Which radiographic projection is best for determining Meyerding grade?

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Meyerding grade measures how far the upper vertebra has slipped forward over the one below in the sagittal plane, so the projection that best shows this anterior displacement is the lateral radiograph of the lumbar spine. On the side view you can clearly gauge how much slip there is and express it as a percentage of the lower vertebral body’s width to assign the grade. Other projections don’t show this forward slip as clearly: AP views look at the spine from the front and can obscure the sagittal relationship, oblique views focus on the pars interarticularis rather than the overall displacement, and flexion-extension views demonstrate movement over time rather than the static grade.