![]() A lot of chiropractors we work with use a wedge filter that attaches to the head of the x-ray machine. Physically changing the amount of material the -rays pass through by using a wedge filter.You could also just use the lateral T-spine technique programmed into your machine (if you have that). and then maybe doubling the mAs on top of that if you still need to see more. From what I see in your image, I would start with increasing kVp by 10. But the more you go up, the more you will burn out the upper c-spine, so you’ll need to find a balance with not over penetrating the upper c-spine but yet still penetrating enough to see the lower. The image you attached shows very limited penetration through the shoulders, so increasing your x-ray will help solve this. Increase your kVp by 10 and/or double your mAs.So, there are a couple of techniques/methods you can try to resolve this, but nothing is perfect. Obviously from a physical standpoint, the shoulders are 4-5x thicker than the neck, and you are using the same amount of x-ray to image both in that shot. That seems to be the million-dollar question. ![]() , RSNA and ACR are not responsible for the content contained on the web pages found at these links.How can I see the entire lateral c-spine on my x-rays?!? Outside links: For the convenience of our users, provides links to relevant websites. Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the Radiological Society of North America (RSNA) and the American College of Radiology (ACR), comprising physicians with expertise in several radiologic areas. Discuss the fees associated with your prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a better understanding of the possible charges you will incur. The costs for specific medical imaging tests, treatments and procedures may vary by geographic region. This website does not provide cost information. To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database. Please contact your physician with specific medical questions or for a referral to a radiologist or other physician. This information originally appeared in the Journal of the American College of Radiology. By Susan Anemone and Bruno Policeni, MD, MBA. If x-rays show hardening of the connecting fibers of the neck vertebrae, CT without contrast is usually appropriate CT myelography or MRI without contrast may be appropriate. CT without contrast or CT myelography may be appropriate. If x-rays show degenerative changes, MRI without contrast is usually appropriate. In chronic neck pain, x-rays are usually appropriate as initial imaging. With headaches originating in the c-spine without weakened nerve function, MRI or CT without contrast may be appropriate, as well as x-rays or nerve block injection. In individuals with cancerous tumors, MRI without and with or only without contrast is usually appropriate x-rays, CT with or without contrast, MRI with contrast, or bone scan or CT may also be appropriate. If infection is suspected, MRI without and with contrast is usually appropriate x-rays, CT, or MRI with or without contrast may be appropriate. If there is history of prior c-spine surgery, x-rays or CT without contrast is usually appropriate MRI with or without contrast (or both) or CT myelography (contrast injection in space around spinal cord) may be appropriate. In cases with spinal nerve irritation (pinched nerve), MRI without contrast is usually appropriate, and x-rays or CT without contrast may be appropriate. In individuals with new or increasing nontraumatic neck pain (no high-risk factors), x-rays are usually appropriate as first imaging test MRI or CT without contrast may be appropriate. Appropriate cervical spine (c-spine) imaging and use of intravenous contrast (venous dye) for neck pain varies depending on clinical scenario.
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