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Twining Method: Lateral Position of the Cervicothoracic Region

IR Size: 10 x 12 in ( 24 x 30 cm ) lengthwise

Position of patient:
– the position often called is “ swimmer’s lateral “ is achieved by placing the patient in lateral position, either seated or standing, before vertical grid.
– have the patient sit or stand straight and adjust the height of the cassette so that the the film is centered to the level of the 2nd thoracic vertebrae.

Position of part:
– Center the midaxillary line of the body to the midline of the table.
– elevate the arm that is adjacent to the stand to a vertical position, flex the elbow, and rest the forearm on the patient’s head.
– Adjust the body in true lateral position, with the MSP parallel with the plane of the film.
– Immobilize by having the patient in hold a sandbag or anchored strip of gauze.
– Respiration is suspended for the exposure. If the patient can cooperate, a long time ( low mA ) exposure may be made while the patient take a shallow breaths.

CR: Direct the central ray to T2 of cervicothoracic area of the film (1) perpendicularly if the shoulder is well depressed or (2) at a caudal angle of 5 degrees when the shoulder cannot be well depressed.

Structure Shown:
– a lateral image of the lower cervical and upper thoracic vertebrae is shown.

Evaluation Criteria:
– Vertebrae should be lateral and not appreciably rotated
– Shoulders should be seen separated from each other.
– area from approximately C5 to T5 should be included.


The author is a Radiologic Technologist, currently in the academic field, hoping to mold and produce future Radiologic Technologists who will be theoretically and technologically competent.

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