C-spine - Straightened lordosis - Lateral

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C-spine - Straightened lordosis - Lateral

  • The cervical spine usually has a lordotic curvature (posterior concavity)
  • This lordosis may be lost when the neck is held by immobilisation devices - as in this image
  • Alignment of the anterior, posterior and spinolaminar lines can still be assessed despite loss of normal lordosis
  • Normal alignment of all three lines is demonstrated in this case

C-spine - Rotated open-mouth view

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C-spine - Rotated open-mouth view

  • Gaining a good 'open-mouth' view is often difficult in the context of trauma
  • In this image the distance between the peg and the lateral masses of C1 appears narrower on the right (A) compared with that on the left (B)
  • This is because the patient's head is slightly rotated
  • The alignment of the lateral masses of C1 and C2 can still be assessed

C-spine - External artifact

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C-spine - External artifact

  • External artifact often obscures important anatomical structures
  • Any image with artifact should be assessed thoroughly before repeat imaging is requested
  • Here there is external artifact which distracts the eye, but a fracture is still visible

C-spine - Calcified anterior ligament - Lateral

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C-spine - Calcified anterior ligament - Lateral

  • Calcification of the anterior ligament can have the appearance of small bone fragments
  • In the context of degenerative changes, such as this, an experienced eye is often required, and careful correlation with clinical features
  • A lower threshold for CT is often necessary for elderly patients with degenerative changes in the C-spine