Swimmer's view X-ray positioning (cervicothoracic lateral)
An extra C-spine view, used when a routine one is not enough. The patient stands side-on, the beam passes from side to side, straight on to the receptor, and the centring point is C7/T1, just above the near shoulder.
By the ScanFlo Editorial Team · Updated
In this section · X-ray positioning
- X-ray positioning guides
- Skull positioning
- Face & sinuses positioning
- Soft tissue neck positioning
- C-spine positioning
- Chest positioning
- Shoulder positioning
- Humerus positioning
- Elbow positioning
- Forearm positioning
- Wrist positioning
- Hand positioning
- T-spine positioning
- Abdomen positioning
- L-spine positioning
- Sacrum & SI joints positioning
- Pelvis positioning
- Hip positioning
- Femur positioning
- Knee positioning
- Tibia & fibula positioning
- Ankle positioning
- Foot positioning
Still being checked: a radiographer is reviewing this guide. If your department does it differently, follow your department.
Patient position
Lateral, erect. Seat the patient lateral to the bucky with the near arm raised alongside the head and the far shoulder dropped as low as possible.
Centring & collimation
Central ray
lateralCentre: C7/T1, just above the near shoulder.
Beam: lateral, perpendicular to the receptor.
Collimate: C5 to T3
Distance, receptor & grid
| Setting | Value | Notes |
|---|---|---|
| SID | 150 cm | |
| Receptor | 24 × 30 cm | portrait |
| Placement | Erect (wall) bucky | Grid in |
| Angulation | None | Perpendicular to the receptor |
Marker & breathing
- Marker: R or L marker on the side nearest the detector
- Breathing: Suspend respiration.
Exposure by patient size
Treat these as a starting point. Your detector, your generator and the patient in front of you will all move the numbers.
| Patient size | kV | mAs (chart) | mAs (DR default) |
|---|---|---|---|
| XS | 80 | 32 | 12.5 |
| S | 80 | 50 | 20 |
| M | 80 | 63 | 25 |
| L | 80 | 100 | 40 |
These start from a classic film-screen chart (80 kV, 50 mAs at 140 cm) and are adjusted for a digital detector at 150 cm. The DR column is what ScanFlo's console suggests; each step up or down changes the mAs by about a quarter.
Image quality checklist
- The C7/T1 junction is shown between the humeral heads.
- The anatomical side marker is visible, correct and clear of the anatomy.
- Collimation borders are visible on all sides, no wider than the area requested.
Faults & how to fix them
| Fault | Cause | Fix |
|---|---|---|
| Humeral heads superimposed over C7/T1 | Shoulders level | Raise one arm, depress the other. |
Common questions
- Where do you centre for a cervicothoracic lateral (swimmer's) X-ray?
- The centring point is C7/T1, just above the near shoulder.
- What distance and beam angle does a cervicothoracic lateral (swimmer's) need?
- 150 cm from the tube to the receptor. The beam passes from side to side, straight on to the receptor.
- What size receptor, and do you need a grid?
- Use a 24 × 30 cm receptor, portrait, in the wall bucky. A grid is needed.
- What should the patient do with their breathing?
- Ask them to stop breathing for the moment of the exposure.
- What goes wrong most often on a cervicothoracic lateral (swimmer's)?
- Humeral heads superimposed over C7/T1. Usual cause: shoulders level. The fix: raise one arm, depress the other.
Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a cervicothoracic lateral (swimmer's) in a 3D room and score your positioning. See ScanFlo XR →
Written by the ScanFlo team from everyday radiographic practice.