Ayesha Isani Majeed, Ambreen Kanwal, Nasreen Naz.
Diagnostic Accuracy of Plain X-Ray in Diagnosis of Cervical Spine Fracture, Keeping CT as Gold Standard.
Ann Pak Inst Med Sci Jan ;12(3):171-4.

Objective: Determine the diagnostic accuracy of plain x-ray in diagnosing cervical spine injury in patients of blunt trauma. Study Design: Cross sectional validation study. Place and Duration of the Study: PIMS hospital Islamabad from July- December 2015. Materials & Methods: A total of 70 patients of 20-60 years of age of either gender with blunt trauma to cervical spine were included in the study. Patients with previous cervical surgery, GSC <15, hemodynamicaly unstable patients, acute paralysis, penetrating trauma, known vertebral disease (rheumatoid arthritis, ankylosing spondylitis) and pregnant females were excluded. First, all the patients underwent plain x-ray (AP & Lateral views) and then computed tomographic scanning. X-ray and CT results were correlated. Results: Mean age was 36.58 ± 8.22 years. Out of 70 patients, 59 (84.29%) were males and 11 (15.71%) were females with male to female ratio of 5.3:1. Plain x-ray cervical spine supported the diagnosis of cervical spine fracture in 31 (44.29%) patients. CT has shown cervical spine fracture in 29 (41.43%) cases. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of x-ray cervical spine in diagnosing cervical spine fracture in blunt trauma patients are 89.66%, 87.80%, 83.87%, 92.31% and 88.57% respectively. Conclusion: This study concluded that x-ray cervical spine is relative low costs, widely available and low dose ionizing radiation imaging modality for immediate assessment of cervical spine in blunt trauma patients.

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