Clinico-radiological assessment of spinal injuries should be managed by. This is because normal C-spine X-rays cannot exclude significant injury, and because a missed C-spine fracture can lead to death, or life long neurological deficit. Note: The upper T-spine may not be visible on the lateral view - if injury is suspected here then a swimmer's view may be helpful - (see Cervical spine - Normal). Clinical considerations are particularly important in the context of Cervical spine (C-spine) injury. Images of the thoracic and lumbar spine are often large and the bones should be scrutinised in detail (see images below). Thoracic spine - Standard viewsĪP and Lateral - Assess both views systematically (see box). The Spine Series is designed to offer a complete training system f. The clinico-radiological assessment of suspected T-spine or L-spine injuries therefore depends on careful consideration of both the clinical and radiological findings. The content is pitched at higher level than our existing upper limb x-ray learning pathways, and there is a bit of assumed knowledge, but with the addition of the related articles and annotated review cases it is. Clinical assessment is also often limited by distracting injuries or reduced consciousness. Ive been reporting cervical spine x-rays for many years and I still found that I learned lots of great new tips from Matts lecture. Good views of the T-spine and L-spine are difficult to achieve in the context of trauma. Imaging should not delay resuscitation.įurther imaging with CT or MRI (not discussed) is often appropriate in the context of a high risk injury, neurological deficit, limited clinical examination, or where there are unclear X-ray findings. Therefore, patients with suspected spinal injury should be managed by experienced clinicians in accordance with local and national clinical guidelines. Incorrect management of patients with spinal injury may cause or worsen neurological deficit. The plain X-ray anatomy and appearances of injuries to both these areas are discussed together. In the context of trauma similar principles apply to imaging both the Thoracic spine (T-spine) and the Lumbar spine (L-spine). Spacing - Discs/Spinous processes/Pedicles.Bones - Cortical outline/Vertebral body height.Thoracolumbar spine - Systematic approach If you see one fracture - check for another.If 'instability' is suspected then further imaging with CT should be considered.Correlate radiological findings with the clinical features.
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