Pediatric emergency medicine trisk 3595 3595
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FIGURE 112.18 A: Posterior cervical line of Swischuk. A line is drawn from the cortex of the
spinous process of C1 to the cortex of the spinous process of C3. Relationship of the line to
cortex of the spinous process of C2 is noted. If the line is situated more than 2 mm anterior to
the cortex of the spinous process of C2, underlying cervical pathology should be present. This
line should be used only with anterior displacement of C2 on C3. B: Pseudosubluxation of C2
on C3 with normal posterior cervical line in a 2-year-old child. Note apparent widening of
prevertebral soft tissue (asterisk ). C: Abnormal posterior cervical line with an underlying
hangman’s fracture (star indicates anterior cortex of spinous process). Actual offset is 4 mm. (C
: Reprinted with permission from Swischuk L. Emergency Radiology of the Acutely Ill or
Injured Child . 2nd ed. Baltimore, MD: Williams & Wilkins; 1986:562–563.)
