What routine radiographs can we do for cervical spine?
- AP open mouth
- AP lower cervical spine
- Lateral
Less commonly: oblique
What does the AP open mouth positioning best demonstrate?
The AA joint
What will we find with the AP open mouth image?
- Dens is superimposed on anterior and posterior arches of C1
- arch borders image as lines so distinguish from fractures
What does AP lower cervical spine demonstrate best?
- demonstrates lower cervical vertebrae, upper thoracic, associated ribs and clavicles
What will we see on an AP Lower cervical spine image?
- vertically aligned vertebral bodies
- midline spinous processes
- lateral column: overlapping articular pillars and Z jts., one smooth bony column lateral to the bodies
What other structures can we see on a AP lower cervical spine image aside from the lower cervical spine?
- TPs difficult to discern
- U joints
- Air filled trachea
- Clavicles
What does a lateral image best demonstrate?
- alignment of all cervical vertebra
What is the normal alignment of the vertebral in a lateral image?
3 ~ parallel lines
What are the 3 parallel lines in the vertebra in a lateral image?
- anterior vertebral borders
- posterior vertebral borders
- spinolaminar line
What is the spinolaminar line?
- spinous process and laminae junction
- represents posterior extent of central spinal canal
What should the 3 parallel lines do?
Remain constant whether neck is in neutral, flexed, or extended aka stress views when investigating mechanical instability
What is lateral the BEST view for?
- view of disc spaces
- view for z joint spaces
What are the vertebral bodies looking like in a lateral image?
boxed with smooth edges
Why can you not really see the TPs in a lateral image?
Superimposed over bodies
What is the space between anterior dens and atlas indicating?
The distance kept by the transverse ligament
How much of the distance should be kept by the transverse ligament in adults? How much is a concern?
2.5mm for adults; ≥ 3.5 is a concern for instability
How much of the distance should be kept by the transverse ligament in children?
4.5mm
What can too much distance indicate?
Transverse ligament may be damaged
What is oblique the best view for?
single side intervertebral foramen
What is the standard imaging in the ER following head and neck trauma?
CT - picks up more fractures
What are routine radiographs for the shoulder?
- AP in external rotation
- AP in internal roatation
What is AP in External rotation a profile of?
Greater tubercle and glenohumeral joint space
What is AP in internal rotation a profile of?
lesser tubercle
What is the scapular Y lateral view most frequently used for?
- assessment of fractures or dislocations. of the proximal humerus
