Lateral Cervical (Swimmers) is a radiography positioning projection of the Spine. Erect lateral, arm raised, CR to C7-T1. Twining method. The centering point is located c7-t1 intervertebral space with arm raised overhead.. The central ray is perpendicular to ir at c7-t1 junction.. Image-quality criteria include c7 and t1 clearly visualized without shoulder overlap., c7-t1 intervertebral disc space open.. Standard exposure ranges from 80 to 90 kVp, 25 to 40 mAs, at an SID of 40 inches (102 cm).
Anatomy demonstrated
- C7 (cervical vertebra prominens).
- T1 (first thoracic vertebra).
- C7-T1 intervertebral disc space.
- Cervicothoracic junction anatomy.
- Lower cervical spinous processes.
Patient preparation
- Verify patient identity using two identifiers.
- Remove neck jewelry, glasses, and hearing aids.
- Erect posture, lateral to IR.
- Raise one arm overhead and flex at elbow.
- Opposite arm down at side for balance.
Position & centering point
C7-T1 intervertebral space with arm raised overhead.
Central ray
Perpendicular to IR at C7-T1 junction.
Exposure / technique
- kVp
- 80–90
- mAs
- 25–40
- SID
- 40" (102 cm)
- Notes
- Arm raised overhead clears shoulder from C7-T1 region.
Image-quality criteria
- C7 and T1 clearly visualized without shoulder overlap.
- C7-T1 intervertebral disc space open.
- Cervical spine aligned with thoracic vertebrae.
- No rotation evident on vertebral alignment.
- Soft tissue of neck visible above shoulder.
Common errors / ARRT traps
- 1 Arm not raised enough leaves shoulder superimposed.
- 2 Patient rotation off true lateral shifts vertebral alignment.
- 3 Insufficient weight shift obscures C7 and T1.
- 4 CR centered too high misses C7-T1 interspace.
Clinical indications
- Evaluation of C7-T1 region not well seen on standard lateral.
- Suspected fracture or pathology of lower cervical-thoracic junction.
- Post-operative follow-up of cervical-thoracic fixation.
- Assessment of cervicothoracic spondylosis.
Aligned to the 2025 ARRT Content Specifications.