Instability of the upper cervical spine in Down syndrome. The related article that I've included on this page is about cervical radiographic projections and Matt has created a series of great illustrations to accompany these, so I would certainly recommend checking them out if you are interested. The X-ray beam must be strictly perpendicular to the anatomical region to be examined. I particularly like the section where he points out the differences between the T1 transverse process and the C7 transverse process, and the idea of the articular pillar having a sinusoidal margin on the frontal projection, which becomes really handy to know later in this learning pathway when he discusses facet joint degeneration. The anatomy that Matt chooses to focus on is particularly useful from an interpretation perspective, like appreciating the normal anteroinferior margin of the vertebral body on the lateral projection and the normal airway outline on the AP projection. He assumes a basic level of existing anatomy knowledge, so I've created some additional annotated images for you to scroll through to supplement this. Matt begins his lecture by running through some normal cervical spine radiographic anatomy. Report problem MENU NEXT Audio transcript demonstrated the intervertebral foramina of the side positioned closer to the image receptor.demonstrates the intervertebral foramina of the side positioned further from the image receptor.also known as a 'peg' projection it demonstrates the C1 (atlas) and C2 (axis).anterior-posterior relationship of the vertebral bodies.soft tissue structures around the c spine.anteroposterior projection of the cervical spine demonstrating the vertebral bodies and intervertebral spaces.Note: in the absence of CT 5 views of the C-spine should be performed: AP, lateral, obliques and odontoid 5. IndicationsĬervical spine radiographs are indicated for a variety of settings including 1-3:Ī decision to pursue C-spine imaging of any kind should be cross-referenced with the 'Canadian C-Spine Rule' for C-spine imaging due to its high sensitivity and specificity 4. Surgical fusion may be required for residual instability of the joint.The cervical spine series is a set of radiographs taken to investigate the bony structures of the cervical spine, albeit commonly replaced by the CT, the cervical spine series is an essential trauma radiograph for all radiographers to understand. Early treatment is crucial to prevent long-term sequelae. Treatment includes anti-inflammatory medications and immobilization of the neck in addition to treatment of the offending infectious cause (if any) with appropriate antibiotics. In select cases, these children may require pre-operative imaging to assess the risk for complications after procedures such as adenoidectomy. Children with Down syndrome have inherently lax ligaments making them susceptible to this condition. Cervical radiculopathy can cause the following symptoms, which can radiate down from your neck to your shoulder, arms and/or hands: Numbness. Pathophysiology of this disease consists of relaxation of the transverse ligament of the atlanto-axial joint.ĭiagnosis can be established using plain film x-rays as well as CT scan of the neck/cervical spine. Healthcare providers use cervical epidural steroid injections to manage a type of chronic pain known as cervical radiculopathy, which is caused by spinal nerve root inflammation and irritation in your neck. Post-operative inflammation after certain procedures such as adenoidectomy can also lead to this condition in susceptible individuals such as those with Down syndrome. The condition often follows soft tissue inflammation in the neck such as in cases of upper respiratory tract infections, peritonsillar or retropharyngeal abscesses. In extreme cases, the condition can lead to quadriplegia and even death from acute respiratory failure. Progressive throat and neck pain and neck stiffness can be followed by neurologic symptoms such as pain or numbness radiating to arms ( radiculopathies). This is a rare disease that usually affects children. Grisel's syndrome is a non-traumatic subluxation of the atlanto-axial joint caused by inflammation of the adjacent tissues.