![]() ![]() We recommend the routine use of a five-view cervical spine series with the inclusion of 30-degree supine oblique views in the evaluation of acute cervical spine injury. The supine oblique view may detect fractures or ligamentous injury not identifiable on the standard three-view examination. Five patients had abnormalities confined to the supine oblique view, and the remaining three had subtle abnormalities on the cross-table lateral view. the central ray is midline centered at the level of C4 to enter immediately below the hyoid bone. These included six fractures and two ligamentous injuries. The emergency department of a university-affiliated hospital with Level I trauma center status.Įighty-three consecutive patients with documented cervical spine injury evaluated during a 20-month period.Įight patients demonstrated abnormality to best advantage on the supine oblique view. the patient is supine or erect, depending on trauma or follow up the detector is placed portrait, running parallel to the long axis of the cervical spine on the patients left the side inform the patient that the image will be taken on suspended expiration Technical factors. The rib series is often considered to be an unnecessary, unjustified projection in many radiology departments. Patients were included in the study if the initial interpretation of the three-view series was normal and the abnormal supine oblique view enabled a correct diagnosis to be established. CERVICAL SPINE WITH OBLIQUES (NON-TRAUMA) ROUTINE POSITIONS: AP. The AP oblique view specifically focuses on the axillary ribs. In a follow-up radiograph, coning down to the scaphoid is favored. Radiographs of patients with documented cervical spine injury were reviewed retrospectively by three neuroradiologists. As scaphoid fractures are associated with FOOSH injuries, it is desirable in the acute setting to collimate to include the wrist in the oblique view, covering all areas around the scaphoid that could be the source of pain. I think they are really helpful.To determine whether the addition of the supine oblique view of the cervical spine can detect fractures or ligamentous injury not seen on the standard three-view examination. So if you ask the MRI facility that you normally use or you have one yourself, I would really suggest distinguishing yourself from the rest of the units in your area by supplying oblique MRI views of the cervical spine. Patient rotated 45° to place spinal column directly over midline of x ray table. This projection shows an anterior and posterior oblique patient position. ![]() I think this is a much better representation of the size and how much this disc extrusion occupies the foraminal canal than a standard axial view. Exposure Criteria: Optimal density and contrast clearly demonstrate zygapophyseal joint from L1 to L5. And if we take a look at the obliques of the foraminal canal, this is given a much larger appearance of the disc extrusion, and where we’re going to see it located is right there. Now look at how much larger this appears here at the 5/6th level with the oblique views. Let’s just take a look and see what happens when we take a look at an oblique picture. So I don’t think this is such a great revelation in terms of what’s happening in the Foraminal Canal. The radiologists have better equipment and magnification and resolution than I do on this reader, but I have probably the typical kind of reader that most of you all might have as well. And if you keep going again, everything sort of disappears. Oblique imaging demonstrating foraminal stenosis at left C5/6 and right C4/5 levels (white arrows), and evidence of. Ahmad authored for AuntMinnie between 20. Download scientific diagram Oblique radiographs of the cervical spine. The manual spans 152 pages and features 16 articles that Dr. Naveed Ahmad, the founder of radiology education website. ![]() We can see it’s again smaller, but not really that big. Welcome to s X-Ray Patient Positioning Manual, a compendium of articles on radiographic patient positioning by Dr. We take a look at the axial slice, and we don’t really get a great sense of how big it is here. However, if you go to the sides, for example, we can see this protrusion here. Well, it’s got a little bit of protrusion and maybe a little indentation of the myelin, but nothing to write home about. In this case, we have a definite protrusion at cervical 5/6, and we can see it’s here, but we don’t really get a true sense of dimension using the the axial slices. One of the challenges when looking at cervical MRIs is really getting a proper look at the foraminal canals, particularly at the cervical levels 3/4 4/5 5/6, and even 6/7. ![]()
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