Cervical - Cervicothoracic (Swimmers) (Twining Method)

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Cervical - Cervicothoracic (Swimmers) (Twining Method)
Area Covered	Lower cervical and upper thoracic (C4 - T3 region) - vertebral bodies, intervertebral disk spaces and zygapophyseal joints
Pathology shown	Payhology involving the inferior cervical spine, superior thoracic spine and adjacent soft tissue structures
Radiographic Anatomy	Cervical Spine Radiographic Anatomy
IR Size & Orientation	24 x 30cm Portrait
Film / Screen Combination	Regular (CR and DR as recommended by manufacturer)
Bucky / Grid	Moving or Stationary Grid
Filter	No
Exposure	80 kVp 60 mAs
FFD / SID	150 - 180 cm
Central Ray	CR perpendicular to IR CR centred to T1 - approximately 2.5cm above sternal notch
Collimation	Four sides of close collimation to area of interest approximately 10 x 15cm in size
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
Positioning	Ensure the removal of artefacts that may superimpose the anatomy of interest, such as necklaces and other jewellery If the patient is erect, The patient is erect and side on to the vertical bucky / IR Position the midsagittal plane so that it is parallel to the IR Place patients arm and shoulder closest to IR up, flexing elbow and resting forearm on head for support Position arm and shoulder away from IR down and slightly anterior to place humeral head anterior to vertebrae Maintain thorax and head in as true lateral position as possible If the patient is supine, The patient is supine on the table side on to the vertical bucky / IR Position the midsagittal plane so that it is parallel to the IR Place patients arm and shoulder closest to IR up, flexing elbow and resting forearm on head for support Position arm and shoulder away from IR down and slightly anterior to place humeral head anterior to vertebrae Maintain thorax and head in as true lateral position as possible Where possible ask the patient to relax their shoulder down and move their finger tips in the direction of their toes on expiration, so that as you expose you have the best chance of penetrating the lower cervical spine area
Critique PACEMAN	Positioning Area Covered Collimation Exposure
Special Notes