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

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.

Diagram

Standard Fuchs view

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
Diagram

Modifed Fuchs view

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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