This allows for discrepancies in the tilt of the head (flexion/extension of the cervical spine). To achieve the best angle, the central ray should be directed at an angle that parallels the plane of the mandible and then directed to just below the hyoid bone. An excessive or insufficient angle can distort these disc spaces. To project the intervertebral disc spaces open, the central ray should be directed perpendicular to the long axis of the vertebral column 3, 4. This angle can and will vary between 5-20° depending on the position of the head. For this reason, a cephalic angle is required to project through the long axis of the vertebral column. Correcting tube angle errors and head tilt errorsĪ lordotic curvature exists in the cervical spine. The spinous process will rotate toward the pedicle of the side farther from the image receptor 3. The spinous process should be midline of the vertebral body, equidistant from both pedicles 3. Any deviation from the midline indicates rotation is present. Rotation can be detected by looking at the spinous processes in relation to the pedicles. make sure that any removable artifacts such as earrings, glasses or metal dentures are removed to avoid obscuring the anatomy of interest.spinous processes should be midline, equidistant to the pedicles, indicating that there is no rotation.cervical spine intervertebral disk spaces should be open 2.The utility of such tests, however, remains to be determined. AAI is primarily caused by laxity of the transverse atlantal ligament. The joint is supported by a transverse ligament, which keeps the odontoid process close to the anterior arch of the atlas, and a pair of alar ligaments. superiorly to include C2 and inferiorly to include T2 Flexion and extension radiographs are often used in the setting of trauma to clear a cervical spine injury. It allows 50 of the normal rotation in the cervical spine, but only 10° of both flexion and extension.laterally to include the entire cervical spine.the central ray is midline centered at the level of C4 to enter immediately below the hyoid bone. This allows for a better idea of how the spine looks in a functional position. FE X-rays are taken with the patient bedning forward or extending backward as far as possible while in the standing position. chin should be raised to align the lower margin of the upper incisors to the mastoid tips/base of the skull (unless trauma when the patient is placed in a cervical collar) In this study, researchers reviewed the use of flexion-extension (F/E) X-rays for patients with LBP.patient shoulders should be at equal distances from the image receptor to avoid rotation.patient positioned erect in AP position (unless trauma when the patient will be supine).This projection helps to visualize pathology relating to C3-C7 in the anatomical position, demonstrating any compression fractures, clay-shoveler fractures and herniated nucleus pulposus (HNP) 1.
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