Cervical spine injuries to children under 11: should we use radiography more selectively in their initial assessment?

Emerg Med J. 2003 May;20(3):225-7. doi: 10.1136/emj.20.3.225.

Abstract

Objectives: To assess the effectiveness of cervical spine radiography in injured children under 11 years old, and suggest improvements.

Methods: Retrospective survey of radiographs and accident and emergency records for children examined during a one year period in a large teaching hospital.

Results: No cervical spine fractures occurred in this age group during the year. The recorded clinical findings did not always justify radiography.

Conclusions: Clinical examination appears undervalued by those assessing injured children and is poorly recorded. Radiography can be used more selectively. Initial assessment using a single lateral projection can be followed in doubtful cases by cross sectional imaging.

MeSH terms

  • Age Distribution
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / injuries*
  • Child
  • Child, Preschool
  • Emergency Service, Hospital
  • England
  • Female
  • Glasgow Coma Scale
  • Humans
  • Infant
  • Male
  • Patient Selection
  • Physical Examination
  • Radiography
  • Retrospective Studies
  • Spinal Fractures / diagnostic imaging*
  • Spinal Fractures / etiology
  • Unnecessary Procedures*