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