What alternate method can be used to demonstrate C7 and its articulation with T1 when shoulders cannot be adequately depressed on a lateral projection of the cervical spine?

The swimmer's technique is specifically designed to visualize the cervicothoracic junction, particularly C7 and its articulation with T1, when anatomical limitations prevent the proper positioning of the shoulders in a standard lateral projection of the cervical spine. This technique involves a slight repositioning of the body and the arms to allow for a clearer view of the lower cervical and upper thoracic vertebrae.

In this technique, the patient is positioned in a lateral manner, with one arm raised above the head and the opposite arm resting down to help separate the shoulders. This positioning reduces the superimposition of the shoulders over the region of interest, allowing for a more accurate representation of C7 and T1.

Other methods like oblique views or an AP view do not specifically address the visualization of the cervicothoracic junction in the context of shoulder depression limitations. A flexed lateral view does not provide the clarity needed for assessing the articulation at C7 and T1. Thus, the swimmer's technique stands out as the most effective alternate method for achieving the desired imaging outcome under these circumstances.