Lateral Cervical

Spine positioning

Lateral Cervical is a radiography positioning projection of the Spine. Erect lateral, CR perpendicular to C4, 72" SID. Standard survey. The centering point is located c4 vertebra, at level of thyroid cartilage.. The central ray is perpendicular to ir at c4.. Image-quality criteria include all seven cervical vertebrae (c1-c7) visualized., intervertebral disc spaces open symmetrically.. Standard exposure ranges from 75 to 85 kVp, 10 to 20 mAs, at an SID of 72 inches (180 cm).

Anatomy demonstrated

  • All cervical vertebrae C1-C7.
  • Intervertebral disc spaces.
  • Spinous processes in profile.
  • Cervical vertebral bodies.
  • Cervical lordotic curve.

Patient preparation

  • Verify patient identity using two identifiers.
  • Remove neck jewelry, glasses, and hearing aids.
  • Erect posture with shoulders relaxed downward.
  • Lateral to IR with arms at sides.
  • Head in neutral alignment, eyes forward.

Position & centering point

C4 vertebra, at level of thyroid cartilage.

Central ray

Perpendicular to IR at C4.

Exposure / technique

kVp
75–85
mAs
10–20
SID
72" (180 cm)
Notes
Upright erect technique. SID 72 inches standard.

Image-quality criteria

  • All seven cervical vertebrae (C1-C7) visualized.
  • Intervertebral disc spaces open symmetrically.
  • Spinous processes aligned vertically without offset.
  • Cervical lordosis demonstrated.
  • Soft tissue outline of neck visible.

Common errors / ARRT traps

  1. 1 Neck flexion or extension alters cervical lordosis.
  2. 2 Rotation or obliquity shifts vertebrae off alignment.
  3. 3 Arms held up shift shoulders into the field and obscure C7.
  4. 4 CR not at C4 level misses key structures.

Clinical indications

  • Cervical spine trauma survey in erect patient.
  • Evaluation of cervical spondylosis or arthropathy.
  • Assessment of intervertebral disc height.
  • Visualization of forward head posture.

Aligned to the 2025 ARRT Content Specifications.

Practice this projection live.

The interactive positioning viewer in the app lets you rotate the patient, see the centering point in 3D, and study the central ray angle. Start free.

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