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

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...

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Bibliographic Details
Published in:Emergency medicine journal : EMJ 2003-05, Vol.20 (3), p.225-227
Main Authors: Smart, P J E, Hardy, P J, Buckley, D M G, Somers, J M, Broderick, N J, Halliday, K E, Williams, L
Format: Article
Language:English
Subjects:
Age Distribution
Age groups
cervical vertebrae
Cervical Vertebrae - diagnostic imaging
Cervical Vertebrae - injuries
Child
Child, Preschool
Coma
Consciousness
Emergency Service, Hospital
England
Female
Glasgow Coma Scale
Humans
Infant
injuries
Male
Neck pain
Original
Patient Selection
Pediatrics
Physical Examination
Radiography
Retrospective Studies
retrospective study
Spinal cord injuries
Spinal Fractures - diagnostic imaging
Spinal Fractures - etiology
Sports injuries
Unnecessary Procedures
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Summary: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.
ISSN:1472-0205
1472-0213
DOI:10.1136/emj.20.3.225