Assessment requires a systematic approach. The lateral view is often the most informative image. The AP view of the cervical spine (i.e. 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. As technology advances, computed tomography (CT) has replaced this projection, yet there remain many institutions (especially in rural areas) where CT is not readily available. Cervical spine lateral view is a lateral projection of the cervical spine. 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. Citation, DOI, disclosures and article data. 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 topic describes cervical spine imaging in adults including the choice of modality, image-acquisition procedures, and diagnostic performance of the imaging examinations. 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. ap, lateral, flexion/extension views of cervical spine radiographic risk factors for neurologic involvement on lateral radiograph include canal diameter of < 13mm (normal is 17mm) Torg-Pavlov ratio (canal/vertebral body width) of < 0.8 (normal is 1. Bones - Cortical outline/Vertebral body heightĬlinical considerations are particularly important in the context of Cervical spine (C-spine) injury.Alignment - Anterior/Posterior/Spinolaminar.Look at all views available in a systematic manner.The most common routine cervical projections are the anteroposterior (AP), AP open mouth, and lateral. If youd like to comment on or contribute to this series, please e-mail. Clinical considerations are of particular importance when assessing appearances of C-spine X-rays This article is the 14th in our series of white papers on radiologic patient positioning techniques for x-ray examinations.
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