Pediatric cervical spine (AP view)

The anteroposterior cervical spine view for pediatrics is one of two views in order to examine the cervical vertebrae.

Indications

This projection demonstrates the cervical spine in its natural anatomical position. It is useful in diagnosing fractures in pediatric patients.

Patient position

• the patient is erect with posterior aspect of the cervical spine in contact with the upright detector

• the chin should be raised with both shoulders in contact with the detector to avoid rotation

Technical factors

• anterior-posterior projection

• centering point

  • at the level of C4

  • 15° cranial angle

• collimation

  • laterally to include the entire cervical spine

  • superiorly to include C2

  • inferiorly to include T2

• orientation

  • portrait 

• detector size

  • 18 cm x 24 cm

• exposure ¹

  • 65-70 kVp

  • 2-5 mAs

• SID

  • 100 cm

• grid

  • no

Image technical evaluation

The spinous processes should be seen midline with open cervical intervertebral disk spaces ². A physical metal marker is ideal for pediatric imaging. 

Practical points

Preparing the room beforehand (setting up the detector, exposure and preparing lead gowns) is important as pediatric patients may not remain still.

Immobilization techniques

It is important for the radiograph to be free from motion artifact and rotation to avoid repeated x-rays.

• it may be necessary for the parent or radiographer to hold the patient in position

• ideally the parent should be in the child's direct line of sight

• techniques will vary based on the department

• distraction techniques can be utilized to avoid scattered radiation to parents and staff ³