title: A missed Jefferson fracture in chiropractic practice.
abstract: 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.
authors: rregelink@wxs.nl
authors: G A
authors: GA
authors: Regelink
authors: A
authors: A
authors: de Zoete
mesh_terms: 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