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Cervical Spine - Lateral
|Adult|| Other related pages of interest|
|Name of projection||Cervical Spine - Lateral supine or erect|
|Area Covered||The cervical spine from C1 down to the C7-T1 joint space and approximately one-third of T1 the first thoracic vertebra|
|Pathology shown||Disruption to the 5 lines of stability, indicating possible fracture, arthritis|
|Radiographic Anatomy||Cervical Spine Radiographic Anatomy|
|IR Size & Orientation||24cm X 30cm |
|Film / Screen Combination|| Regular|
(CR and DR as recommended by manufacturer)
|Bucky / Grid||Moving or Stationary Grid|
|Filter||Can be used when using film|
|Exposure||70 kVp |
|FFD / SID|| 180 cm|
This larger distance helps overcome the OID (object to image receptor distance) to reduce magnification and improve the sharpness of the image.
|Central Ray||Directed to the level of C4|
Perpendicular to the IR
If the patient has torticollis, a wry neck, then direct the central ray to the inner, concave side to use the diverging rays to help penetrate the intervertebral joint spaces
Shutter A: Open to include the top of the ear superiorly
Shutter B: Open to include the soft tissue of the neck anteriorly
The collimation may be angled to match the slope of the neck. For example, when the patient stands, C1 is usually more anterior than C7, so the collimation square may be tilted to match this slope.
|Markers|| Anterior to Cervical Spine clear of perivertebral soft tissues|
Marker orientation AP
|Shielding||Gonadal (check your department's policy guidelines)|
|Respiration||Suspended respiration on expiration.|
The shoulders are able to relax downwards on expiration which will maximise the chances of being able to visualise the C7-T1 junction on the image.
|Positioning|| Ensure the removal of artefacts that may superimpose the anatomy of interest, such as earrings and other jewellery |
If the patient is erect,
| Critique || Positioning|
|Special Notes||The 5 lines of stability|
1. Prevertebral (anterior) soft tissue
2. Anterior vertebral bodies
3. Posterior vertebral bodies
4. Spino-lamina line
5. Tips of spinous processes
One line of disruption indicates a stable fracture
Two or more lines of disruption indicate an unstable fracture
Determining the direction of rotation
The posterior vertebral bodies should be superimposed. If this is not the case, to determine the direction of rotation first identify which posterior vertebral body is magnified. This is the side that is furthest from the IR. You can then use this information to correct the positioning.
For example, assume the patient is positioned so that the left side is closest to the IR/bucky and the posterior vertebral bodies are not superimposed. The left margin of the posterior vertebral body is sharper and less magnified, as it is closer to the IR. The right margin is further away and posterior. Therefore, correct the patient's position, bring the right side of the patient forward until the midsagittal plane is parallel to the IR/bucky.
Intervertebral disc spaces
Providing there is no pathology, with good positioning, the intervertebral disc spaces should be
Latest page update: made by AndyC
, Jun 4 2011, 10:59 PM EDT
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|Started By||Thread Subject||Replies||Last Post|
|PeterGleeson||Collimate to exclude the thyroid||0||Oct 15 2014, 11:20 PM EDT by PeterGleeson|
Thread started: Oct 15 2014, 11:20 PM EDT Watch
There is no valid reason to irradiate the thyroid. Just before exposure, lean the patient forward so the collimation is 2cm inside the skin edge.
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