Yield of computed tomography of the cervical spine in cases of simple assault

Objective: To compare morphological and positional variations of the hyoid bone in unoperated infants with cleft lip and palate (CL/P) with those in noncleft infants. Design: Retrospective, cross sectional. Patients and Methods: Three-dimensional computed tomography scans were obtained from 29 unoperated CL/P infants of Malay origin aged between 0 and 12 months and from 12 noncleft infants in the same age range. Observations were made and measurements were obtained with a software package developed at the Australian Craniofacial Unit. The sizes of the hyoid bones and the position of the hyoid body and epiglottis in relation to the cervical spine were measured. Anatomical anomalies of the hyoid and prevalence of aspiration pneumonia were also documented. Results: The hyoid bones and epiglottis were found to be located more inferiorly in CL/P infants compared with the noncleft infants. Also, 17% (5/29) of the CL/P infants had nonossified hyoid bodies. Conclusion: The results suggest that there are differences in the location and genesis of the hyoid bone in infants with CL/P that warrant further investigation.

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Trauma Imaging

DeckerMed Surgery ◽

10.2310/surg.2185 ◽

2020 ◽

Author(s):

Joel A. Gross ◽

Martin L. Gunn ◽

Kathleen R. Fink

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Cervical Spine ◽

Magnetic Resonance ◽

Penetrating Trauma ◽

Organ Injury ◽

Bladder Rupture ◽

Subdural Hemorrhage ◽

Solid Organ ◽

Resonance Imaging

Due to increased use of computed tomography (CT) and ultrasonography, technological advances in equipment design, and increased availability of imaging equipment in the emergency department, imaging studies have revolutionized the assessment of the trauma patient in the past three decades. This review examines commonly used imaging modalities in trauma evaluation, initial and additional imaging, brief introduction to CT, and an overview of CT image processing and reviewing a CT scan. Head imaging, spine imaging, chest imaging, and abdominal and pelvic imaging are presented, along with injury grading, solid-organ injury appearances and specific abdominal solid-organ injuries, urinary system injury, penetrating trauma, unexplained intraperitoneal fluid, vascular injury and musculoskeletal injury. Figures show lateral view of the cervical spine; volume rendering of the pelvis; CT windows; CT imaging of acute intracranial bleeding, herniation in acute subdural hemorrhage, post-traumatic pseudoaneurysm of descending thoracic aorta, subscapular hematoma of the liver, liver laceration, pseudoaneurysm of the liver, shattered kidney and the nonperfused right kidney attributable to a traumatic renal artery injury, tigroid spleen, a focus of gas and stranding adjacent to the lateral wall of the ascending colon, extravasated urinary contrast (white material) surrounding the proximal right indicating ureteral laceration or transection, intraperitoneal bladder rupture, and contrast extravasation in the liver; magnetic resonance imaging versus CT of shear injuries; and magnetic resonance imaging in the setting of cervical spine trauma. This review contains 18 highly rendered figures, 23 tables, and 83 references. Keywords:Trauma, computed tomography, radiography, magnetic resonance imaging, ultrasonography, imaging study

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Computed Tomography- and Radiography-Based Morphometric Analysis of the Lateral Mass of the Subaxial Cervical Spine in the Indian Population

Asian Spine Journal ◽

10.4184/asj.2018.12.1.18 ◽

2018 ◽

Vol 12 (1) ◽

pp. 18-28

Author(s):

Nirmal D Patil ◽

Sudhir K Srivastava ◽

Sunil Bhosale ◽

Shaligram Purohit

Keyword(s):

Computed Tomography ◽

Cervical Spine ◽

Indian Population ◽

Tertiary Care ◽

X Rays ◽

Lateral Mass ◽

Cross Sectional ◽

X Ray ◽

Subaxial Cervical Spine ◽

Screw Length

<sec><title>Study Design</title>This was a double-blinded cross-sectional study, which obtained no financial support for the research.</sec><sec><title>Purpose</title>To obtain a detailed morphometry of the lateral mass of the subaxial cervical spine.</sec><sec><title>Overview of Literature</title>The literature offers little data on the dimensions of the lateral mass of the subaxial cervical spine.</sec><sec><title>Methods</title>We assessed axial, sagittal, and coronal computed tomography (CT) cuts and anteroposterior and lateral X-rays of the lateral mass of the subaxial cervical spine of 104 patients (2,080 lateral masses) who presented to a tertiary care public hospital (King Edward Memorial Hospital, Mumbai) in a metropolitan city in India.</sec><sec><title>Results</title>For a majority of the parameters, males and females significantly differed at all levels (<italic>p</italic><0.05). Females consistently required higher (<italic>p</italic><0.05) minimum lateral angulation and lateral angulation. While the minimum lateral angulation followed the order of C5<C4<C6<C3, the lateral angulation followed the order of C3<C5<C4<C6. The lateral mass becomes longer and narrower from C3 to C7. In axial cuts, the dimensions increased from C3 to C6. The sagittal cut thickness and diagonal length increased and the sagittal cut height decreased from C3 to C7. The sagittal cut height was consistently lower in the Indian population at all levels, especially at the C7 level, as compared with the Western population, thereby questioning the acceptance of a 3.5-mm lateral mass screw. A good correlation exists between X-ray- and CT-based assessments of the lateral mass.</sec><sec><title>Conclusions</title>Larger lateral angulation is required for Indian patients, especially females. The screw length can be effectively calculated by analyzing the lateral X-ray. A CT scan should be reserved for specific indications, and a caution must be exercised while inserting C7 lateral mass screws.</sec>

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