ChestFull access
Soft tissue neck, airway and swallowing studies
Thumb sign on the lateral is epiglottitis, steeple sign on the AP is croup; aspiration means barium went below the vocal cords.
Soft tissue neck
The soft tissue neck (upper airway) series is an AP and a lateral, taken erect when possible with the air-filled airway as natural contrast. The lateral is the key view: a true lateral with the shoulders pulled down, chin slightly raised, at 72 inches SID to reduce magnification. Center to about C6 and C7, midway between the laryngeal prominence and the jugular notch, and include from the external acoustic meatus down to the upper thorax. Expose during a slow, deep inspiration so the trachea is filled with air, and use a soft tissue technique, lower than for a C-spine, so the epiglottis and prevertebral soft tissue are not burned out.