Is Harris’ ring 7 normal? A break in either the anterior or posterior margin of the ring indicates the high probability of a fracture of the Peg/body of C2 (p. Is the line of the posterior cortex of the Peg continuous with the posterior cortex of the body of C2? Any displacement or break indicates a Peg fracture.Ħ. Is the line of the anterior cortex of the Peg continuous with the anterior cortex of the body of C2? Any displacement implies a Peg fracture or fracture of C2 body.ĥ. Is the anterior cortex of the odontoid peg (the Peg) closely apposed to the “coffee bean”?Ĥ. Have I identified the anterior arch of the C1 vertebra (the “coffee bean”)?ģ. Is the radiograph technically adequate? Ensure that the C1–C2 articulation and the superior surface of the T1 vertebra are clearly seen.Ģ. Lying down method is done in cases of injury or patients who cannot stand.1. The first method is done routinely on ambulatory patients in the outpatient department. Special view radiographs may be required in many cases for proper diagnosis of the disease.Ĭervical spine x-ray can be taken in standing position or lying down on the table. Though both the views are important, the lateral view is more informative. Most common of these causes a change in curvature is cervical spondylosis.įor examination of the cervical spine, both anteroposterior and lateral views are required. In diseases or spasm of the cervical spine, this lordosis of the normal cervical spine is lost. The spinous processes are in a straight line and spaced approximately evenly. The lateral edges of the cervical spine are aligned.Ĭheck for bony integrity to rule out fractures The AP view should cover the whole cervical spine and the upper thoracic spine. That means the anterior part of the spine appears convex and posterior concave. The view in the present picture is lateral view.Īs you can view it, normal cervical spine appears lordotic. The present x-ray shows vertebra from C1 to C7. This x-ray shows a normal cervical spine. – The normal prevertebral soft tissue is narrow down to C4 and wider below The width is measured between the anterior line and anterior margin of soft tissue visible on the x-ray. Some fractures cause widening of the prevertebral soft tissue due to the prevertebral hematoma. These spaces should be approximately equal in height increase as we come lower down. The vertebral bodies are spaced apart by the intervertebral discs – not directly visible with X-rays. Otherwise, a swimmer’s view may be acquired.Īnterior line or the line of the anterior longitudinal ligament, the posterior line the line of the posterior longitudinal ligament formed by connecting posterior margins of cervical vertebrae] and the spinolaminar line or the line formed by the anterior edge of the spinous processes are checked for continuity.Ĭortical outline of all the bones should be checked for fractures. If T1 is not visible then a repeat image with the patient’s shoulders lowered. A normal cervical spine x-ray – Lateral ViewĪll vertebrae are visible should be visible from skull base to the top of T1 is considered adequate. Prevertebral shadow is studied for any increase in width. Disc spaces are looked for any reduction of space. Vertebrae are studied for smooth cortical outline and height. Normal cervical spine x-ray would reveal a smooth lordotic curve and any loss of lordosis indicates spasm. Next, alignment of the vertebrae is looked for. In a lateral view first thing to look for is if the cervical spine is adequately covered in the view. The lateral view is often the most informative image. It must be noted that normal cervical spine x-rays do not exclude significant injury. Seventh cervical vertebra or C7 is also called vertebra prominens. The spine begins with C1 vertebra which is also called Atlas. It is formed by first 7 vertebrae of the spine numbered from C1 to C7. The cervical spine is the part of the spine that is present in the neck region. Last Updated on JNormal Cervical Spine X-ray A normal cervical spine x-ray – Lateral View.
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