![]() The AP view shows good alignment of the spinous processes and equal spacing. Note: The upper T-spine may not be visible on the lateral view - if injury is suspected here then a swimmer's view may be helpful - (see Cervical spine - Normal). The pre-vertebral soft tissue space is within normal limits. superiorly to include C2 and inferiorly to include T2. laterally to include the entire cervical spine. The oblique views allow assessment of the bony. adequate image penetration and image contrast is evident by clear visualization of thoracic vertebral bodies, with both trabecular. Failure to visualize the seventh cervical vertebra and the CT/TI junction is the most common error made in the radiographic assessment of cervical spine injury. the central ray is midline centered at the level of C4 to enter immediately below the hyoid bone. A five-view series consists of a lateral, AP, open mouth Peg view, right oblique, left oblique view. intervertebral joints are seen in profile. Images of the thoracic and lumbar spine are often large and the bones should be scrutinised in detail (see images below). The entire thoracic spine should be visible from T1 to T12: no patient rotation as evident by central spinous processes with sternoclavicular joints appearing equidistant. Thoracic spine - Standard viewsĪP and Lateral - Assess both views systematically (see box). The clinico-radiological assessment of suspected T-spine or L-spine injuries therefore depends on careful consideration of both the clinical and radiological findings. Clinical assessment is also often limited by distracting injuries or reduced consciousness. Good views of the T-spine and L-spine are difficult to achieve in the context of trauma. 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. Therefore, patients with suspected spinal injury should be managed by experienced clinicians in accordance with local and national clinical guidelines. Incorrect management of patients with spinal injury may cause or worsen neurological deficit. The plain X-ray anatomy and appearances of injuries to both these areas are discussed together. In the context of trauma similar principles apply to imaging both the Thoracic spine (T-spine) and the Lumbar spine (L-spine). Spacing - Discs/Spinous processes/Pedicles.Bones - Cortical outline/Vertebral body height.Thoracolumbar spine - Systematic approach If you see one fracture - check for another.If 'instability' is suspected then further imaging with CT should be considered.Correlate radiological findings with the clinical features.
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