Case 1

A 40-year-old roofer attends the ED after falling from a garage roof he was repairing. He has a fracture of his right wrist and has been immobilised by the ambulance service from scene. He complains of midline tenderness in his upper cervical spine.

Can you clear his neck using the NEXUS Low Risk Criteria?

You decide to image his neck using CT.

Are the x-rays adequate?

Click on the x-rays to enlarge.

You decide to perform a swimmers view.

Are the x-rays now adequate?

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Is any abnormality demonstrated?

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You arrange for a CT scan of his cervical spine.

What is the abnormality showing in these images?

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