Saturday, December 24, 2011

Flexion-Extension Radiography in Evaluation of Suspected Cervical Spine Trauma

The clinical utility of flexion-extension radiography for diagnosing ligamentous injury in patients with suspected cervical spine trauma is questionable. The rate of technically inadequate studies, low sensitivity, and high false-positive rate make the technique too unreliable. In addition, the risk of inducing spinal cord injury makes flexion and extension radiography contraindicated until other imaging studies have been performed.

Flexion and extension radiography and dynamic fluoroscopy can be useful in assessing the significance of equivocal MR findings such as abnormal ligamentous signal without definite disruption and in patients with a normal MR and continued clinical concern for ligamentous injury.


Daffner RH, Hackney DB. ACR Appropriateness Criteria on suspected spine trauma. J Am Coll Radiol. 2007 Nov;4(11):762-75.

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