2. INTRODUCTION
Cervical spine swimmers lateral view is a modified lateral projection
of the cervical spine to visualize the C7/T1 junction.
As technology advances, computed tomography has replaced this
projection, yet there remain many institutions where computed
tomography is not readily available.
The swimmer’s view is an important view for evaluating the
relationship of the cervicothoracic junction and upper thoracic
vertebrae C7 throughT3.
Swimmer’s view x-ray is a difficult x-ray. Its positioning is difficult and
requires high dosing. In the case of trauma patients, this x-ray
becomes even more difficult.
4. BASICVIEWS
This projection
helps to visualize
pathology relating
to C3 – C7 in the
anatomical
position,
demonstrating any
compression
fractures .
5. This projection helps to
visualize pathology in
the trauma setting .
It helps to demonstrate
any adjacent soft
tissue structure,
osteoarthritis and
spondylosis.
8. ODONTOIDVIEW
The odontoid or ‘peg’
projection, also known
as the open mouth AP
projection .
This view focuses on
the odontoid process of
C2, and is useful in
visualizing odontoid
fracture.
12. INDICATIONS
Pathology involving the inferior cervical spine, superior thoracic spine, and adjacent soft
tissue structures.
Various fractures and subluxation.
13. PATIENT POSITION
The patient is supine or erect, depending on trauma or follow up
The detector is placed running parallel to the long axis of the cervical
spine
The arm closest to the detector is placed above the patient's head,
resting on the head for support
The opposite arm is placed by the patient's side, as posterior to the
patient as possible (maintaining spinal precautions if they are in
place)
Image is taken on suspended expiration
14. TECHNICAL FACTORS
• Centering point
• 2.5 cm above the jugular notch at the level of T1
• Collimation
• superior to C1
• inferior to T3
• anterior to the extent of the vertebral bodies
• posterior to the spinous process
• Orientation
• landscape
• Detector size
• 24 cm x 30 cm
16. STRUCTURE SEEN
Vertebrae C6 throughT3 in lateral position
without significant rotation. Bodies, disk
spaces, spinous process, and zygapophyseal
joints are demonstrated between shoulders.
.
17.
18. COMPENSATING FILTERS
This projection will be improved with the use of a
compensating filter because of the extreme
difference between the thin lower neck and the
very thick upper thoracic region.
With the use of specially designed filter, the C7-
T1 are can be more clearly seen.
19. RESPIRATIONTECHNIQUE
Suspend respiration on full expiration.
If patient can cooperate and remain
immoblized, a low mA and 3- or 4- second
exposure time can be used , with patient
breathing short, even breaths during the
exposure to blur out overlying lung structures.
20. IMAGETECHNICAL EVALUATION
•There should be a clear visualization of C7 to T1
•The vertebral bodies are superimposed laterally
•Image quality will be increased if the bucky is
used in preference to a stationary grid.