Plain film X-rays--the traditional initial means of diagnosing spine injuries in blunt trauma victims--are not necessary if an appropriate multidetector CT (MDCT) examination is done, a new study shows. Eliminating the plain film examination will save money, time for the patient and the radiology staff, and will reduce the radiation dose to the patient.

The study reviewed 238 blunt and penetrating trauma patients (vehicle accident victims, pedestrians hit by cars, etc.) who had undergone both a plain film and CT examination. "Of the 28 patients who were found to have fractures in the thoracic spine, 15 were seen on the plain film. All 28 were seen on the chest CT," said Luis Rivas, MD, chief of trauma and emergency radiology at the University of Miami-Jackson Memorial Hospital-Ryder Trauma Center. "Of the 36 patients found to have fractures in the lumbar spine, 16 were seen on the plain film. All were seen on CT of the abdomen and pelvis," said Dr. Rivas. "In addition to detecting the fractures, CT was able to characterize them, making it much easier for the surgeon to operate if necessary," Dr. Rivas added.

"It is standard trauma procedure to examine the spine of these patients," said Dr. Rivas. "Traditionally we've done a plain film examination, which could take 45 minutes or more. Most of these patients have already had a CT examination. Past studies have shown that CT alone works to diagnose injuries to the cervical spine; this study shows that CT alone is extremely useful in diagnosing injury to the lumbar and thoracic spine as well," Dr. Rivas said.

Dr. Rivas will present the study on May 4 at the American Roentgen Ray Society Annual Meeting in Miami Beach, FL.

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Contact: Keri Sperry
keri@arrs.org
703-858-4306
American Roentgen Ray Society
4-May-2004

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