The patient’s shoulders are lowered – this may be accomplished by asking a person accompanying the patient to pull the patient’s arms downwards. The patient’s head is supported by a pad and kept in a position that is least painful for the patient. Position of part Remove necklaces, hair grips, and anything else from the hair. If there is suspicion of neck injury or fracture, the head should not be lifted onto a pad without a doctor’s permission. A supporting sponge or pad may be placed under the head provided there is no trauma to the neck. This view is used in patients who cannot sit due to injuries. The arms are by the side of the body and the shoulders are flat on the table. Purpose and Structures Shown An additional lateral projection of the cervical spine for patients with injuries. There should be no rotation of the head and neck. The entire dens should be clearly demonstrated in the foramen magnum along with the anterior and posterior atlas arches. The patient is asked to suspend respiration when the exposure is taken. Position of part The gonads are shielded. The neck is extended and the tip of the chin rests on the table. The patient’s elbows are flexed and the arms are placed in a comfortable position with the shoulders in the same horizontal plane. The midsagittal plane of the body is centered and perpendicular to the grid. This position is NOT to be attempted in patients with suspected or known fractures or degenerative disease of the upper cervical spine. Purpose and Structures Shown An additional view to demonstrate the dens and atlas through the foramen magnum. The mandible, cranium, and vertebrae should be symmetric. The dens should be clearly demonstrated in the foramen magnum. The neck is extended until the tips of the chin and mastoid process are oriented vertically. A support may be placed under the knees for comfort. The patient’s arms are placed by the side of the body and the shoulders are flat on the table. ![]() This position is NOT to be attempted in patients with fracture or degenerative disease of the upper cervical spine. Purpose and Structures Shown An additional view to demonstrate the dens in the foramen magnum. The patient should be asked to stop breathing when the exposure is taken. Purpose and Structures Shown An additional view of the cervical spine for patients with injuries. Video Credit : Jocelyn Caldwell Cervical Spine AP Supine The patient should be turned to the other side for the other oblique view and the process repeated. The patient should be positioned so that he or she is at a 45-degree angle to the cassette holder. Purpose and Structures Shown An additional view of the cervical spine. Video Credit : CentralazRAD Cervical Spine Oblique In uninjured patients, a 1 kg (2 lb) weight should be placed in each hand. The arms should be by the sides and the shoulders should be as low as possible. The patient should be positioned with the shoulder against the cassette holder. The knob at the back of the head should be at the same level as the lower jaw (chin). The patient should be asked to place the chin against the cassette holder. ![]() Purpose and Structures Shown A basic view of the cervical spine. The density should be appropriate with soft tissues and bony structures well visualized. Radiologists consider a cervical spine X-ray to be of good quality when the lateral view shows all 7 cervical vertebrae plus the C7-T1 junction.
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