title: Validity of palpation of the C1 transverse process: comparison with a radiographic reference standard.
abstract: OBJECTIVE
  Primary goal: to determine the validity of C1 transverse process (TVP) palpation compared to an imaging reference standard.
  
  
  METHODS
  Radiopaque markers were affixed to the skin at the putative location of the C1 TVPs in 21 participants receiving APOM radiographs. The radiographic vertical distances from the marker to the C1 TVP, mastoid process, and C2 TVP were evaluated to determine palpatory accuracy.
  
  
  RESULTS
  Interexaminer agreement for radiometric analysis was "excellent." Stringent accuracy (marker placed ±4mm from the most lateral projection of the C1 TVP) = 57.1%; expansive accuracy (marker placed closer to contiguous structures) = 90.5%. Mean Absolute Deviation (MAD) = 4.34 (3.65, 5.03) mm; root-mean-squared error = 5.40mm.
  
  
  CONCLUSIONS
  Manual palpation of the C1 TVP can be very accurate and likely to direct a manual therapist or other health professional to the intended diagnostic or therapeutic target. This work is relevant to manual therapists, anesthetists, surgeons, and other health professionals.
authors.affiliation: Palmer West College of Chiropractic ; Palmer Center for Chiropractic Research.
authors.forename: Robert
authors.initials: R
authors.lastname: Cooperstein
authors.affiliation: Palmer West College of Chiropractic ; Palmer Center for Chiropractic Research.
authors.forename: Morgan
authors.initials: M
authors.lastname: Young
authors.affiliation: Palmer West College of Chiropractic.
authors.forename: Makani
authors.initials: M
authors.lastname: Lew
keywords: C1 TVP; chiropractic; palpation; radiograph; validity