title: Are plain radiographs sufficient to exclude cervical spine injuries in low-risk adults?
abstract: BACKGROUND
  The routine use of clinical decision rules and three-view plain radiography to clear the cervical spine in blunt trauma patients has been recently called into question.
  
  
  OBJECTIVE
  In low-risk adult blunt trauma patients, can plain radiographs adequately exclude cervical spine injury when clinical prediction rules cannot?
  
  
  METHODS
  Four observational studies investigating the performance of plain radiographs in detecting cervical spine injury in low-risk adult blunt trauma patients were reviewed.
  
  
  CONCLUSIONS
  The consistently poor performance of plain radiographs to rule out cervical spine injury in adult blunt trauma victims is concerning. Large, rigorously performed prospective trials focusing on low- or low/moderate-risk patients will be needed to truly define the utility of plain radiographs of the cervical spine in blunt trauma.
authors.affiliation: Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Benton R
authors.initials: BR
authors.lastname: Hunter
authors.affiliation: Department of Emergency Medicine, The University of Arizona College of Medicine, Tucson, Arizona.
authors.forename: Samuel M
authors.initials: SM
authors.lastname: Keim
authors.affiliation: Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Rawle A
authors.initials: RA
authors.lastname: Seupaul
authors.affiliation: Department of Emergency Medicine, Alameda County Medical Center - Highland, Oakland, California.
authors.forename: Gene
authors.initials: G
authors.lastname: Hern
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011859:Radiography; D012680:Sensitivity and Specificity; D013124:Spinal Injuries / Q000000981:diagnostic imaging*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging
keywords: cervical spine injury; cost-effectiveness; medical imaging; radiographs