Interpreting lateral neck films usually involves children with respiratory infections, foreign bodies, or cervical spine conditions. Case 10 in Volume 1 reviewed the radiographic findings distinguishing several types of respiratory infections that result in airway symptoms (croup, retropharyngeal abscess, and epiglottitis). Case 8 in Volume 1 reviewed some of the clinical and radiographic features of airway foreign bodies. Cases 1 and 7 in Volume 2 reviewed some of the complications of esophageal and bronchial foreign bodies. Case 5 in Volume 1 reviewed the radiographic features of C2-C3 pseudosubluxation versus true subluxation. With this background information, 16 lateral neck radiographs are contained in this case for review to test your interpretation skills. No clinical information is given here. Some of these films are soft tissue studies, while others are cervical spine studies. To conserve disk space, the images are limited to the area of interest only. A general approach to reviewing these radiographs can be more consistent if one adheres to a standard method of review.

• Bony Alignment: Line up the anterior borders of the vertebral bodies, the posterior borders of the vertebral bodies, the vertebral arches, and the spinous processes.
  
  
• Height of the vertebral bodies and disk spaces.
  
  
• Relationship of the odontoid (C2) and the atlas (C1).
  
  
• Positioning of the neck: Is the neck in flexion, extension, or neutral.
  
  
• Width of the prevertebral soft tissue space. This thickness is usually half the width of a vertebral body and should not exceed the width of a vertebral body.
  
  
• Epiglottis: Examine the shape of the epiglottis and the size of the pre-epiglottic space (vallecula).
  
  
• Subglottic airway size.