Swimmer’s view.pptx

Swimmer view of cervical

1. Swimmer’s view By: Tanish khandelwal

2. Introduction Cervical spine swimmers lateral view is a modified lateral projection of the cervical spine to visualize the C7/T1 junction. As technology advances, computed tomography has replaced this projection, yet there remain many institutions where computed tomography is not readily available. The swimmer’s view is an important view for evaluating the relationship of the cervicothoracic junction and upper thoracic vertebrae C7 through T3. Swimmer’s view x-ray is a difficult x-ray. Its positioning is difficult and requires high dosing. In the case of trauma patients, this x-ray becomes even more difficult.

3. INDICATIONS Trauma Infection Osteoporosis Degenerative changes Dizziness Fracture Vertigo

4. BASIC VIEWS This projection helps to visualize pathology relating to C3 – C7 in the anatomical position, demonstrating any compression fractures .

5. This projection helps to visualize pathology in the trauma setting . It helps to demonstrate any adjacent soft tissue structure, osteoarthritis and spondylosis .

6. SUPPLEMENTAL VIEWS Functional study to demonstrate vertebral mobility . Note : Never attempt these positions on a trauma patient until authorized by a physician .

7. ODONTOID VIEW The odontoid or ‘peg’ projection, also known as the open mouth AP projection . This view focuses on the odontoid process of C2, and is useful in visualizing odontoid fracture .

8. Additional projection (FUCHS VIEW) This view focuses primarily on the odontoid process, and is useful in visualizing odontoid fracture.

9. SWIMMER’S VIEW

10. INDICATIONS Pathology involving the inferior cervical spine, superior thoracic spine, and adjacent soft tissue structures. Various fractures and subluxation.

11. patient position The patient is supine or erect, depending on trauma or follow up   The detector is placed running parallel to the long axis of the cervical spine The arm closest to the detector is placed above the patient's head, resting on the head for support The opposite arm is placed by the patient's side, as posterior to the patient as possible (maintaining spinal precautions if they are in place) Image is taken on suspended expiration

12. Technical factors Centering point 2.5 cm above the jugular notch at the level of T1 Collimation superior to C1 inferior to T3 anterior to the extent of the vertebral bodies posterior to the spinous process Orientation    landscape Detector size 24 cm x 30 cm

13. CONT… Exposure 80-90 kVp 120-150 mAs SID 100 cm grid yes

14. structure seen Vertebrae C6 through T3 in lateral position without significant rotation. Bodies, disk spaces, spinous process, and zygapophyseal joints are demonstrated between shoulders. .

15. compensating filters This projection will be improved with the use of a compensating filter because of the extreme difference between the thin lower neck and the very thick upper thoracic region. With the use of specially designed filter, the C7- T1 are can be more clearly seen.

16. Respiration technique Suspend respiration on full expiration. If patient can cooperate and remain immoblized , a low mA and 3- or 4- second exposure time can be used , with patient breathing short, even breaths during the exposure to blur out overlying lung structures.

17. IMAGE TECHNICAL EVALUATION There should be a clear visualization of C7 to T1 The vertebral bodies are superimposed laterally Image quality will be increased if the bucky is used in preference to a stationary grid.