Cervical Spine Radiography Interpretation Lab. Annie T. Sadosty, M.D. Department of Emergency Medicine Mayo Clinic, Rochester. Who Needs a C-Spine X-ray?. Patients w/ Neck Trauma who: have mid-line cervical tenderness have distracting injuries have focal neurologic deficits
Cervical Spine Radiography Interpretation Lab Annie T. Sadosty, M.D. Department of Emergency Medicine Mayo Clinic, Rochester
Who Needs a C-Spine X-ray? • Patients w/ Neck Trauma who: • have mid-line cervical tenderness • have distracting injuries • have focal neurologic deficits • have mental status depression • are intoxicated Hoffman et al, NEXUS Trial, NEJM 2000;343:94-9.
Radiographic C-Spine Evaluation • Lateral • AP • Odontoid
Adequacy of film Four lines Soft tissue ASL PSL SLL A/O joint Odontoid Predental space Harris’ ring Vertebral bodies Facets Spinous processes Approach to C-Spine X-ray Interpretation
Radiographic Unknowns Look at the following radiographs systematically and attempt to identify the injury.
Summary • C-Spine injuries are tricky. • Do not trust the exam of a drunk, demented or distracted individual. • When in doubt, image. • Keep the patient immobilized until you are certain there is not an injury. • Review the x-rays carefully and use a systematic approach to do so.