Common C-Spine Xray Findings - Interpretation

Question 1

When would you order a CSpine Xray

Answer 1

Canadian CSpine rules

• 65+
• dangerous MOI
• limb paraesthesia

No low risk criteria

• delayed neck pain
• no midline tenderness
• sitting in ED
• can walk

Low risk criteria BUT CANNOT ACTIVELY MOVE NECK

Question 2

Introduction

-view

Answer 2

Patient name, DOB, no
Date, time of image
Past imaging

AP
Lateral
Odontoid

Question 3

1. Adequacy and alignment

Answer 3

Adequacy
AP, lateral - C7-T1 junction visible
Odontoid - atlas and axis completely visible behind teeth

Alignment 
Lateral
-anterior longitudinal line
-posterior longitudinal line
-spinolaminar line

AP

• 2 lateral lines
• spinous process line

Odontoid
-lateral masses

Any asymmetry - fracture, dislocation?

Question 4

2. Bones
3. Cartilage
4. Soft tissue

Answer 4

Assess cortices

In lateral view, can assess peg within C1

Intervertebral discs - roughly similar in height

Above C4 - prevertebral tissue U1/3 vertebral width
Below C4 - prevertebral tissue U1 vertebral width

Increased widening => hematoma from fracture in that area