Studies have also stated that patients with a low risk of injury can undergo 3-projection cervical spine radiography.13 Plain-film radiographs can be insensitive for cervical spine injuries, with inadequate imaging rates of 37% to 72%. Inadequate images can occur due to, overlapping of the shoulder girdle and rib cage on the lateral projection, Suboptimal images, Patient size and body habitus, incorrect interpretations by physicians and incomplete visualization of the cervical spine from the skull base to T1.
Some studies have also stated that NEXUS and CCR are inadequate and cervical spine fractures cannot be excluded without CT. CT imaging is the preferred method due to its high accuracy, speed, and ability to reconstruct images in the coronal …show more content…
It is indicated to further evaluate patients when CT scan is negative and there is presence of neurologic deficits. It is also helpful when patients are in lethargy that makes physical examination unreliable, or moderate-to-severe spinal degenerative disease that makes CT difficult to interpret. However it is not necessary when cervical spine CT scan is negative and there is no history of high-impact trauma. Also, patients who are obtunded but do not have any gross motor deficits after a cervical spine CT scan do not need MR imaging for the cervical spine to be cleared. In other trauma patients with a negative CT scan, decision-making is up to the clinician without clear guidelines. It could be catastrophic, if a cervical spine injury that is occult on a CT scan is …show more content…
Decreased respiratory function commonly is seen with flail chest. Fractures in the upper ribs, especially the first rib, should raise suspicion of intrathoracic injuries such as vascular or aortic damage (see Figure 32).18 When aortic injury is suspected, CT scan should be done, as it has poor prognosis when undiagnosed and untreated. C T provides detailed visualization of the aorta and signs of aortic trauma, such as intimal flaps, pseudoaneurysm, irregularity of the contours of vessel walls, and extravasation of