Comments on: Cervical Spine CTs for Trauma

By: bohica

bohica — Tue, 23 Oct 2007 19:41:02 +0000

I have never understood why we get c, t and l films on our level 1 and 2 trauma patients after we ct them, especially since I have seen plenty fractures that were captured by ct that xray missed, but never have Iseen one captured by xray that ct has missed, know any reason why we do both? And FYI, we always go to ct first, not the xray.

By: X-Ray Geek

X-Ray Geek — Mon, 22 Oct 2007 23:08:08 +0000

CT = 10 Minutes
Plain Films = 45 Minutes(could be longer or shorter depending on how fast the crosstable lat can be cleared)

CT has better images.

CT has better reliability.

No brainer.

By: jeffreydach

jeffreydach — Sun, 21 Oct 2007 19:37:49 +0000

I practiced radiology for 25 years and a large part of my job was reading C spine films taken in the ER on trauma patients.

Over the years, when Hi-res CAT scans became available, we started doing a CAT scan in addition to the plain film and discovered that many of the negative plain films were actually positive for subtle fracture on CAT scan.

This is just a limitation of the plain film technique and a testiment to the added resolution in the axial plane of the CAT scanner. The soft tissues from the shoulders makes plain film imaging especially around C7-T1 difficult.

Jeffrey Dach MD
http://www.drdach.com