title: "Artifactual fracture-subluxation" of cervical spine in computed tomography screening sans plain radiographs.
abstract: BACKGROUND
  Computed tomography (CT) has become the sole modality of screening for cervical injury in polytrauma because of the high sensitivity, speed, and convenience, thereby eliminating the need for plain radiographs.
  
  
  OBJECTIVE
  We report two cases of misleading artifactual fracture-subluxation of cervical spine in CT, which could have resulted in needless treatment, and describe its characteristics.
  
  
  METHODS
  Case report and review.
  
  
  METHODS
  Two patients who were initially diagnosed with fracture-subluxation on screening CT cervical spine were later noted to have motion artifacts and were reviewed.
  
  
  RESULTS
  The artifactual nature of the supposed fracture-subluxation was unmasked by the soft-tissue findings of obscuration in sagittal reconstruction and duplication in axial images, along with the presence of double bony margins.
  
  
  CONCLUSIONS
  Motion artifact in cervical CT screening can lead to a misdiagnosis of fracture subluxation. Duplication of soft tissue is highly suggestive of this motion artifact, and an additional single lateral plain radiograph may avert this pitfall.
authors.affiliation: Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. Electronic address: ssdhandapani.neurosurg@gmail.com.
authors.forename: Sivashanmugam
authors.initials: S
authors.lastname: Dhandapani
authors.forename: Pravin
authors.initials: P
authors.lastname: Salunke
authors.forename: Kanchan K
authors.initials: KK
authors.lastname: Mukherjee
mesh_terms: D000328:Adult; D016477:Artifacts; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D003951:Diagnostic Errors; D006801:Humans; D007091:Image Processing, Computer-Assisted; D004204:Joint Dislocations / Q000000981:diagnostic imaging*; D008297:Male; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D013124:Spinal Injuries / Q000000981:diagnostic imaging*
keywords: Artifactual fracture-subluxation; Cervical spine injury; Mis-diagnosis; Motion artifact; Plain radiograph