For a lateral cervical spine radiograph, what is the correct technique?

• A. Head rotated 15 degrees toward affected side
• B. CR angled 5 degrees cephalad
• C. CR perpendicular to C4, centered at midline; include occiput to T1
• D. Shoulders placed in contact with chin

Answer: (C)

A true lateral projection of the cervical spine is obtained when the beam is perpendicular to the midline at the level of C4 and the field includes from the occiput through T1. The head should be in a neutral position and the shoulders depressed to move them away from the spine for a clear view of the lower cervical vertebrae. No rotation or angulation of the central ray is used in this view, because any rotation or tilt would distort the foramina and alignment and obscure pathology. Depressing the shoulders rather than letting them rise or contact the chin keeps the lower cervical spine free of superimposition and ensures the entire region is visualized.