![]() Two or more lines of disruption indicate an unstable fracture One line of disruption indicates a stable fracture Minimal patient motion and sufficient contrast and density to show sharp, clear cortical margins and bony trabecular markings of the cervical vertebrae.Sufficient contrast and density to show the anterior soft tissue of the neck, including the airway.Shutter B: Open to show the soft tissue of the neck anteriorly, and the spinous processes of the cervical spine posteriorly.Shutter A: Open to show the EAMs superioly and the C7-T1 joint space and 1/3 of T1 inferiorly.Also the anterior soft tissue of the neck and airway are seen. All of the cervical vertebrae are shown, including spinous processes and the C7-T1 joint space and 1/3 of T1.No superimposition of the mandible over the cervical spine.The intervertebral disc spaces of the cervical spine are all open (see notes below).The posterior vertebral bodies are superimposed (see notes below).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 Traction on arms may be required to see T1.Only raise the chin slightly if the possibility of spinal injury has been ruled out, so that the mandible does not superimpose over the cervical spine.Position the interpupillary line so that it is perpendicular to the IR.If the patient is on a barouche, then this is easily achieved by moving the bed. Position the midsagittal plane so that it is parallel to the IR.Position the patient so that the bucky/IR is along one side (usually the left side is closest to the IR).Raise the chin slighlty, so that the mandible does not superimposed the cervical spine. ![]() Position the interpupillary line so that it is perpendicular to the IR (in an erect patient, this will also be parallel to the floor).Position the midsagittal plane so that it is parallel to the IR.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).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.Įnsure the removal of artefacts that may superimpose the anatomy of interest, such as earrings and other jewellery Gonadal (check your department's policy guidelines) For example, when the patient stands, C1 is usually more anterior than C7, so the collimation square may be tilted to match this slope.Īnterior to Cervical Spine clear of perivertebral soft tissues The collimation may be angled to match the slope of the neck. Shutter B: Open to include the soft tissue of the neck anteriorly Shutter A: Open to include the top of the ear superiorly 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 This larger distance helps overcome the OID (object to image receptor distance) to reduce magnification and improve the sharpness of the image. (CR and DR as recommended by manufacturer) The cervical spine from C1 down to the C7-T1 joint space and approximately one-third of T1 the first thoracic vertebraĭisruption to the 5 lines of stability, indicating possible fracture, arthritis
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