Cervical spine evaluation: efficacy of open-mouth odontoid view for nontraumatic radiography.
OBJECTIVE
The open-mouth odontoid view has been a standard component of radiographic cervical spine series regardless of setting or indication. This study examines the prevalence of disease in C-1 to C-2 in an outpatient setting for nontraumatic neck evaluations.


METHODS
Reports of 1,033 nontraumatic cervical spine series on file at two large medical centers and at a large multispecialty clinic were reviewed retrospectively for patient characteristics, indications, and radiologic evaluations.


RESULTS
The odontoid view in 10 patients demonstrated radiographic abnormalities in C-1 to C-2. Four of these patients had rheumatoid arthritis, two had metastatic carcinoma, one had Down syndrome, and the remaining three had no predisposing conditions for disease in C-1 to C-2.


CONCLUSIONS
Odontoid view radiography is warranted in patients with conditions with increased risk for disease in C-1 to C-2, but for the vast majority of outpatients it is not worth the technical difficulty, radiation exposure, or expense.
Department of Surgery, University of Kansas School of Medicine, St Francis Regional Medical Center, Wichita 67214.
M J
MJ
Johnson
G L
GL
Lucas
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D002574:Cervical Vertebrae / Q000002:abnormalities / Q000000981:diagnostic imaging*; D002648:Child; D003937:Diagnosis, Differential; D004314:Down Syndrome / Q000000981:diagnostic imaging; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D011859:Radiography; D013122:Spinal Diseases / Q000000981:diagnostic imaging