Pediatric cervical spine (lateral view)

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

Indications

This projection demonstrates the cervical spine orthogonal to the AP cervical spine view. It is useful in diagnosing fractures in pediatric patients.

Patient position

• the patient is erect with the left shoulder in contact with the upright detector

• shoulders should be relaxed to ensure visualization of C7

Technical factors

• lateral projection

• centering point

  • at the level of C4

• collimation

  • anteroposteriorly to include soft tissue

  • superiorly to include C1

  • inferiorly to include T1

• orientation

  • portrait 

• detector size

  • 18 cm x 24 cm

• exposure ¹

  • 65-75 kVp

  • 2.5-10 mAs

• SID

  • 100 cm

• grid

  • no

Image technical evaluation

Clear visualization of C1 to T1 with vertebral bodies superimposed laterally 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