Diagnosis and follow-up of minor cervical trauma.
In order to evaluate sensitivity, specificity and accuracy of radiographic findings, 1347 patients with minor cervical injury underwent clinical, orthopaedic, neurosurgical examination, and were classified as monosymptomatic (only cervical pain) or polysymptomatic (cervical pain plus additional symptoms). X-rays were taken in anteroposterior, lateral and open-mouth views; additional views if necessary. X-ray outcome was normal in 69.8% of monosymptomatic patients and there were no fractures. In 45.1% of polysymptomatic patients, outcome was normal, but there were seven fractures. Computed tomography/magnetic resonance (CT/MR) was performed in patients with documented injury and/or strong persistent symptoms. X-ray follow-up at 4-6 weeks included flexion-extension examination. Elevated statistical radiographic values were reached. All patients with minor cervical trauma should undergo clinical, neurosurgical and three-view radiographic follow-up. A simplified algorithm could lead to substantial savings and decrease patients' exposure to radiation.
Department of Radiology, University La Sapienza of Rome, Policlinico Umberto I, V. le Regina Elena 324, 00161 Rome, Italy. francescom.drudi@uniromal.it
F M
FM
Drudi
E
E
Spaziani
A
A
Di Filippo
G
G
Pavia
A
A
Ramieri
M
M
Domenicucci
A
A
Mingoli
A
A
Righi
R
R
Passariello
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002574:Cervical Vertebrae / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013124:Spinal Injuries / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*