Difference between revisions of "Template:Neck trauma - choice of modality"

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==={{#ifeq: {{PAGENAME}} |Trauma| Neck (cervical spine) | Choice of modality }}{{#ifeq: {{PAGENAME}} |Cervical fractures| in trauma|}}===
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==={{#ifeq: {{PAGENAME}} |Trauma| Neck (cervical spine) | Choice of modality }}{{#ifeq: {{PAGENAME}} |Cervical fractures| in trauma|}}===
 
Recommendations differ somewhat between children and adults:
 
Recommendations differ somewhat between children and adults:
 
*In '''children''', '''[[CT of the neck in trauma]]''' is indicated in more severe cases such as neurologic deficits, whereas '''[[X-ray of the cervical spine]]''' is preferable in milder cases, by both US<ref name=UpToDateChildren>{{cite web|url=https://www.uptodate.com/contents/evaluation-and-acute-management-of-cervical-spine-injuries-in-children-and-adolescents|title=Evaluation and acute management of cervical spine injuries in children and adolescents|author=Julie C Leonard|date=2018-02-12|website=UpToDate}}</ref> and UK<ref name=NICE>{{cite web|url=https://www.nice.org.uk/guidance/CG176|title=Head injury: assessment and early management|date=2014|website=National Institute for Health and Care Excellence (NICE)}} Updated in June 2017</ref> guidelines. Swedish guidelines recommend CT rather than X-ray in all children over the age of 5.<ref>{{cite web|url=https://vardgivare.skane.se/vardriktlinjer/medicinska-omraden/akutsjukvard/vardprogram-riktlinjer/traumamanual/#Nackskada|website=Region Skåne|title=Traumamanual}} Last updated: 2018-03-29</ref> It is thus reasonable to indicate CT by a combination of higher severity and older age.
 
*In '''children''', '''[[CT of the neck in trauma]]''' is indicated in more severe cases such as neurologic deficits, whereas '''[[X-ray of the cervical spine]]''' is preferable in milder cases, by both US<ref name=UpToDateChildren>{{cite web|url=https://www.uptodate.com/contents/evaluation-and-acute-management-of-cervical-spine-injuries-in-children-and-adolescents|title=Evaluation and acute management of cervical spine injuries in children and adolescents|author=Julie C Leonard|date=2018-02-12|website=UpToDate}}</ref> and UK<ref name=NICE>{{cite web|url=https://www.nice.org.uk/guidance/CG176|title=Head injury: assessment and early management|date=2014|website=National Institute for Health and Care Excellence (NICE)}} Updated in June 2017</ref> guidelines. Swedish guidelines recommend CT rather than X-ray in all children over the age of 5.<ref>{{cite web|url=https://vardgivare.skane.se/vardriktlinjer/medicinska-omraden/akutsjukvard/vardprogram-riktlinjer/traumamanual/#Nackskada|website=Region Skåne|title=Traumamanual}} Last updated: 2018-03-29</ref> It is thus reasonable to indicate CT by a combination of higher severity and older age.

Revision as of 15:03, 19 July 2019

Choice of modality

Recommendations differ somewhat between children and adults:

  • In children, CT of the neck in trauma is indicated in more severe cases such as neurologic deficits, whereas X-ray of the cervical spine is preferable in milder cases, by both US[1] and UK[2] guidelines. Swedish guidelines recommend CT rather than X-ray in all children over the age of 5.[3] It is thus reasonable to indicate CT by a combination of higher severity and older age.
  • In adults, UK guidelines are largely similar as in children.[2] US guidelines, on the other hand, recommend CT of the neck in trauma in all cases where medical imaging is indicated, and that X-ray of the cervical spine is only acceptable where CT is not readily available.[4]

References

  1. Julie C Leonard (2018-02-12). Evaluation and acute management of cervical spine injuries in children and adolescents. UpToDate.
  2. 2.0 2.1 . Head injury: assessment and early management. National Institute for Health and Care Excellence (NICE) (2014). Updated in June 2017
  3. . Traumamanual. Region Skåne. Last updated: 2018-03-29
  4. Amy Kaji, Robert S Hockberger (2018-05-24). Evaluation and acute management of cervical spinal column injuries in adults.