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Erschienen in: European Journal of Trauma and Emergency Surgery 5/2013

01.10.2013 | Original Article

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

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

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 5/2013

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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.
Literatur
2.
Zurück zum Zitat Holm LW, Carroll LJ, Cassidy JD, et al. The burden and determinants of neck pain in whiplash-associated disorders after traffic collisions: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33(4 Suppl):S52–9.PubMedCrossRef Holm LW, Carroll LJ, Cassidy JD, et al. The burden and determinants of neck pain in whiplash-associated disorders after traffic collisions: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33(4 Suppl):S52–9.PubMedCrossRef
3.
Zurück zum Zitat Spitzer WO, Skovron ML, Salmi LR, et al. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining “whiplash” and its management. Spine. 1995;20:1S–73S.PubMedCrossRef Spitzer WO, Skovron ML, Salmi LR, et al. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining “whiplash” and its management. Spine. 1995;20:1S–73S.PubMedCrossRef
4.
Zurück zum Zitat Nordin M, Carragee EJ, Hogg-Johnson S, et al. Assessment of neck pain and its associated disorders: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33(4 Suppl):S101–22.PubMedCrossRef Nordin M, Carragee EJ, Hogg-Johnson S, et al. Assessment of neck pain and its associated disorders: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33(4 Suppl):S101–22.PubMedCrossRef
5.
Zurück zum Zitat Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group. N Engl J Med. 2000;343:94–9. Erratum in N Engl J Med 2001;344:464.PubMedCrossRef Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group. N Engl J Med. 2000;343:94–9. Erratum in N Engl J Med 2001;344:464.PubMedCrossRef
6.
Zurück zum Zitat Barboza R, Fox JH, Shaffer LE, Opalek JM, Farooki S. Incidental findings in the cervical spine at CT for trauma evaluation. AJR Am J Roentgenol. 2009;192:725–9.PubMedCrossRef Barboza R, Fox JH, Shaffer LE, Opalek JM, Farooki S. Incidental findings in the cervical spine at CT for trauma evaluation. AJR Am J Roentgenol. 2009;192:725–9.PubMedCrossRef
7.
Zurück zum Zitat Sanchez B, Waxman K, Jones T, Conner S, Chung R, Becerra S. Cervical spine clearance in blunt trauma: evaluation of a computed tomography-based protocol. J Trauma. 2005;59:179–83.PubMedCrossRef Sanchez B, Waxman K, Jones T, Conner S, Chung R, Becerra S. Cervical spine clearance in blunt trauma: evaluation of a computed tomography-based protocol. J Trauma. 2005;59:179–83.PubMedCrossRef
8.
Zurück zum Zitat Camp JD. The normal and pathologic anatomy of the sella turcica as revealed at necropsy. Radiology. 1923;1:65–73. Camp JD. The normal and pathologic anatomy of the sella turcica as revealed at necropsy. Radiology. 1923;1:65–73.
9.
Zurück zum Zitat Edwards WC, LaRocca H. The developmental segmental sagittal diameter of the cervical spinal canal in patients with cervical spondylosis. Spine. 1983;8:20–7.PubMedCrossRef Edwards WC, LaRocca H. The developmental segmental sagittal diameter of the cervical spinal canal in patients with cervical spondylosis. Spine. 1983;8:20–7.PubMedCrossRef
10.
Zurück zum Zitat Witteman JC, Kok FJ, van Saase JL, Valkenburg HA. Aortic calcification as a predictor of cardiovascular mortality. Lancet. 1986;2(8516):1120–2.PubMedCrossRef Witteman JC, Kok FJ, van Saase JL, Valkenburg HA. Aortic calcification as a predictor of cardiovascular mortality. Lancet. 1986;2(8516):1120–2.PubMedCrossRef
11.
Zurück zum Zitat Barrett TW, Schierling M, Zhou C, et al. Prevalence of incidental findings in trauma patients detected by computed tomography imaging. Am J Emerg Med. 2009;27(4):428–35.PubMedCrossRef Barrett TW, Schierling M, Zhou C, et al. Prevalence of incidental findings in trauma patients detected by computed tomography imaging. Am J Emerg Med. 2009;27(4):428–35.PubMedCrossRef
12.
Zurück zum Zitat Eskandary H, Sabba M, Khajehpour F, Eskandari M. Incidental findings in brain computed tomography scans of 3000 head trauma patients. Surg Neurol. 2005;63:550–3.PubMedCrossRef Eskandary H, Sabba M, Khajehpour F, Eskandari M. Incidental findings in brain computed tomography scans of 3000 head trauma patients. Surg Neurol. 2005;63:550–3.PubMedCrossRef
13.
Zurück zum Zitat van Vugt R, Dekker HM, Deunk J, et al. Incidental findings on routine thoracoabdominal computed tomography in blunt trauma patients. J Trauma. 2011. van Vugt R, Dekker HM, Deunk J, et al. Incidental findings on routine thoracoabdominal computed tomography in blunt trauma patients. J Trauma. 2011.
14.
Zurück zum Zitat Ekeh AP, Walusimbi M, Brigham E, Woods RJ, McCarthy MC. The prevalence of incidental findings on abdominal computed tomography scans of trauma patients. J Emerg Med. 2010;38(4):484–9.PubMedCrossRef Ekeh AP, Walusimbi M, Brigham E, Woods RJ, McCarthy MC. The prevalence of incidental findings on abdominal computed tomography scans of trauma patients. J Emerg Med. 2010;38(4):484–9.PubMedCrossRef
15.
Zurück zum Zitat Morishita Y, Naito M, Hymanson H, Miyazaki M, Wu G, Wang JC. The relationship between the cervical spinal canal diameter and the pathological changes in the cervical spine. Eur Spine J. 2009;18(6):877–83.PubMedCrossRef Morishita Y, Naito M, Hymanson H, Miyazaki M, Wu G, Wang JC. The relationship between the cervical spinal canal diameter and the pathological changes in the cervical spine. Eur Spine J. 2009;18(6):877–83.PubMedCrossRef
16.
Zurück zum Zitat Rennenberg RJ, Kessels AG, Schurgers LJ, van Engelshoven JM, de Leeuw PW, Kroon AA. Vascular calcifications as a marker of increased cardiovascular risk: a meta-analysis. Vasc Health Risk Manag. 2009;5:185–97.PubMedCrossRef Rennenberg RJ, Kessels AG, Schurgers LJ, van Engelshoven JM, de Leeuw PW, Kroon AA. Vascular calcifications as a marker of increased cardiovascular risk: a meta-analysis. Vasc Health Risk Manag. 2009;5:185–97.PubMedCrossRef
18.
Zurück zum Zitat Ellis MH, Manor Y, Witz M. Risk factors and management of patients with upper limb deep vein thrombosis. Chest. 2000;117:43–6.PubMedCrossRef Ellis MH, Manor Y, Witz M. Risk factors and management of patients with upper limb deep vein thrombosis. Chest. 2000;117:43–6.PubMedCrossRef
19.
Zurück zum Zitat Weisberg LA, Zimmerman EA, Frantz AG. Diagnosis and evaluation of patients with an enlarged sella turcica. Am J Med. 1976;61:590–6.PubMedCrossRef Weisberg LA, Zimmerman EA, Frantz AG. Diagnosis and evaluation of patients with an enlarged sella turcica. Am J Med. 1976;61:590–6.PubMedCrossRef
20.
Zurück zum Zitat Messersmith WA, Brown DF, Barry MJ. The prevalence and implications of incidental findings on ED abdominal CT scans. Am J Emerg Med. 2001;19:479–81.PubMedCrossRef Messersmith WA, Brown DF, Barry MJ. The prevalence and implications of incidental findings on ED abdominal CT scans. Am J Emerg Med. 2001;19:479–81.PubMedCrossRef
21.
Zurück zum Zitat Paluska TR, Sise MJ, Sack DI, Sise CB, Egan MC, Biondi M. Incidental CT findings in trauma patients: incidence and implications for care of the injured. J Trauma. 2007;62(1):157–61.PubMedCrossRef Paluska TR, Sise MJ, Sack DI, Sise CB, Egan MC, Biondi M. Incidental CT findings in trauma patients: incidence and implications for care of the injured. J Trauma. 2007;62(1):157–61.PubMedCrossRef
22.
Zurück zum Zitat Bird S. Failure to follow up CT reports. Aust Fam Physician. 2007;36:949–50.PubMed Bird S. Failure to follow up CT reports. Aust Fam Physician. 2007;36:949–50.PubMed
Metadaten
Titel
Do cervical spine X-rays for trauma have clinically significant incidental findings?
verfasst von
L. Koren
A. Simonovich
D. Norman
S. Israelit
M. Jerdev
R. Sherter
Y. Yagil
R. Rozenberg
E. Peled
Publikationsdatum
01.10.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 5/2013
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-013-0290-6

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