Display options
Share it on

Eur J Trauma Emerg Surg. 2013 Oct;39(5):477-80. doi: 10.1007/s00068-013-0290-6. Epub 2013 Apr 20.

Do cervical spine X-rays for trauma have clinically significant incidental findings?.

European journal of trauma and emergency surgery : official publication of the European Trauma Society

L Koren, A Simonovich, D Norman, S Israelit, M Jerdev, R Sherter, Y Yagil, R Rozenberg, E Peled

Affiliations

  1. Division of Orthopedics, Rambam Health Care Campus, P.O. Box 9602, Haifa, 31096, Israel. [email protected].
  2. Department of Radiology, Rambam Health Care Campus, Haifa, Israel.
  3. Division of Orthopedics, Rambam Health Care Campus, P.O. Box 9602, Haifa, 31096, Israel.
  4. Department of Emergency Medicine, Rambam Health Care Campus, Haifa, Israel.

PMID: 26815443 DOI: 10.1007/s00068-013-0290-6

Abstract

OBJECTIVES: About 800,000 cervical X-rays for trauma are taken every year in the USA. Those X-rays are reviewed by orthopedic specialists in the emergency room (ER) for traumatic findings. The quantity of incidental atraumatic findings in this very prevalent examination is unknown. We sought to determine the incidence of those findings.

METHODS: We retrospectively reviewed 521 consecutive cervical X-rays of patients with a whiplash injury that visited our ER from February to July 2010. X-rays that were technically insufficient were excluded. This left 356 X-rays that met the inclusion criteria, which were analyzed for incidental findings. The examinations were reviewed by five staff radiologists for incidental findings. The findings were reviewed and classified.

RESULTS: We identified incidental X-ray findings in 22 of the 356 patients (6.2 %) who underwent X-ray of the cervical spine during their visit to the ER. Stenosis with disk narrowing was the most common finding (2.8 %), followed by congenital anomaly of the cervical spine (2.2 %). Other findings were enlarged sella turcica (0.6 %), carotid atherosclerosis (0.3 %), and calcification of the stylomastoid ligament (0.3 %). Older age was found to be a risk factor for an incidental finding (p < 0.0001).

CONCLUSION: Incidental findings in the cervical spine were associated with older age. Awareness of the prevalence of incidental findings is important in order to ensure that they are detected and managed appropriately.

Keywords: Cervical; Incidental findings; Trauma

References

  1. Lancet. 1986 Nov 15;2(8516):1120-2 - PubMed
  2. Chest. 2000 Jan;117(1):43-6 - PubMed
  3. J Trauma. 2007 Jan;62(1):157-61 - PubMed
  4. AJR Am J Roentgenol. 2009 Mar;192(3):725-9 - PubMed
  5. Am J Emerg Med. 2001 Oct;19(6):479-81 - PubMed
  6. Neurosurgery. 2004 Oct;55(4):897-902; discussion 902-3 - PubMed
  7. Spine (Phila Pa 1976). 1983 Jan-Feb;8(1):20-7 - PubMed
  8. Eur Spine J. 2009 Jun;18(6):877-83 - PubMed
  9. J Emerg Med. 2010 May;38(4):484-9 - PubMed
  10. Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S52-9 - PubMed
  11. Surg Neurol. 2005 Jun;63(6):550-3; discussion 553 - PubMed
  12. Aust Fam Physician. 2007 Nov;36(11):949-50 - PubMed
  13. Spine (Phila Pa 1976). 1995 Apr 15;20(8 Suppl):1S-73S - PubMed
  14. Am J Med. 1976 Nov;61(5):590-6 - PubMed
  15. Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S101-22 - PubMed
  16. J Trauma Acute Care Surg. 2011 Apr 29;72 (2):416-421 - PubMed
  17. Vasc Health Risk Manag. 2009;5(1):185-97 - PubMed
  18. J Trauma. 2005 Jul;59(1):179-83 - PubMed
  19. N Engl J Med. 2000 Jul 13;343 (2):94-9 - PubMed
  20. Am J Emerg Med. 2009 May;27(4):428-35 - PubMed
  21. Pain. 1994 Sep;58(3):283-307 - PubMed

Publication Types