Cervical - Lateral (Flexion)

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Cervical - Lateral (Hyper Flexion)
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	A functional study to demonstrate motion or lack of motion of cervical vertibra, done in conjunction with neutral and hyper extension view they demonstrate natural spinal curvature, range of spinal motion and ligament stability
Radiographic Anatomy	Cervical Spine Radiographic Anatomy
IR Size & Orientation	24cm x 30cm Portrait
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 20 mAs
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
Collimation	Centre: C4 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 Patient erect, The patient is side on to the bucky/IR (usually left side is closest to the IR, however if the patient has torticollis, a wry neck, then direct the central ray to the inner, concave side) Position the midsagittal plane so that it is parallel to the IR Chin should be depressed until it touches the chest or as much as the patient tolerates Where possible ask the patient to relax their shoulders 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