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<meta name="DC.Title" content="Screening Cervical Spine CT in the Emergency Department, Phase 2: A Prospective Assessment of Use" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3306" />
<meta name="DC.Date" content="2013-04-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The National Emergency X-Radiography Utilization Study Low-Risk Criteria were established to identify patients with a low probability of cervical spine injury in whom imaging of the cervical spine was unnecessary. The purpose of this study was to ascertain the number of unnecessary cervical spine CT studies on the basis of proper application of established clinical guidelines and, secondarily, to determine indications for ordering studies in the absence of guideline criteria.

MATERIALS AND METHODS: All patients presenting to a level I trauma center for whom a screening cervical spine CT was ordered in the setting of blunt trauma were eligible for enrollment. For each study, the requesting clinician completed a survey regarding study indications. CT examinations were evaluated by a board-certified radiologist blinded to survey data to determine the presence or absence of cervical spine injury.

RESULTS: Of 507 CT examinations, 5 (1%) were positive and 497 (98.0%) were negative for acute cervical spine injury. Five studies (1%) were indeterminate for acute injury but demonstrated no abnormality on subsequent imaging and clinical follow-up. Of the 502 studies without cervical spine injury, 81 (16.1%) were imaged despite meeting all 5 NEXUS criteria for nonimaging. Of these, the most common study indication was dangerous mechanism of injury (48.1%) followed by subjective neck pain (40.7%).

CONCLUSIONS: Strict application of NEXUS criteria could potentially reduce the number of screening cervical spine CT scans in the setting of blunt trauma; this change would avoid a considerable amount of unnecessary radiation and cost.

CCR
:   Canadian Cervical Spine Rule
NEXUS
:   National Emergency X-Radiography Utilization Study
NLC
:   NEXUS Low-Risk Criteria
CSI
:   cervical spine injury" />
<meta name="DC.Contributor" content="B. Griffith" />
<meta name="DC.Contributor" content="M. Kelly" />
<meta name="DC.Contributor" content="P. Vallee" />
<meta name="DC.Contributor" content="M. Slezak" />
<meta name="DC.Contributor" content="J. Nagarwala" />
<meta name="DC.Contributor" content="S. Krupp" />
<meta name="DC.Contributor" content="C.P. Loeckner" />
<meta name="DC.Contributor" content="L.R. Schultz" />
<meta name="DC.Contributor" content="R. Jain" />
<meta name="article:published_time" content="2013-04-01" />
<meta name="article:section" content="Spine" />
<meta name="citation_title" content="Screening Cervical Spine CT in the Emergency Department, Phase 2: A Prospective Assessment of Use" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The National Emergency X-Radiography Utilization Study Low-Risk Criteria were established to identify patients with a low probability of cervical spine injury in whom imaging of the cervical spine was unnecessary. The purpose of this study was to ascertain the number of unnecessary cervical spine CT studies on the basis of proper application of established clinical guidelines and, secondarily, to determine indications for ordering studies in the absence of guideline criteria.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;All patients presenting to a level I trauma center for whom a screening cervical spine CT was ordered in the setting of blunt trauma were eligible for enrollment. For each study, the requesting clinician completed a survey regarding study indications. CT examinations were evaluated by a board-certified radiologist blinded to survey data to determine the presence or absence of cervical spine injury.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Of 507 CT examinations, 5 (1%) were positive and 497 (98.0%) were negative for acute cervical spine injury. Five studies (1%) were indeterminate for acute injury but demonstrated no abnormality on subsequent imaging and clinical follow-up. Of the 502 studies without cervical spine injury, 81 (16.1%) were imaged despite meeting all 5 NEXUS criteria for nonimaging. Of these, the most common study indication was dangerous mechanism of injury (48.1%) followed by subjective neck pain (40.7%).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Strict application of NEXUS criteria could potentially reduce the number of screening cervical spine CT scans in the setting of blunt trauma; this change would avoid a considerable amount of unnecessary radiation and cost.&lt;/p&gt;" />
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<meta name="twitter:title" content="Screening Cervical Spine CT in the Emergency Department, Phase 2: A Prospective Assessment of Use" />
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MATERIALS AND METHODS: All patients presenting to a level I trauma center for whom a screening cervical spine CT was ordered in the setting of blunt trauma were eligible for enrollment. For each study, the requesting clinician completed a survey regarding study indications. CT examinations were evaluated by a board-certified radiologist blinded to survey data to determine the presence or absence of cervical spine injury.

RESULTS: Of 507 CT examinations, 5 (1%) were positive and 497 (98.0%) were negative for acute cervical spine injury. Five studies (1%) were indeterminate for acute injury but demonstrated no abnormality on subsequent imaging and clinical follow-up. Of the 502 studies without cervical spine injury, 81 (16.1%) were imaged despite meeting all 5 NEXUS criteria for nonimaging. Of these, the most common study indication was dangerous mechanism of injury (48.1%) followed by subjective neck pain (40.7%).

CONCLUSIONS: Strict application of NEXUS criteria could potentially reduce the number of screening cervical spine CT scans in the setting of blunt trauma; this change would avoid a considerable amount of unnecessary radiation and cost.

CCR
:   Canadian Cervical Spine Rule
NEXUS
:   National Emergency X-Radiography Utilization Study
NLC
:   NEXUS Low-Risk Criteria
CSI
:   cervical spine injury" />
<meta name="og-title" property="og:title" content="Screening Cervical Spine CT in the Emergency Department, Phase 2: A Prospective Assessment of Use" />
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MATERIALS AND METHODS: All patients presenting to a level I trauma center for whom a screening cervical spine CT was ordered in the setting of blunt trauma were eligible for enrollment. For each study, the requesting clinician completed a survey regarding study indications. CT examinations were evaluated by a board-certified radiologist blinded to survey data to determine the presence or absence of cervical spine injury.

RESULTS: Of 507 CT examinations, 5 (1%) were positive and 497 (98.0%) were negative for acute cervical spine injury. Five studies (1%) were indeterminate for acute injury but demonstrated no abnormality on subsequent imaging and clinical follow-up. Of the 502 studies without cervical spine injury, 81 (16.1%) were imaged despite meeting all 5 NEXUS criteria for nonimaging. Of these, the most common study indication was dangerous mechanism of injury (48.1%) followed by subjective neck pain (40.7%).

CONCLUSIONS: Strict application of NEXUS criteria could potentially reduce the number of screening cervical spine CT scans in the setting of blunt trauma; this change would avoid a considerable amount of unnecessary radiation and cost.

CCR
:   Canadian Cervical Spine Rule
NEXUS
:   National Emergency X-Radiography Utilization Study
NLC
:   NEXUS Low-Risk Criteria
CSI
:   cervical spine injury" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node12325--5" data-node-nid="12325" id="top-node-12325--6908051948" data-pisa="ajnr;34/4/899" data-pisa-master="ajnr;ajnr.A3306" data-apath="/ajnr/34/4/899.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Screening Cervical Spine CT in the Emergency Department, Phase 2: A Prospective Assessment of Use</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">B. Griffith</span>, <span class="highwire-citation-author" data-delta="1">M. Kelly</span>, <span class="highwire-citation-author" data-delta="2">P. Vallee</span>, <span class="highwire-citation-author" data-delta="3">M. Slezak</span>, <span class="highwire-citation-author" data-delta="4">J. Nagarwala</span>, <span class="highwire-citation-author" data-delta="5">S. Krupp</span>, <span class="highwire-citation-author" data-delta="6">C.P. Loeckner</span>, <span class="highwire-citation-author" data-delta="7">L.R. Schultz</span> and <span class="highwire-citation-author" data-delta="8">R. Jain</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">April 2013,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">34 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">899-903; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3306 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-12325--6908051948" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">B. Griffith </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (B.G., M.K., R.J.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.%2BGriffith%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Griffith%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AB.%2BGriffith%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M. Kelly </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (B.G., M.K., R.J.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BKelly%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kelly%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.%2BKelly%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">P. Vallee </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Emergency Medicine (P.V., M.S., J.N., S.K., C.P.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BVallee%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Vallee%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AP.%2BVallee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">M. Slezak </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Emergency Medicine (P.V., M.S., J.N., S.K., C.P.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BSlezak%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Slezak%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.%2BSlezak%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">J. Nagarwala </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Emergency Medicine (P.V., M.S., J.N., S.K., C.P.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BNagarwala%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Nagarwala%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.%2BNagarwala%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">S. Krupp </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Emergency Medicine (P.V., M.S., J.N., S.K., C.P.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BKrupp%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Krupp%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.%2BKrupp%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">C.P. Loeckner </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Emergency Medicine (P.V., M.S., J.N., S.K., C.P.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.P.%2BLoeckner%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Loeckner%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AC.P.%2BLoeckner%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">L.R. Schultz </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Public Health Sciences (L.R.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.R.%2BSchultz%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Schultz%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AL.R.%2BSchultz%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">R. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a>

<div class="cit ref-cit ref-book" id="cit-34.4.899.1"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Pitts</span>  <span class="cit-name-given-names">SR</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Niska</span>  <span class="cit-name-given-names">RW</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Xu</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-source">National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary—National Health Statistics Reports; No 7</span>. <span class="cit-publ-loc">Hyattsville, Maryland</span>: <span class="cit-publ-name">National Center for Health Statistics</span>; <span class="cit-pub-date">2008</span></cite></div><div class="cit-extra"></div></div></li><li><span class="ref-label">2.</span><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2. in text" id="ref-2">↵</a>

<div class="cit ref-cit ref-journal" id="cit-34.4.899.2" data-doi="10.1016/j.annemergmed.2003.10.036"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Dickinson</span>  <span class="cit-name-given-names">G</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Stiell</span>  <span class="cit-name-given-names">IG</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Schull</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Retrospective application of the NEXUS low-risk criteria for cervical spine radiography in Canadian emergency departments</span>. <abbr class="cit-jnl-abbrev">Ann Emerg Med</abbr> <span class="cit-pub-date">2004</span>;<span class="cit-vol">43</span>:<span class="cit-fpage">507</span>–<span class="cit-lpage">14</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.annemergmed.2003.10.036&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=15039695&amp;link_type=MED&amp;atom=%2Fajnr%2F34%2F4%2F899.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000220501300012&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">3.</span><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3. in text" id="ref-3">↵</a>

<div class="cit ref-cit ref-journal" id="cit-34.4.899.3" data-doi="10.1097/TA.0b013e3181a5b0cc"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Bailitz</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Starr</span>  <span class="cit-name-given-names">F</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Beecroft</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">CT should replace three-view radiographs as the initial screening test in patients at high, moderate, and low risk for blunt cervical spine injury: a prospective comparison</span>. <abbr class="cit-jnl-abbrev">J Trauma</abbr> <span class="cit-pub-date">2009</span>;<span class="cit-vol">66</span>:<span class="cit-fpage">1605</span>–<span class="cit-lpage">09</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1097/TA.0b013e3181a5b0cc&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=19509621&amp;link_type=MED&amp;atom=%2Fajnr%2F34%2F4%2F899.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">4.</span><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4. in text" id="ref-4">↵</a>

<div class="cit ref-cit ref-journal" id="cit-34.4.899.4" data-doi="10.1016/j.jemermed.2008.01.014"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Greenbaum</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Walters</span>  <span class="cit-name-given-names">N</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Levy</span>  <span class="cit-name-given-names">PD</span></span></li></ol><cite>. <span class="cit-article-title">An evidence based approach to radiographic assessment of cervical spine injuries in the emergency department</span>. <abbr class="cit-jnl-abbrev">J Emerg Med</abbr> <span class="cit-pub-date">2009</span>;<span class="cit-vol">36</span>:<span class="cit-fpage">64</span>–<span class="cit-lpage">71</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.jemermed.2008.01.014&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=18783909&amp;link_type=MED&amp;atom=%2Fajnr%2F34%2F4%2F899.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">5.</span><a class="rev-xref-ref" href="#xref-ref-5-1" title="View reference 5. in text" id="ref-5">↵</a>

<div class="cit ref-cit ref-journal" id="cit-34.4.899.5"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Griffen</span>  <span class="cit-name-given-names">MM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Frykberg</span>  <span class="cit-name-given-names">ER</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kerwin</span>  <span class="cit-name-given-names">AJ</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Radiographic clearance of blunt cervical spine injury: plain radiograph or computed tomography scan?</span> <abbr class="cit-jnl-abbrev">J Trauma</abbr> <span class="cit-pub-date">2003</span>;<span class="cit-vol">55</span>:<span class="cit-fpage">222</span>–<span class="cit-lpage">26</span>, <span class="cit-comment">discussion 226–27</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=12913629&amp;link_type=MED&amp;atom=%2Fajnr%2F34%2F4%2F899.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000184906000002&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">6.</span><a class="rev-xref-ref" href="#xref-ref-6-1" title="View reference 6. in text" id="ref-6">↵</a>

<div class="cit ref-cit ref-book" id="cit-34.4.899.6"><div class="cit-metadata"><cite><span class="cit-auth cit-collab">Committee on the Future of Emergency Care in the United States Health System</span>. <span class="cit-source">Hospital-Based Emergency Care: At the Breaking Point</span>. <span class="cit-publ-loc">Washington, DC</span>: <span class="cit-publ-name">National Academies Press</span>; <span class="cit-pub-date">2007</span>:<span class="cit-fpage">19</span>–<span class="cit-lpage">23</span></cite></div><div class="cit-extra"></div></div></li><li><span class="ref-label">7.</span><a class="rev-xref-ref" href="#xref-ref-7-1" title="View reference 7. in text" id="ref-7">↵</a>

<div class="cit ref-cit ref-journal" id="cit-34.4.899.7" data-doi="10.1001/jama.2010.1408"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Korley</span>  <span class="cit-name-given-names">FK</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Pham</span>  <span class="cit-name-given-names">JC</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kirsch</span>  <span class="cit-name-given-names">TD</span></span></li></ol><cite>. <span class="cit-article-title">Use of advanced radiology during visits to US emergency departments for injury-related conditions, 1998–2007</span>. <abbr class="cit-jnl-abbrev">JAMA</abbr> <span class="cit-pub-date">2010</span>;<span class="cit-vol">304</span>:<span class="cit-fpage">1465</span>–<span class="cit-lpage">71</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1001/jama.2010.1408&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=20924012&amp;link_type=MED&amp;atom=%2Fajnr%2F34%2F4%2F899.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">8.</span><a class="rev-xref-ref" href="#xref-ref-8-1" title="View reference 8. in text" id="ref-8">↵</a>

<div class="cit ref-cit ref-journal" id="cit-34.4.899.8" data-doi="10.1056/NEJM200007133430203"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Hoffman</span>  <span class="cit-name-given-names">JR</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Mower</span>  <span class="cit-name-given-names">WR</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Wolfson</span>  <span class="cit-name-given-names">AB</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma: National Emergency X-Radiography Utilization Study Group</span>. <abbr class="cit-jnl-abbrev">N Engl J Med</abbr> <span class="cit-pub-date">2000</span>;<span class="cit-vol">343</span>:<span class="cit-fpage">94</span>–<span class="cit-lpage">99</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1056/NEJM200007133430203&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=10891516&amp;link_type=MED&amp;atom=%2Fajnr%2F34%2F4%2F899.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000088116500003&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">9.</span><a class="rev-xref-ref" href="#xref-ref-9-1" title="View reference 9. in text" id="ref-9">↵</a>

<div class="cit ref-cit ref-journal" id="cit-34.4.899.9" data-doi="10.1001/jama.286.15.1841"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Stiell</span>  <span class="cit-name-given-names">IG</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Wells</span>  <span class="cit-name-given-names">GA</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Vandemheen</span>  <span class="cit-name-given-names">KL</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">The Canadian C-spine rule for radiography in alert and stable trauma patients</span>. <abbr class="cit-jnl-abbrev">JAMA</abbr> <span class="cit-pub-date">2001</span>;<span class="cit-vol">286</span>:<span class="cit-fpage">1841</span>–<span class="cit-lpage">48</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1001/jama.286.15.1841&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=11597285&amp;link_type=MED&amp;atom=%2Fajnr%2F34%2F4%2F899.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000171595300024&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">10.</span><a class="rev-xref-ref" href="#xref-ref-10-1" title="View reference 10. in text" id="ref-10">↵</a>

<div class="cit ref-cit ref-journal" id="cit-34.4.899.10" data-doi="10.1016/j.jacr.2007.08.006"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Daffner</span>  <span class="cit-name-given-names">RH</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Hackney</span>  <span class="cit-name-given-names">DB</span></span></li></ol><cite>. <span class="cit-article-title">ACR appropriateness criteria on suspected spine trauma</span>. <abbr class="cit-jnl-abbrev">J Am Coll Radiol</abbr> <span class="cit-pub-date">2007</span>;<span class="cit-vol">4</span>:<span class="cit-fpage">762</span>–<span class="cit-lpage">75</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.jacr.2007.08.006&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=17964500&amp;link_type=MED&amp;atom=%2Fajnr%2F34%2F4%2F899.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">11.</span><a class="rev-xref-ref" href="#xref-ref-11-1" title="View reference 11. in text" id="ref-11">↵</a>

<div class="cit ref-cit ref-journal" id="cit-34.4.899.11" data-doi="10.2214/AJR.10.5731"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Griffith</span>  <span class="cit-name-given-names">B</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Bolton</span>  <span class="cit-name-given-names">C</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Goyal</span>  <span class="cit-name-given-names">N</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Screening cervical spine CT in a level I trauma center: overutilization?</span> <abbr class="cit-jnl-abbrev">AJR Am J Roentgenol</abbr> <span class="cit-pub-date">2011</span>;<span class="cit-vol">197</span>:<span class="cit-fpage">463</span>–<span class="cit-lpage">67</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.2214/AJR.10.5731&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=21785095&amp;link_type=MED&amp;atom=%2Fajnr%2F34%2F4%2F899.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000293062600056&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">12.</span><a class="rev-xref-ref" href="#xref-ref-12-1" title="View reference 12. in text" id="ref-12">↵</a>

<div class="cit ref-cit ref-journal" id="cit-34.4.899.12" data-doi="10.1056/NEJMoa031375"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Stiell</span>  <span class="cit-name-given-names">IG</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Clement</span>  <span class="cit-name-given-names">CM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">McKnight</span>  <span class="cit-name-given-names">RD</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">The Canadian C-spine rule versus the NEXUS low risk criteria in patients with trauma</span>. <abbr class="cit-jnl-abbrev">N Engl J Med</abbr> <span class="cit-pub-date">2003</span>;<span class="cit-vol">349</span>:<span class="cit-fpage">2510</span>–<span class="cit-lpage">18</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1056/NEJMoa031375&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=14695411&amp;link_type=MED&amp;atom=%2Fajnr%2F34%2F4%2F899.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000187529500006&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">13.</span><a class="rev-xref-ref" href="#xref-ref-13-1" title="View reference 13. in text" id="ref-13">↵</a>

<div class="cit ref-cit ref-journal" id="cit-34.4.899.13" data-doi="10.1097/TA.0b013e31804798d5"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Duane</span>  <span class="cit-name-given-names">TM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Dechert</span>  <span class="cit-name-given-names">T</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Wolfe</span>  <span class="cit-name-given-names">LG</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Clinical examination and its reliability in identifying cervical spine fractures</span>. <abbr class="cit-jnl-abbrev">J Trauma</abbr> <span class="cit-pub-date">2007</span>;<span class="cit-vol">62</span>:<span class="cit-fpage">1405</span>–<span class="cit-lpage">10</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1097/TA.0b013e31804798d5&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=17563656&amp;link_type=MED&amp;atom=%2Fajnr%2F34%2F4%2F899.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000247326600020&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li></ol></div></div>  </div>

  
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      <div class="highwire-cite-highlight"><a href="/content/34/4"  class="highlight-image-linked"><img class="highlight-image" src="http://ajnr-stage2.stage.highwire.org/sites/default/files/styles/medium/public/highwire/ajnr/34/4.cover-source.jpg?itok=_XdN_zEn" alt="American Journal of Neuroradiology: 34 (4)" /></a></div>
  
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          <a href="/content/34/4" class="highwire-cite-linked-title" data-icon-position="" data-hide-link-title="0"><span class="highwire-cite-title">American Journal of Neuroradiology</span></a>      
      
        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 34</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 4 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Apr 2013 </div></div>
      
      
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Apr 2013, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">34 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">899-903; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3306 </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Griffith</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Kelly</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Vallee</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Slezak</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Nagarwala</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Krupp</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">C.P.</span> <span class="nlm-surname">Loeckner</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">L.R.</span> <span class="nlm-surname">Schultz</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Jain</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Apr 2013, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">34 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">899-903; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3306 </span></div>
  
  
  
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