title: Rational ordering of cervical spine radiographs following trauma.
abstract: A retrospective review of 312 hospitalized patients with cervical spine injuries was conducted to identify presenting signs, symptoms, and coexisting conditions, and to determine if any injuries were not diagnosed in the emergency department. Of the 257 (82%) patients who were alert on ED evaluation, 215 (84%) complained of neck pain or tenderness. Of the remaining 42 alert patients without neck pain, 34 had sensory or motor symptoms or signs suggestive of cervical spine injury, and eight had significantly painful other injuries. Of the 284 patients presenting within the first 48 hours after injury, 23 were not diagnosed initially, 21 because radiographs were initially read as negative and two because no radiographs were taken. A significant number of patients had more than one fracture of the spinal column. A stepwise approach to rational ordering of cervical spine radiographs in blunt trauma is proposed.
authors.affiliation: University of Iowa Hospitals & Clinics, Iowa City 52242.
authors.forename: B J
authors.initials: BJ
authors.lastname: Ringenberg
authors.forename: A K
authors.initials: AK
authors.lastname: Fisher
authors.forename: L F
authors.initials: LF
authors.lastname: Urdaneta
authors.forename: M A
authors.initials: MA
authors.lastname: Midthun
mesh_terms: D000328:Adult; D000465:Algorithms; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D006259:Craniocerebral Trauma / Q000150:complications; D003955:Diagnostic Tests, Routine / Q000592:standards*; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D006746:Hospital Bed Capacity, 500 and over; D006801:Humans; D007484:Iowa; D004204:Joint Dislocations / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D011859:Radiography; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000000981:diagnostic imaging