• Spine J · Nov 2013

    Case Reports

    "Artifactual fracture-subluxation" of cervical spine in computed tomography screening sans plain radiographs.

    • Sivashanmugam Dhandapani, Pravin Salunke, and Kanchan K Mukherjee.
    • Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. Electronic address: ssdhandapani.neurosurg@gmail.com.
    • Spine J. 2013 Nov 1; 13 (11): e45-8.

    Background ContextComputed tomography (CT) has become the sole modality of screening for cervical injury in polytrauma because of the high sensitivity, speed, and convenience, thereby eliminating the need for plain radiographs.PurposeWe report two cases of misleading artifactual fracture-subluxation of cervical spine in CT, which could have resulted in needless treatment, and describe its characteristics.Study DesignCase report and review.MethodsTwo patients who were initially diagnosed with fracture-subluxation on screening CT cervical spine were later noted to have motion artifacts and were reviewed.ResultsThe artifactual nature of the supposed fracture-subluxation was unmasked by the soft-tissue findings of obscuration in sagittal reconstruction and duplication in axial images, along with the presence of double bony margins.ConclusionsMotion artifact in cervical CT screening can lead to a misdiagnosis of fracture subluxation. Duplication of soft tissue is highly suggestive of this motion artifact, and an additional single lateral plain radiograph may avert this pitfall.Copyright © 2013 Elsevier Inc. All rights reserved.

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