![]() If the base of skull is superimposed over the upper aspect of the dens, the head needs to be hyperflexed or in the case of trauma, the central ray should be angled caudally. If teeth are superimposed over the upper aspect of the dens, the head needs to be hyperextended or in the case of trauma, the central ray should be angled cephalic. Three views (AP, lateral, focused lateral lumbosacral) will cover most causes of lumbar pain. Some providers prefer longer and narrow films that include more of the lumbar spine, while others may want smaller films. Positional errors Teeth superimposing the dens The region included will depend on the film size and centering used by the radiographer. make sure that any removable artifacts such as earrings, glasses or metal dentures are removed to avoid obscuring the anatomy of interest.the zygapophyseal joint space between C1 and C2 is symmetrical. ![]() the dens is free from superimposition of the adjacent atlas lateral masses or other tissues 2.superior-inferior to include the upper incisors and lower incisors.angle accordingly see 'patient positioning'.the central ray is centered at the center of the open mouth.do not move the head in trauma, angle the central accordingly.the head should be positioned so the lower margin of the upper incisors and the base of the skull are perpendicular to the image receptor.at the last instant, the patient is instructed to open their mouth as wide as possible.patient’s shoulders should be at equal distances from the image receptor to avoid rotation, the head facing straight forward.patient positioned erect in AP position unless trauma the patient will be supine.This view focuses primarily on the odontoid process of C2, and is useful in visualizing odontoid and Jefferson fractures.
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