quirk fixed

AP Fullspine: made normal line end at level of top vertebra
Patient Report template form: if the user checks “Page Number” or “Page Header” and the “Page Frame” isn’t checked, display a warning.
DMX form: If DMX folder wasn’t drilled down to the level of the DMX file and the DMX File did drill down, an exception was produced. This has been fixed.
LC Fullspine: If C7 not present, don’t try to calculate the C2-C7 posterior tangent angle
Export Evaluation Image form: First Name label in the selection tab was black instead of blue
LC ext/flex/-Tz/+Tz: C0-C1 Chamberlain to APL direction calculated and sign of the result now reflects the direction

CLEAR method:
– QD added for Nasium, AP Thoracic and AP Lumbar
– QD added for LCN, AP Cervical, AP Thoracic and AP Lumbar
– For LCN, there was a QD under another name: When all vertebrae was unchecked (initially) only the S-Line markers were digitized. QD checkbox replaced.
– For AP Lumbar initially FH only was checked. This has been removed and when QD checked, we digitized the two vertical markers and two FH markers.

What’s New in Version 22 of PostureRay?

  • New CBP Lateral Lumbar Predicted normal based on Pelvic Incidence 
  • NEW Report Branding – Change colors of reports and edit logo position
  • New Normal Line thickness Change Selector
  • New option to allow reports to flip x-rays back to Chiropractic View (Left on your reading Left)
  • New Annotation Tools Added: Line Bisection, Draw angle and distance to horizontal or Vertical
  • AP and Lateral Fullspine x-rays are maximized now much and much larger in Patient and Impression Reports for better viewing when printed.
  • Fixes to Digitization Auto-scrolling.
  • ViewBox resizing is now available
  • Warnings if Duplicate name exists in database, to avoid staff from creating multiple accounts for the same patient
  • Optional Digitization Cursor
  • Multiple new additional references to Impression report for better documentation
  • On AP Fullspine, C2-C7 are now optional
  • Ap Fullspine – added HB angle
  • X-Rays Maximized in patient ROF report for AP and Lateral Fullspine
  • Added endplate AMA guides lines and highlighting to Lateral Thoracic analysis
  • Highlighting of lateral lumbar sacral base if S1 to Horizontal < 33 or >= 45 degrees
  • CBP Ideal Values now listed in the View Results Screen in Parenthesis in evaluation form
  • Multiple bug fixes and enhancements to user interface

New CBP Lateral Lumbar Predicted normal based on Pelvic Incidence
Video link:


New Branding Color Controls for Reports
Video link:

New Normal Line thickness Change Selector & Alternate Cursor
Video Link:

AP and Lateral Fullspine x-rays are maximized
Video link:

What’s New in Version 21 of PostureRay?

  • X-ray and Posture Annotation tool -long awaited, add notes as well as unique measurements on top of x-rays that is outside of the normal digitization EHR functions.
  • Custom Patient Report Template – Custom PDFs in your PostureRay Reports
  • AP Fullspine and Fullspine Scoliosis
  • Modified Ferguson Short Leg view Scoliosis Analysis – Finally we know you all wanted this!
  • Ability in scoliosis views to select superior or inferior portion of vertebrae for Cobb analysis
  • “Image Jumping – automatic image scrolling” to location when digitizing under magnification to save time!
  • Reporting of AP Cervical from AP Fullspine: if more than one apex in C2-T9 region, the apex with the biggest Translation from T9 is selected
  • Reporting of Sectional Scoliosis from Fullspine scoliosis: the curves having the larges Risser-Fergusson values are selected
  • Increased vertebrae digitizing levels on multiple views
  • Atlas and Genesis EHR integration updated
  • Lateral sectional and Fullspine – New CBP measurement S1centroid offset to hip axis
  • quicker method to jump into new examination when entering new client demographics.

Image Jump Image Scrolling to Location when digitizing under magnification
Video link:

Annotation Module for marking additional information on x-ray images
video link:

AP FullSpine Analysis
Video link:

Custom PDF Report Builder
Now you can insert any PDF documents and customize your PostureRay Report documents!
video link:

Whats new in Mid 2015 Release of PostureRay Version 20

  • PostureScreen direct importing from iOS device (iPad/iPhone/iPod Touch)
  • All 4 views in PostureScreen available on ViewBox and Reports
  • CBP Cervical Morphology is available on lateral fullspines if no lateral cervical is digitized
  • Macro support for the “Notes” tab
  • PostureScreen push to PostureRay will setup PostureRay account if client doesn’t exist in PostureRay
  • PostureScreen import from iPad will append posture views to existing x-ray exam for same date
  • Postures viewed in Viewbox can be selected as individual so as to pair with an x-ray
  • Genesis EHR (Billing Precision / Vericle) direct upload exporting annotated images
  • Improved DICOM image support
  • DICOM mapping one image to several xrays (AP Fullspine to multiple AP sectionals)
  • Improved date narrowing for ranges of evaluations and importing x-rays
  • Set date range to current week (or any time period) for quick look up of evaluations
  • DMX import image rotation for using DMX for Correction Potential X-rays
  • INSTABILITY UPDATE – Ability to use percentage of translational movement vs mm of translations for instability reporting on cervical and lumbar flexion and extension studies
  • Numerous Bug and Stability Fixes

Some Video Highlights are as follows: 

PostureScreen Importing
Video Link:

PostureScreen 4 Views in ViewBox and Reports, Comments & Impression Macros
video link:

Genesis EHR Integration 
Video Link:

DICOM mapping one image to several xrays (AP Fullspine to multiple AP sectionals)
Video link:

INSTABILITY UPDATE: Ability to use percentage of translational movement vs mm of translations for instability reporting on cervical and lumbar flexion and extension studies
video link:

This is What’s New in the mid 2014 Release update of PostureRay Version 19

  • Cervical Morphology Measurements for CBP Technique 
  • Added Anterior and Posterior Cervical Translation stress views
  • Sagittal Vertical Axis (SVA) for lateral fullspine view C1-S1, C7-S1, T1-S1
  • Fixed lateral fullspine normal model at C7/T1 junction (smoothed curve transition)
  • View Box options: Show lateral fullspine SVA, Show lateral cervical, thoracic and lumbar vertical axis, New text overlay for all segmental values, Numbering of vertebrae, Quickly toggle on and off Cobb and Risser Ferguson Scoliosis Views, Toggle between Patient lines, Impression Lines and Endplate analysis where applicable
  • Moved Zoom/Contrast buttons down to not accidentally open up when setting lateral cervical x-ray
  • Zoom ‘bug’ fixed when zoomed in if you erase a digitized point, you are no longer zoomed out.
  • Added ability to search and create cases easier
  • Multiple other tweaks and bug fixes


All New ViewBox



Fall 2013 Release!

We have a lot of new and exciting features with the Fall 2013 PostureRay Release. 
Below we highlight some of the many new upgraded features that we know you will love.

There are certain times where time is of the essence.  When you wish to do a partial ROF or show the patient immediately where their spine is compared to normal.  Now using just 2-3 clicks, the Harrison Idealspinal model can be superimposed properly over the patient’s film without digitizing all the segments.  This is helpful in cases where you must work on an acute case, but wish to educate them briefly on their abnormalities.  This allows you to even show them on the view box, as well as generate educational reports (however only translational global measurements will be given).
video link:

This feature is extremely helpful when a patient had many x-rays on file or for specific stress/correction potential x-rays, labeling the individual x-rays for both viewing in the view box as well during the x-ray exporting as a .jpg so that if you import into another EHR, the x-rays are labeled and at a glance you know specifics such as heel lift size used, or Denneroll size, or functional mirror image order of a scoliosis setup, or label it based on injury or phase of care, etc.

​video link:


This new feature has been requested for utilization to more easily convey sagital balance points.  These vertical axis lines are based on the Harrison Ideal Spine Elliptical model.
video link:

ALL NEW REPORT COVER PAGES – This update was needed to address that in certain states, certain insurance companies require specific labeling on their x-ray reports.
video link:

video link:

NASIUM CENTER SKULL LINE UPDATE – ability to manually over ride traditional bisection of skull and force ending point through the Dens.  Video link:

This was a popular request in that many office get side tracked midway through loading films, and they ‘forget’ what films they had already loaded for a particular study.  So now these are listed for you when you come back to a case, and the films to choose from will be deleted as they are utilized.
video link:

video link:



 Version 18

You can see this tutorial online through youtube at:

To be eligible  for this update, you only need to be active on your technical support agreement which is attached as a PDF to this support FAQ document.

Exciting NEW Features:

  1. Nasium upper cervical Analysis
  2. Ability to import and comment on other xray views which are not digitized and even AP and Lateral postures!
  3. Label exams so you now can tell which exams you need to compare quickly and easily
  4. View box can now include uploaded PostureScreen photos
  5. Patient reports can now include postural photos from PostureScreen Mobile
  6. Digitzation helper lines, for better reliability when a doctor is digitizating, acting as a straight edge ruler (lateral views)
  7. Ability to perform various comparative reports, such as Denneroll stress views, Heel lift stress views, folow up xrays, post exam reports – the introduction paragraphs are now specific to the type of examination you are generating report on.
  8. Reports have an all new and more professional look!
  9. Ability to import logos to impression reports as well as the patient reports.
  10. Expanded impression report documentation area for up to 10, 000 characters!
  11. Radiographic “Summary” documentation reporting options – a clinical correlation report can now use Phrase Builder to quickly document the proper supporting documentation.