A missed Jefferson fracture in chiropractic practice.
OBJECTIVE
To review the case of a missed cervical spine fracture in a patient with neck pain.


METHODS
A 21-year-old thatcher with neck pain presented to a chiropractic clinic after a fall from a roof 4 m high. The hospital radiographs were read as normal. The chiropractor suspected a Jefferson fracture of the atlas after evaluation of the same radiographs.


RESULTS
The chiropractor retook the anteroposterior open-mouth radiograph to confirm the suspected fracture. The patient was referred for further imaging and underwent neurosurgical treatment, after which he recovered well.


CONCLUSIONS
Normal radiologic reports from a hospital cannot be relied on for contraindications to manipulative treatment in all instances, as shown in this case of a missed fracture. Chiropractors should therefore always evaluate radiographs that are brought to them.
Regelink
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rregelink@wxs.nl
de Zoete
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D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries*; D002684:Chiropractic; D003951:Diagnostic Errors; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D009426:Netherlands; D014057:Tomography, X-Ray Computed