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Multi-Position CBCT (Kinematic Imaging)

Most typical scans and images are taken in neutral positions. But many symptoms aren't in these positions.

In select cases, we capture CBCT images in specific end-range positions like rotation, side-bending, flexion, or extension, to better understand how the upper neck behaves under the exact conditions that reproduce symptoms.

Why "Normal" Scans Can Still Leave You Stuck

Standard imaging is usually a still snapshot in a single posture. But many cases are directional: symptoms flare when you look up, turn, side-bend, or hold a sustained position.

Symptoms are reliably triggered by a specific movement or posture​

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Imaging looks "normal," but function clearly isn't

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Prior care or treatment improved some things ... but the pattern keeps returning ​​​

What Is Multi-Position CBCT

Multi-Position CBCT imaging, called kinematic imaging in research, is cone beam imaging performed while you hold a specific, coached end-range position (for example: right rotation or extension). The goal is to study biomechanics in the direction that actually matters, not just neutral.

This is not "more imaging for everyone."
It's targeted imaging for the right case.

What This Can Help Us Clarify

Multi-position imaging can add useful context when symptoms are motion-dependent. It’s one piece of a larger diagnostic picture—integrated with your history, exam, and functional testing.

  • Better clarity on direction-specific symptom triggers​

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  • Improved precision in pacing and treatment design

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  • More confident prognosis conversations (what's likely to change vs what may take more time)

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  • A more specific map for rehab emphasis (visual/balance/cervical control)

Who Is This For

We consider Multi-Position CBCT when there is a clear clinical reason
and it is likely to change decision-making.

  • Your symptoms are consistently provoked by specific movements (turning, looking up, etc.)​

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  • You’ve tried other approaches with limited or temporary results

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  • You've had multiple injuries to the neck directly, or indirectly (like a concussion)

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  • Your case is complex enough that biomechanics context matters

Safety and Selective Use

CBCT uses ionizing radiation, similar to X-ray.
At Keystone, we follow a simple rule: we only add imaging positions when there is a clear clinical question and the information is likely to change the plan.

We use the minimum necessary positions (often 1-3 added positions)​

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We keep imaging targeted and optimized

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We integrate imaging with the full evaluation, not in isolation ​​​

What to Expect If You're a Candidate

CBCT uses ionizing radiation, similar to X-ray.
At Keystone, we follow a simple rule: we only add imaging positions when there is a clear clinical question and the information is likely to change the plan.

Step 1

We identify the symptom provoking direction(s) based on your history and exam

Step 2

You're coached into a postion safely and briefly while the scan is captured

Step 3

We interpret the findings in context of the full workup and explain what it changes

Frequently Asked Questions

FAQ 1: Do you do Multi-Positioning CBCT for everyone?

No. It's reserved for cases where there's a high likelihood that it answers a clear clinical question and changes the plan​

 

FAQ 2: How many positions will I need?

Most cases require only 1-3 additional positions. Complex cases may require a broader series.

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FAQ 3: Will this diagnose the cause of my symptoms?

It can add meaningful context, especially when symptoms are position-dependent, but it's not a standalone diagnosis in most cases. Positional scans are integrated with the full evaluation.

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FAQ 4: What kind of symptoms does this relate to?

Most commonly, motion or position-triggered headaches, dizziness/imbalance patterns, neck pain/stiffness, and complex "normal scan" cases where the pattern is position-dependent.

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FAQ 5: What about radiation dose?

Dose depends on the exact protocol and field of view. Published estimates for head/cervical CBCT are commonly reported around 0.05–0.25 mSv per scan (device/protocol dependent).
For context, average natural background radiation is about ~3.1 mSv/year (and total annual exposure including medical sources is often cited around ~6.2 mSv/year).

Ready for Clarity?

If you feel like your situation matches what you’ve read here, the next step isn’t to guess whether this approach will work for you, it’s to have a focused conversation.

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A complimentary Discovery Call with Dr. Bearder is where we:

  • Review your story and what you’ve already tried​

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  • Decide together whether the Keystone Approach is a good fit​

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  • Outline what an evaluation would look like, including costs, if we move forward

If you're ready for that level of clarity, your next step is simple.

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