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AbstractObjectiveTo describe the origins of the anteroposterior (AP) open-mouth radiograph. MethodsSearches in PubMed, standard radiography texts, and telephone interviews. ResultsThe AP open-mouth radiograph has a long history of use in the chiropractic and medical professions. The view is taken to assess the upper cervical vertebrae (C1 and C2), and some chiropractors include assessment of the atlantooccipital articulation by using the AP open-mouth radiograph procedure. One text cited a 1910 background reference for this view, but further investigation revealed an earlier edition of the 1910 publication, which gave a description of how to take an AP open-mouth radiograph. The first documentation that this view had been taken was found in a 1919 chiropractic text. Chiropractors appear to have been the first to include an atlantooccipital biomechanical analysis with the AP open-mouth radiograph. ConclusionThe origins of the AP open-mouth radiograph date back to the early 1900s. A medical doctor in Germany appears to have been the first to describe the procedure for this radiographic view. By the 1930s, chiropractors were including the occiput in the view's analysis, along with the traditional application of C1 and C2 assessment. Section snippetsResultsA search in JAMA Letters sections in the 6 months of issues that followed Dr. Goodley's published letter showed that no one challenged the claim that chiropractors originated the AP open-mouth radiograph. After locating and asking Dr. Goodley about his claim made in JAMA, he replied that he obtained his information from a physiotherapist in Europe. The author located the physiotherapist, who replied that he believed B.J. Palmer originated the view. He recommended a text, in German, titled Atlas Discussion and conclusionIt was admirable of a medical doctor to credit chiropractors for originating the AP open-mouth radiograph, but in view of the evidence presented here, it appears that it is time for the chiropractic profession to return that credit back to a medical doctor, Dr Albers-Schonberg from Germany, for at least providing the first description of the procedure involved in 1906. The first description of the AP open-mouth radiograph in the United States appears to have been described in 1919 in 2 different AcknowledgmentThe author thanks the following people for their kind assistance: Phillip Ballinger, MS, RT (reference search assistance); Paul Goodley, MD (reference search assistance); Greenville Public Library (interlibrary loan assistance); Christian Kaffke and Carsten Reinhardt (translation of pertinent excerpts from Die Roentgentechnik); Dennis Peterson and David D. Palmer, Health Sciences Library (reference search assistance); Sherman College of Straight Chiropractic Administration (support of this
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There are more references available in the full text version of this article. Cited by (1)Recommended articles (6)Copyright © 2004 National University of Health Sciences. Published by Mosby, Inc. All rights reserved. When taking an AP cervical open mouth xray image Where should the central ray be pointed?This angle can and will vary between 5-20° depending on the position of the head. To project the intervertebral disc spaces open, the central ray should be directed perpendicular to the long axis of the vertebral column 3, 4.
What needs to be aligned when positioning a patient for an AP open mouth cervical?Positioning for open-mouth projection of the cervical spine
Align the patient's head so that the midsagittal plane is perpendicular to the plane of the table and center the cassette at the level of the axis.
When performing an AP axial projection of the cervical spine in order for the central ray to pass through C4 What is the appropriate entrance point for the beam?When performing an AP axial projection of the cervical spine, the central ray should be angled 15-20 degrees cephalad. Because the central ray should pass through C4, and because there is a cephalic angulation of the beam, the central ray should enter inferior to the level where it exits.
Which of the following is are demonstrated in the AP projection of the cervical spine?Spine Question's. |
In order to demonstrate the first two cervical vertebrae in an AP open mouth projection
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