Hoffman et al determined criteria when cervical spine radiographs should be performed after blunt trauma. The goal was to reduce the number of unnecessary imaging studies. The study was done at UCLA in Los Angeles, California.


Patient selection: 974 patients were evaluated with 27 patients having fractures of the cervical spine


Criteria for performing Cervical spine radiographs: X-rays should be done if the patient has one or more of the following:

(1) the patient has midline neck tenderness (over the bony cervical spine)

(2) the patient is intoxicated

(3) the patient shows an altered level of alertness

(4) the patient has a severely painful injury elsewhere



• Sensitivity was 100% (all patients with fracture included).

• There was a 33% reduction in radiographs ordered using these criteria.


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