#X RAY CERVICAL SPINE AP LATERAL FULL#

Always gauge the vertical heights of the vertebral bodies and the intervertebral disc spaces. An unrecognized and displaced fracture has the potential to cause a serious cord injury. For example, if the C7 vertebra is not included on the lateral cervical spine radiograph, a fracture of C7 might go unrecognized.

This is especially important in trauma situations as a fracture could be lurking in nonvisualized areas of the spine, and the result could be catastrophic. Things you must see include all seven cervical vertebrae, the entire C7 and T1 intervertebral disc space, and, ideally, the T1 vertebral body. Make note of the normal lines that should be intact on this view ( Fig. 6.1B). A patient in a hard cervical collar also has a straightened curvature. When the patient has pain, straightening of the spine may occur secondary to muscle spasm. This can lead to serious consequences! On the lateral radiograph, the normal cervical curve should be mildly convex anteriorly (lordotic). It is not uncommon to stop looking once one abnormality is found. If it does, put that aside and force yourself to look at the entire study. Glance at the entire image to see whether something obvious jumps out at you. Start with the lateral radiograph ( Fig. 6.1A) as it is the most important cervical spine radiograph. You will eventually develop your own system, but the following one will work until you do ( Table 6.3). In addition, some patients may not be able to have an MRI because the strong magnetic field may disrupt a pacemaker or displace an aneurysm clip, or the patient may not tolerate the relatively confined space.Īs previously emphasized in other anatomic regions, a systematic approach for evaluating the spine is needed. However, MRI costs approximately twice as much as CT imaging ( Table 6.2). MRI is also used when a spine fracture is present and an associated cord injury is suspected. MRI is very good for imaging soft tissues and the bone marrow and allows a wonderful view of the spinal cord and the intervertebral discs. CT is also useful in screening for disc disease and degenerative disease but has largely been replaced by MRI for this purpose.

#X RAY CERVICAL SPINE AP LATERAL FULL#

Full series are useful during follow-up of cervical spine injuries, so a thorough understanding of the radiographs remains important. Lateral radiographs are used to assess for instability with flexion–extension views. CT is helpful for localizing the exact position of vertebral fracture fragments, particularly important when the fracture fragments are displaced into the spinal canal. CT is excellent for bone detail and is useful for diagnosing fractures not visible on plain radiographs as well as better defining the extent of injury. For this reason, CT is obtained following myelography to better delineate the contrast distribution in the dural sac and visualize the intervertebral discs. One significant shortcoming of myelography is its inability to demonstrate lateral disc herniations and lateral stenosis. CT delineates anatomy and pathology more clearly than does myelography. These images may be supplemented with oblique and coned-down views to better visualize an area, and occasionally lateral flexion and extension views are requested to document spine motion and stability.Ĭomputed tomography (CT) and magnetic resonance imaging (MRI) are extremely useful noninvasive diagnostic tools in visualizing the spine, and their use is increasing while use of the invasive myelogram is decreasing. Following a thorough history and physical examination, routine anteroposterior (AP) and lateral radiographs often are the first radiologic consultation to be requested to evaluate the symptomatic region of the spine. When patients do seek medical care for back pain, radiologic imaging often becomes an important diagnostic tool. Occupation-related back injuries are common, and other common etiologies of back pain are listed in Table 6.1. Most people recover from their back pain with little or no medical care. The pelvis articulates with the sacrum on each side, supports many soft tissue structures, articulates with the femurs, and is the proximal attachment for many muscles involved in locomotion.īack pain is a problem for the majority of our patients at some time in their lives. The spine consists of cervical, thoracic, lumbar, and sacral divisions composed of bones, joints, ligaments, muscular attachments, and nerves.

It is the main structural support for the body and, as a result, is subjected to many stresses. It consists of the skull (which is covered separately), the spine, and the pelvis. The axial skeleton is the next focus for our consideration. Ankylosing Spondylitis, Psoriasis, and Reiter’s Disease

X ray cervical spine ap lateral