![]() Are the pre-vertebral soft tissues normal (p. ![]() Are the three main contour lines/arcs normal (p. Are the other vertebrae (C3–C7) intact (p. Are the posterior arches of C1 and C2 intact?Ĩ. 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. UQ Radiology how to series: Spine: Cervical by Craig Hacking NRA Spine and pelvis by Tom Molyneux Normal Radiographs by Osamah A. 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. The soft tissues around the vertebrae look normal. No broken bones, dislocations, or foreign objects are present. Spinal X-ray Normal: The bones of the spine (vertebrae) are normal in number, size, shape, appearance, and how they are lined up. Assessment requires a systematic approach.1. It takes pictures of the 7 neck (cervical) bones. The lateral view is often the most informative image. ![]() If the lateral view does not show the vertebrae down to T1 then a repeat view with the arms lowered or a ' Swimmer's view' may be required. This online presentation reviews a variety of cervical spine entities, with case examples and illustrations to clarify concepts, and discusses differential considerations and potential diagnostic pitfalls. In the context of trauma these images are all difficult to acquire because the patient may be in pain, confused, unconscious, or unable to cooperate due to the immobilisation devices. example 1: sag bone and soft tissue, axial bone. example 4: pediatric (12 years old) example 5: including swimmer's view. The 3 standard views are - Lateral view - Anterior-Posterior (AP) view - and the Odontoid Peg view (or Open Mouth view). The normal spine is composed of 7 cervical vertebrae, 12 lumbar vertebrae, 5 lumbar vertebrae, 5 sacral vertebrae and 4 coccyx vertebrae. example 3: flexion and extension views only. Imaging should not delay resuscitation.įurther imaging with CT or MRI (not discussed) is often appropriate in the context of a high risk injury, neurological deficit, limited clinical examination, or where there are unclear X-ray findings. This is because normal C-spine X-rays cannot exclude significant injury, and because a missed C-spine fracture can lead to death, or life long neurological deficit.Ĭlinico-radiological assessment of spinal injuries should be managed by experienced clinicians in accordance with local and national clinical guidelines. 2 radiographs of the cervical spine (front and profile view) detail the cervical vertebrae: bony structures (vertebral body, uncus, transverse, spinous and.
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