4/1/2024 0 Comments Cervical spine x rayThe image is distorted, but does provide valuable visualisation of the cervical facet joints and intervertebral foramen The X-ray tube is angled 45 degrees as shown This technique is a non-grid technique in which the X-ray cassette is placed on the table top. This page considers two approaches to the problem and a useful positioning aid. Whilst this is a relatively easy examination in an ambulant non-trauma patient, a special approach is required in a trauma patient who cannot be moved. The oblique projection of the cervical spine is either a routine view or a supplementary view in many Emergency Departments. Some of the intervertebral foramina are visible but are obscured to varying degrees. The beam collimation is arguably too generous. Note that the intervertebral foramina are partially "closed", particularly at the lower cervical level. Also, the patient's head is not in the lateral position causing the mandible to be superimposed over C1/C2. The patient is under-rotated (too PAish). 70 - 75 kVp, short exposure time to minimise movement unsharpness.What exposure technique should be employed? 15 degrees caudal for PA technique and 15 degrees cephalic for AP technique.Note that the cervical spine is not in the 'centre of the neck' in the lateral projection- it is a posterior neck structure.Cone to include all of the cervical spine anatomy and the centre point will look after itself.your choice- consider which technique is easier and safer for the patient.aim to include all of the cervical spine anatomy.45 degrees with the patient's head in the lateral position.always do both obliques- left and right (either AP or PA).Image prior to horizontal flipping (note the positioning is PA oblique and the side marker is PA) The PA technique tends to be the most confusing because the image is flipped horizontally for viewingįor the left oblique the patient is positioned like this. labelling has an English spelling with 2 "L"s and an American spelling with one "L" The convention also has utility for the radiographer in terms of avoiding mislabelling through consistency and clarity of thinking.Ī further more general convention is to present the image in the anatomical position- AP oblique not PA oblique If an oblique cervical spine image has a left side marker, the left intervertebral foramina are demonstrated (see left) This convention is a simple aid to the radiologist. The cervical spine images on this page all have the side marker on the side of the intervertebral foramen demonstrated. Some centres will prefer the side marker to also refer to the intervertebral foramina demonstrated. The images need to be flipped horizontally to be viewed in the anatomical position. The PA obliques have the marker placed PA on the IR on the side touching the IR. Given that they are taken AP, they do not need to be flipped horizontally to be viewed The AP obliques have marker placement on the side away from the IR. Oblique cervical spine views can be performed erect or supine and AP or PA.Įssentials of Skeletal RadiologyTerry Yochum and Lindsay Rowe3rd Edition, Volume 1 Osteophyte impingement of intervertebral foramen arrowed Patient with severe degenerative disease. The cervical nerve roots can be seen in this model exiting through the intervertebral foramina Oblique radiographs of the cervical spine are necessary if the condition is to be confirmed radiologically. This is a common cause of brachialgia in middle age. The presence of osteo-arthritis in the unco-vertebral articulations of the lower cervical spine frequently produces pressure on the nerve-roots lying in the intervertebral foramina. The oblique view shows the intervertebral foramina formed by the inferior notch of the pedicle of the vertebrae above and the superior notch of the pedicle of the vertebrae below. This can be caused by pressure on the nerves which exit the cervical spine through the intervertebral foramina. The oblique view of the cervical spine can be important in patients with pain and/or altered sensation in their upper limbs. This page is dedicated to answering some of these questions
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |