AP soft tissue neck X-ray positioning
An extra soft tissue neck view, used when a routine one is not enough. The patient stands, the beam passes front to back (AP), straight on to the receptor, and the centring point is the thyroid cartilage.
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
X-ray positioning/Soft tissue neck
Still being checked: a radiographer is reviewing this guide. If your department does it differently, follow your department.
Patient position
Erect. Stand or sit the patient facing the tube, chin slightly raised.
Centring & collimation
Central ray
APCentre: the thyroid cartilage.
Beam: AP, perpendicular to the receptor.
Collimate: the airway from mandible to sternal notch
Distance, receptor & grid
| Setting | Value | Notes |
|---|---|---|
| SID | 110 cm | |
| Receptor | 24 × 30 cm | portrait |
| Placement | Erect (wall) bucky | Grid in |
| Angulation | None | Perpendicular to the receptor |
Marker & breathing
- Marker: anatomical side marker on the side being examined, clear of anatomy
- Breathing: Breathe in and hold.
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 | 70 | 4 | 1.6 |
| S | 70 | 6.3 | 2.5 |
| M | 70 | 8 | 3.2 |
| L | 70 | 12.5 | 5 |
These start from a classic film-screen chart (70 kV, 12.5 mAs at 140 cm) and are adjusted for a digital detector at 110 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
- Trachea central and visible.
- Soft tissue exposed (not overexposed).
- 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 |
|---|---|---|
| Airway burnt out | Bone technique | Use a soft-tissue technique. |
Common questions
- Where do you centre for a neck soft tissue AP X-ray?
- The centring point is the thyroid cartilage.
- What distance and beam angle does a neck soft tissue AP need?
- 110 cm from the tube to the receptor. The beam passes front to back (AP), 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 breathe in and hold it while you expose.
- What goes wrong most often on a neck soft tissue AP?
- Airway burnt out. Usual cause: bone technique. The fix: use a soft-tissue technique.
Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a neck soft tissue ap in a 3D room and score your positioning. See ScanFlo XR →
Written by the ScanFlo team from everyday radiographic practice.