Question

Case Study #1 The Patient in Trauma (C-Spine) Description >> Your patient is a 25 year old man who was injured while diving into a shallow swimming pool. He is very muscular and stocky. He is supine on a stretcher and sandbags are placed on the sides of his head. The doctor has ordered a cervical spine examination. With the patient in the supine position, you have taken a lateral image of the cervical spine using a horizontal central ray. This radiograph demonstrated five cervical vertebrae, C1 through C5. The radiographer with whom you are working has stated that the only way to demonstrate the last two vertebrae is to pull the patients shoulders down. He quickly puts on a lead apron and gloves and announces that he is "just going to yank his shoulders down a bit." You do not feel comfortable with his announcement. What do you do? Identify the following: Goal: Observation Options and consequences Selection of the best option: Options and consequences: Option 1 You might suggest the shoulders be pulled down as slowly abd gently as possible. Option 2 Suggest placing a sheet or strap under patient heels. Ask the patient to hold the ends of the sheet and slowly work his hands down the sheets as far as they can go. If the patient experiences pain, tell him to stop Option 3 Take another radiograph of the patient's lower cervical region using the "swimmers" technique.

Answer 1

Goal - To get the radiographic image of last two vertebrae C6 and C7.

Observation - On observation with the patient in supine position using a central horizontal ray we are getting the radiographic image of lateral 5 cervical spine.

Best options :-

Option 3 - Take another radiograph of the patient's lower cervical region using the 'swimmers 'technique

Cervical spine swimmer's lateral view is a modified lateral projection of the cervical spine to visualize the C7/T1 junction. It is most often performed in the setting of trauma, where a standard lateral projection cannot image the cervicothoracic junction.