![]() ![]() Patient supine or on left lateral with one arm extended above head and one at side. Central Ray: perpendicular to film, through opened mouth.ĭOCTORS HOSPITAL OF NELSONVILLE Cervical SpineĢ. Patient supine or erect, adjust head so that upper occlusal plane is perpendicular to table, have patient open mouth.ĥ. ![]() Patient supine or erect with chin extended.Ģ. Move the patient and position the area of interest along the long axis of your collimated field, rather than rotating the collimator. Visualize how the image would look on a monitor. Symptomatic AAI, which affects 12 of individuals with DS, manifests with spinal cord compression. The condition is mostly asymptomatic and diagnosed on radiography by an enlarged anterior atlanto-odontoid distance. Center the x-ray beam directly over the area of interest. Atlantoaxial instability (AAI) affects 1020 of individuals with Down syndrome (DS). Rotate patient so that they are 45 degrees away form film for each side.Ģ. Take at least two views of each anatomic regionremember, you’re capturing a three-dimensional object. Patient sitting or standing with back against upright film holder.Ģ. A decision to pursue C-spine imaging of any kind should be cross-referenced with the Canadian C-Spine Rule for C-spine imaging due to its high sensitivity and specificity 4. Patient sitting or standing at upright film holder.ġ. Cervical spine radiographs are indicated for a variety of settings including 1-3: trauma. has cleared films and collar is removed do the following:Ģ. Central Ray: perpendicular to film, through opened mouth.Īfter E.R. Patient supine with collar ON, open mouth as wide as possible.Ĥ. Position the patient in lateral recumbency (Figure 3). Cervical spine swimmers lateral view is a modified lateral projection of the cervical spine to visualize the C7/T1 junction. Central Ray: center to neck with film 2" above EAM.Ģ. Sedation is highly recommended for these patients to avoid additional movement. Citation, DOI, disclosures and article data. *NO FLEXION AND EXTENSION ARE TO BE DONE UNLESS SPECIFICALLY ORDERED.Ĥ. Once cleared ER is to remove c-collar then do the following films: Trauma with collar do lateral, AP, and odontoid, either supine or if on backboard move patient to table on board and shoot through, then get cleared. Assessment requires a systematic approach.Radiographic Positioning: Radiographic Positioning of a Trauma C-spine The lateral view is often the most informative image. If the lateral view does not show the vertebrae down to T1 then a repeat view with the arms lowered or a ' Swimmer's view' may be required. In the context of trauma these images are all difficult to acquire because the patient may be in pain, confused, unconscious, or unable to cooperate due to the immobilisation devices. This article reviews the proper use of cervical spine radiographs in the trauma patient. The 3 standard views are - Lateral view - Anterior-Posterior (AP) view - and the Odontoid Peg view (or Open Mouth view). Imaging should not delay resuscitation.įurther imaging with CT or MRI (not discussed) is often appropriate in the context of a high risk injury, neurological deficit, limited clinical examination, or where there are unclear X-ray findings. This is because normal C-spine X-rays cannot exclude significant injury, and because a missed C-spine fracture can lead to death, or life long neurological deficit.Ĭlinico-radiological assessment of spinal injuries should be managed by experienced clinicians in accordance with local and national clinical guidelines. Bones - Cortical outline/Vertebral body heightĬlinical considerations are particularly important in the context of Cervical spine (C-spine) injury. Technical factors lateral projection centering point 2.Alignment - Anterior/Posterior/Spinolaminar.Look at all views available in a systematic manner.Clinical considerations are of particular importance when assessing appearances of C-spine X-rays More likely to avoid structures overlapping the odontoid than with the open mouth odontoid view.(This might mean laying down or standing up. An X-ray of your neck is a cervical spine X-ray. You might need a spine X-ray if you have neck or back pain. Normal C-spine X-rays do not exclude significant injury A spine X-ray uses radiation to take detailed pictures of your spinal bones. ![]()
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