sasawi.blogg.se - Cervical spine xray

Cervical spine xray full#
Cervical spine xray portable#
Cervical spine xray series#

18 The decision to take oblique views is best made by the clinician and the radiologist who will be reviewing the films.īesides identifying fractures, plain radiographs can also be useful in identifying ligamentous injuries. 16, 17 Others would obtain these views only if there is a question of a fracture on the other three films or if the films are inadequate because the cervicothoracic junction is not visualized. In addition to the views listed above, some authors suggest adding two lateral oblique views. While some missed cervical fractures, subluxations and dislocations are the result of film misinterpretation, the most frequent cause of overlooked injury is an inadequate film series. The importance of obtaining all of these views and visualizing all of the vertebrae cannot be overemphasized. The patient should be maintained in cervical immobilization, and plain films should be repeated or computed tomographic (CT) scans obtained until all vertebrae are clearly visible.

Cervical spine xray series#

Any film series that does not include these three views and that does not visualize all seven cervical vertebrae and the junction of C7-T1 is inadequate. If all seven vertebrae and the C7-T1 junction are not visible, a swimmer's view, taken with one arm extended over the head, may allow adequate visualization of the cervical spine. If no arm injury is present, traction on the arms may facilitate visualization of all seven cervical vertebrae on the lateral film. An adequate cervical spine series includes three views: a true lateral view, which must include all seven cervical vertebrae as well as the C7-T1 junction, an anteroposterior view and an open-mouth odontoid view. Initial films may be taken through the cervical collar, which is generally radiolucent.

Cervical spine xray full#

11, 12 The patient's neck should remain immobilized until a full cervical spine series can be obtained in the radiographic department. This view is insufficient to exclude a cervical spine fracture and frequently must be repeated in the radiographic department.

Cervical spine xray portable#

The single portable cross-table lateral radiograph, which is sometimes obtained in the trauma room, should be abandoned. Once the decision is made to proceed with a radiographic evaluation, the proper views must be obtained.

Initial Treatment of Cervical Spine and Cord.

Cervical Spine Series and Computed Tomography.

Attention to these criteria can substantially reduce the use of cervical spine radiographs. 10 On review, however, most of the reported cases did not meet the low-risk criteria in Table 1. Some concern has been expressed about case reports suggesting that “occult” cervical spine fractures will be missed if asymptomatic trauma patients do not undergo radiography of the cervical spine. An 18-year-old patient can give a more reliable history than a five-year-old child. Although studies suggest that these criteria may also be used in the management of verbal children, 7 – 9 caution is in order, since the study series are small, and the ability of children to complain about pain or sensory changes is variable. However, the criteria apply only to adults and to patients without mental status changes, including drug or alcohol intoxication. 1 – 6 Patients who meet these criteria ( Table 1) do not require radiographs to rule out cervical fractures. Low-risk criteria have been defined that can be used to exclude cervical spine fractures, based on the patient's history and physical examination. This article reviews the proper use of cervical spine radiographs in the trauma patient. Once an injury to the spinal cord is diagnosed, methylprednisolone should be administered as soon as possible in an attempt to limit neurologic injury.Īlthough cervical spine radiographs are almost routine in many emergency departments, not all trauma patients with a significant injury must have radiographs, even if they arrive at the emergency department on a backboard and wearing a cervical collar. The “SCIWORA” syndrome (spinal cord injury without radiographic abnormality) is common in children. The most common reason for a missed cervical spine injury is a cervical spine radiographic series that is technically inadequate.

The lateral view must include all seven cervical vertebrae as well as the C7-T1 interspace, allowing visualization of the alignment of C7 and T1. Views required to radiographically exclude a cervical spine fracture include a posteroanterior view, a lateral view and an odontoid view. Significant cervical spine injury is very unlikely in a case of trauma if the patient has normal mental status (including no drug or alcohol use) and no neck pain, no tenderness on neck palpation, no neurologic signs or symptoms referable to the neck (such as numbness or weakness in the extremities), no other distracting injury and no history of loss of consciousness.