Neck Xray Flashcards
What does the trauma series of neck xray consist of of?
Lateral
AP
Open mouth (peg view)
Which view is this?
Which views this?
Which view is this?
How is the upper c spine evaluated on x-ray?
C1-C2
Predebtal space < 3mm adults
< 5mm in children
What is Harrison ring?
Super imposed over C 2 and should be complete
What is the basion-dental interval?
Distance between the tip of clivus (bastion) and tip of dense should be <12mm it’s used in the diagnosis of atlanto-occipital dissociation injuries.
What is an adequate c-spine film?
Cover from ocipito- cervical junction to the top of T1
What is the swimmers view?
Patients shoulders are pulled down to optimize image quality
How do you asses c spine alignment anterior vertebrae line
Its also called Georges. Line and connects the
anterior body of the vertebrae merging with the anterior surface of the odontoid peg.
What is the posterior vertebrae line I a c spine x-ray?
passes along the posterior wall of the vertebrae bodies, merging with the posterior surface of
the peg < than 12 mm from basion
Describe the spinolaminar line of Cervical spine.
line connects the base of the spinous processes. One should be able to trace these smooth ‘arcuate
lines’ without any steps or interruptions.
What is the significance of the lines?
One should be able to trace these smooth ‘arcuate
lines’ without any steps or interruptions. Any steps could
potentially indicate an underlying injury and the surrounding
structures should be studied closely for an associated fracture
or dislocated facet join
How are ligamentous injuries assesed?
injury is ligamentous, this may only be seen
on MRI.
How should the vertebral bodies be assessed on c spine xray?
Vertebral body heights
should be maintained both anteriorly and posteriorly
How is a c1 c2 subluxation excluded on xray?
odontoid peg needs to be closely applied to the anterior arch of C1, which appears as a small ovoid structure
What is the atlantodental interval?
The distance between the anterior aspect of the peg and the posterior aspect of
C1, i.e. the atlantodental interval (also referred to as the atlan-toaxial distance), should not exceed 3 mm in adults but can measure up to 5 mm in children
What is the Harris ring?
a dense ring projected over the base of the peg
and extending onto the body of C2,
What is the significance of the Harris line?
The inferior most aspect of this ring is allowed to be incomplete; however, the rest of the ring should be intact. Fractures through the base of the peg can be associated with a disruption in Harris’ ring (Figure 2).
Harris ring
Width of prevertebral tissue?
Should not exceed 7 mm at C1-4 and 22 mm at C5-7 approximated to 7 mm at C2 and 2 cm at C7
How can anterior dislocation be identified on c spine X-ray?
widening of the
interspinous distance by more than 50% in comparison with the
adjacent intervals, which could indicate an anterior dislocation.
Name the view and significance.
The open mouth AP view is also known as the peg view and is used for further assessment of the peg and atlanto-axial joint
(Figure 5
What phenomenon is depicted on the xray and its significance?
Mach lines or the Mach effect, which is the projection of black lines across the peg as a
result of superimposed soft tissues, mimicking fractures. Therefore care should be taken in analysing the peg view
What does this imaging show
show a significant
widening of the atlanto-axial interval on flexion, indicating instability
Which fracture is this
Burst fracture of C1 (Jefferson’s fracture). The distance between the peg and C1 lateral masses is widened and the lateral margins of the C1 and C2 vertebral bodies are no longer aligned
Assessment of upper c spine on peg view
Lateral aspects of the lateral masses should have <1-2mm malalignment
Atlant-dental spaces symmetrical
Spine lines
Hangman fracture
