Smooth and continuous and that C2 does not appear "fat" (i.e. Make sure the basion-dens space is Make sure the atlantodens interval (ADI or pre-dental space) is Check that the intervertebral spaces are uniform at each level.Surface of the occipital and sphenoid bones) Clivus should be pointing toward the odontoid (the clivus lies at the base of the skull is made from the.Inspect each vertebral body, pedicle, lamina and spinous process from C1 - C7 Check the posterior vertebral line (posterior longitudinal ligament line).Check the anterior vertebral line (anterior longitudinal ligament line).Evaluate the orientation of the epiglottis, hyoid bone, tracheal shadow and check for any foreign bodies.Vertebral body) and < 22 mm in front of C6 (or no more than width of C6 Tissue is < 7 mm in thickness in front of C2 (or < 50% of the width of C2 Make sure you can see all 7 cervical spinous process.The clinician should establish a process or order they follow each time. To the tip of the dens (or odontoid process). The dorsal surface of the clivus and is used to measure the distance of space This is a line drawn from the caudal extension of The tip of the dens should lie less than 4.5 cm above this line. Draw a line from the posterior edge of the hard palate to the caudal end of the occipital curve. Opisthion (posterior aspect of the foramen magnum) cannot be identified on a
To recognize the presence of basilar invagination (a craniocervical junctionĪbnormality where the tip of the dens project up into the foramen magnum). If the tip of the dens extends > 3 mm above this line then it helps.
The odontoid tip extends above this line. Posterior surface of the hard palate to the tip of the opisthion (posteriorĪspect of the foramen magnum) and is used to measure the distance of how much (normal CT values for men is > 23.7 mm and for women is > 24.2 mm) can be used instead. Tip of the dens is eroded then the Redlund-Johnell and modified Ranawat methods The dens (or odontoid process) should be ~5 mm below this line. Lateral radiograph of the skull or on a sagittal cut from a CT or MRI scan thatĬonnects the posterior and anterior aspects of the foramen magnum. The Radiologist will usually comment on the alignment of the vertebrae and the presence or absence of any ‘wear and tear’ changes, usually related to normal aging and known as degenerative changes or osteoarthritis.Note: Scroll over or tap on the image to see labels & lines Sometimes, a Radiologist may also be requested to interpret the images.Ĭ-Spine X-Rays taken in the non-urgent setting are reported by a Radiologist, and the report is usually sent to the doctor who ordered the test. In cases of trauma, the cervical spine x-ray is usually interpreted immediately by an emergency doctor such as an Emergency Physician, an Orthopaedic Surgeon, or a General Surgeon involved in the care of the patient. A spinal x-ray can reveal things such as spinal fractures, disk problems, infections, tumors, abnormal curvature of the spine, Scoliosis, arthritis and pretty much anything that may be impacting the spine negatively, including congenital issues that a person may be born with.