If a cross-table lateral projection of the cervical spine does not demonstrate the C7-T1 interspace, which adjustment should be performed?

If a cross-table lateral projection of the cervical spine does not demonstrate the C7-T1 interspace, which adjustment should be performed?

• A. Increase tube angle
• B. Extend the neck
• C. Swimmer's position
• D. Add a soft tissue lateral view

Answer: (C)

The main idea here is to clear the shoulders from the lower cervical region so the C7–T1 interspace can be seen on a lateral view. The swimmer’s position achieves this by moving the shoulder girdle away from the spine: have the patient raise the arm on the side toward the image receptor above the head while the opposite arm rests down at the side. This positioning widens the distance between the shoulders and the cervical spine, reducing superimposition over C7–T1 and allowing the interspace to be visualized more clearly. The technique is typically performed with the patient in a true lateral, and the CR aimed at the C7–T1 level. Other adjustments don’t specifically address why the lower cervical interspace is obscured. Simply changing tube angle doesn’t reliably separate the shoulders; extending the neck may alter anatomy but won’t effectively clear the shoulder girdle; and a soft tissue lateral view doesn’t provide the bone detail needed for C7–T1 visualization. Swimmer’s position directly targets the cause of the issue.

The main idea here is to clear the shoulders from the lower cervical region so the C7–T1 interspace can be seen on a lateral view. The swimmer’s position achieves this by moving the shoulder girdle away from the spine: have the patient raise the arm on the side toward the image receptor above the head while the opposite arm rests down at the side. This positioning widens the distance between the shoulders and the cervical spine, reducing superimposition over C7–T1 and allowing the interspace to be visualized more clearly. The technique is typically performed with the patient in a true lateral, and the CR aimed at the C7–T1 level.

Other adjustments don’t specifically address why the lower cervical interspace is obscured. Simply changing tube angle doesn’t reliably separate the shoulders; extending the neck may alter anatomy but won’t effectively clear the shoulder girdle; and a soft tissue lateral view doesn’t provide the bone detail needed for C7–T1 visualization. Swimmer’s position directly targets the cause of the issue.