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Chiropractic Research Review

Reading Lateral Cervical Radiographs in Trauma Cases: Clinical Pearls

Cervical lateral radiographs are often obtained in situations in which patients have incurred trauma, such as in motor vehicle accidents. With this particular view, there is a tendency for doctors to focus on the spine itself, yet the careful observer can find clues to other nonspinal injuries.

This pictorial essay of radiographs shows a spectrum of findings which can help facilitate earlier detection, appropriate follow-up imaging, and intervention for serious injuries. Numerous plain films with instructional markers point out tips for more accurate detection of mandible, skull and facial fractures. Several facial and skull radiographs are also presented, illustrating image-reading nuances.

The authors point out that up to 50% of mandible fractures are bilateral, and that patients with these fractures have an increased incidence of upper cervical spine injuries. They also mention that subjects with facial fractures are twice as likely to suffer cervical spine fractures, a relationship that is five times greater in patients with skull fractures. Pneumocephalus is also presented. This condition, an introduction of air into the skull which can occur as a result of sinus fracture, can be detected by the astute clinician.

Note: A complete copy of this article, including all of the images, can be accessed for free at http://www.ajronline.org.

Perry JR, Stern EJ, Mann FA, et al. Lateral radiography of the cervical spine in the trauma patient: looking beyond the spine. American Journal of Roentgenology 2001:176, pp381-86.

Chiropractic Research Review

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