Cervical spine injuries to children under 11: should we use radiography more selectively in their initial assessment?
OBJECTIVE
To assess the effectiveness of cervical spine radiography in injured children under 11 years old, and suggest improvements.


METHODS
Retrospective survey of radiographs and accident and emergency records for children examined during a one year period in a large teaching hospital.


RESULTS
No cervical spine fractures occurred in this age group during the year. The recorded clinical findings did not always justify radiography.


CONCLUSIONS
Clinical examination appears undervalued by those assessing injured children and is poorly recorded. Radiography can be used more selectively. Initial assessment using a single lateral projection can be followed in doubtful cases by cross sectional imaging.
Diagnostic Imaging Directorate, Queen's Medical Centre, Nottingham, UK. pjesmart@btclick.com
P J E
PJ
Smart
P J
PJ
Hardy
D M G
DM
Buckley
J M
JM
Somers
N J
NJ
Broderick
K E
KE
Halliday
L
L
Williams
D017677:Age Distribution; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D004739:England; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D008297:Male; D018579:Patient Selection; D010808:Physical Examination; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000209:etiology; D019564:Unnecessary Procedures