What shielding considerations apply to cervical spine radiographs?

• A. Gonadal shielding is mandatory on all views
• B. Thyroid shielding must always be used
• C. Gonadal shielding when it does not obscure anatomy; optional thyroid shielding if it does not obscure; avoid shielding over odontoid view
• D. Shielding should be avoided entirely

Answer: (C)

Shielding should protect radiosensitive tissues without compromising the diagnostic quality of the image. Gonadal shielding is used when it will not obscure any anatomy necessary for the exam, so it is not mandatory on every cervical view if it would interfere with the projection or anatomy. Thyroid shielding can be used when it does not degrade the image, but you must avoid shielding over the odontoid (open-mouth) view because that projection requires a clear view of the dens and upper cervical vertebrae. This combination—shield gonads when possible, shield the thyroid if it won’t obscure the anatomy, and do not shield the odontoid projection—best balances protection with image clarity.