Normal trauma chest, pelvis and spine imaging

Case contributed by Dr Andrew Dixon

Presentation

Car accident.

Patient Data

Age: 25
Gender: Male

Trauma Series

Modality: X-ray

Normal supine trauma series in a young adult male including thoracic and lumbar radiographs. 

CT Cervical Spine

Modality: CT

Normal cervical spine CT in a young adult trauma patient. Note how the scan extends down to T5 and that there is decreased image quality at the cervicothoracic junction due to beam attenuation through the patient's shoulders.      

Case Discussion

Normal supine trauma x-ray series and cervical spine CT in a young adult male.

The patient had a low pre-imaging probability for injury and therefore did not undergo CT examination of the chest, abdomen and pelvis. Thoracic and lumbar spine x-rays were performed to assist in clearing his spine. In obese or elderly patients, the quality of horizontal beam x-rays of the thoracic and lumbar spine is often not adequate to exclude injury. In young thin patients (like this man), x-rays are very often adequate and can avoid unnecessary CT radiation exposure. 

Unfortunately, cervical spine x-rays all to often miss significant injuries following motor vehicle accidents and patients requiring imaging for spinal clearance should proceed straight to CT examination. If chest CT is not being performed, then trauma cervical spine CT should ideally extend down to the T4-T5 level. This is because the upper thoracic vertebra are not adequately assessed on x-rays of the thoracic spine. 

 

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Case Information

rID: 31535
Case created: 15th Oct 2014
Last edited: 27th Sep 2015
Systems: Chest, Spine
Inclusion in quiz mode: Excluded

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