Cervical - Cervicothoracic (Swimmers) (Twining Method)This is a featured page

Radiographic Positioning


Adult
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Name of projection Cervical - Cervicothoracic (Swimmers) (Twining Method)
Area Covered Lower cervical and upper thoracic (C4 - T3 region) - vertebral bodies, intervertebral disk spaces and zygapophyseal joints
Pathology shownPayhology involving the inferior cervical spine, superior thoracic spine and adjacent soft tissue structures
Radiographic AnatomyCervical Spine Radiographic Anatomy
IR Size & Orientation 24 x 30cm
Portrait
Film / Screen Combination Regular
(CR and DR as recommended by manufacturer)
Bucky / Grid Moving or Stationary Grid
FilterNo
Exposure 80 kVp
60 mAs
FFD / SID 150 - 180 cm
Central Ray CR perpendicular to IR
CR centred to T1 - approximately 2.5cm above sternal notch
Collimation Four sides of close collimation to area of interest approximately 10 x 15cm in size
Markers Anterior to Cervical Spine clear of perivertebral soft tissues
Marker orientation AP
Shielding Gonadal (check your department's policy guidelines)
RespirationSuspended respiration on expiration - the shoulders are able to relax downwards on expiration
PositioningEnsure the removal of artefacts that may superimpose the anatomy of interest, such as necklaces and other jewellery

If the patient is erect,
  • The patient is erect and side on to the vertical bucky / IR
  • Position the midsagittal plane so that it is parallel to the IR
  • Place patients arm and shoulder closest to IR up, flexing elbow and resting forearm on head for support
  • Position arm and shoulder away from IR down and slightly anterior to place humeral head anterior to vertebrae
  • Maintain thorax and head in as true lateral position as possible

If the patient is supine,
  • The patient is supine on the table side on to the vertical bucky / IR
  • Position the midsagittal plane so that it is parallel to the IR
  • Place patients arm and shoulder closest to IR up, flexing elbow and resting forearm on head for support
  • Position arm and shoulder away from IR down and slightly anterior to place humeral head anterior to vertebrae
  • Maintain thorax and head in as true lateral position as possible
Where possible ask the patient to relax their shoulder down and move their finger tips in the direction of their toes on expiration, so that as you expose you have the best chance of penetrating the lower cervical spine area
Critique

Positioning
Area Covered
Collimation
Exposure
Special Notes



AndyC
AndyC 		Latest page update: made by AndyC , Jun 4 2011, 2:38 AM EDT (about this update About This Update AndyC Edited by AndyC

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