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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

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Cervical Spine Radiography Interpretation Lab


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    1. Cervical Spine Radiography Interpretation Lab Annie T. Sadosty, M.D. Department of Emergency Medicine Mayo Clinic, Rochester

    2. 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.

    3. Radiographic C-Spine Evaluation • Lateral • AP • Odontoid

    4. Normal Lateral C-Spine

    5. Normal AP C-Spine

    6. Odontoid View

    7. 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

    8. 4 Lines

    9. C1-C2 Relationship

    10. Swimmer’s View

    11. Radiographic Unknowns Look at the following radiographs systematically and attempt to identify the injury.

    12. Unknown

    13. Unknown

    14. C1-C2 Relationship

    15. Unknown

    16. Unknown

    17. Unknown

    18. Odontoid Fractures

    19. Unknown

    20. Hangman’s Fracture Example

    21. Unknown

    22. Hyperflexion Strain Example

    23. Unknown

    24. 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.