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.
Johnson
M J
MJ
Department of Surgery, University of Kansas School of Medicine, St Francis Regional Medical Center, Wichita 67214.
Lucas
G L
GL
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