Closed mouth odontoid AP view (Fuchs view)

Case contributed by Dr Matt A. Morgan

Presentation

Chronic neck pain. Part of a three radiograph series including: frontal AP neutral chin view, lateral view, and this... the closed mouth odontoid AP view.

Patient Data

Age: 54Y
Gender: Male
Modality: X-ray

Normal C1-C2 AP view (Fuchs view).

The chin is tilted upward and a nonangled x-ray beam travels just below the mental protuberance (chin), centered on the odontoid process.

Standard Fuchs view

Modality: Diagram

Diagram of the standard Fuchs view.

Modified image from Gray's anatomy via Wikimedia Commons. The original images can be seen at

  • https://commons.wikimedia.org/wiki/File%3AGray188_no_text_bw.png
  • https://commons.wikimedia.org/wiki/Category:Gray%27s_Anatomy_plates#/media/File:Gray_111_-_Vertebral_column.png

Modifed Fuchs view

Modality: Diagram

Diagram of the modified Fuchs view. 

Modified image from Gray's anatomy via Wikimedia Commons. The original images can be seen at

  • https://commons.wikimedia.org/wiki/File%3AGray188_no_text_bw.png
  • https://commons.wikimedia.org/wiki/Category:Gray%27s_Anatomy_plates#/media/File:Gray_111_-_Vertebral_column.png

Case Discussion

The Fuchs view is an alternative way to image C1-C2 and the dens (odontoid process), instead of the much more common open mouth odontoid view.

The standard Fuchs view (diagram 1) should not be used in a trauma patient since one does not want to manipulate a potentially unstable cervical spine into position. In this situation a modified Fuchs view can be obtained (diagram 2). Instead of lifting the chin, the beam is angled ~35-40° upward and sent in just under the chin.

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Case Information

rID: 37348
Case created: 4th Jun 2015
Last edited: 29th Aug 2015
Inclusion in quiz mode: Excluded

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