C-spine - Inadequate lateral

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C-spine - Inadequate lateral

  • To be considered adequate a lateral C-spine X-ray should include the skull base superiorly and the cervico-thoracic junction inferiorly
  • On this image the cervico-thoracic junction (C7/T1) is obscured by structures of the shoulder
  • Following full assessment of the image provided further imaging should be performed either by repeating the image with the shoulders lowered or by performing a 'swimmer's' view

C-spine - Swimmer's view

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C-spine - Swimmer's view

  • The swimmer's view allows assessment of the cervico-thoracic junction, which is normal in this case

C-spine - Inadequate lateral

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C-spine - Inadequate lateral

  • This lateral view does not show C7/T1. Further imaging is required

C-spine - Lateral with arms pulled downwards

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C-spine - Lateral with arms pulled downwards

  • (Same patient as image above)
  • A repeat image - with the shoulders lowered - demonstrates a significant injury not shown on the initial image above
  • This image shows loss of vertebral alignment, widening of the facet joints at C6/7 and subtle fractures
  • Post-traumatic imaging of the cervical spine should include adequate images of the cervico-thoracic junction, with CT if necessary