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Cervical Spine Radiography Interpretation Lab

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.

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