A 22-Year-Old Man Comes to the Emergency Department After a Motor

question 640

Multiple Choice

A 22-year-old man comes to the emergency department after a motor vehicle collision.  His car was stopped at a red light when another vehicle hit his car's rear end at approximately 16 kph (9.9 mph) .  The patient was restrained; however, on impact, his head moved suddenly backward then forward.  He has mild neck soreness but no other pain.  Temperature is 36.8 C (98.3 F) , blood pressure is 128/74 mm Hg, pulse is 82/min, and respirations are 14/min.  The patient does not appear intoxicated.  Glasgow Coma Scale score is 15, and neurologic examination is normal.  Palpation of the midline spine elicits no pain.  The rest of the physical examination is unremarkable.  Which of the following is the most appropriate imaging for evaluating this patient's cervical spine for injury?

• A)Lateral, anteroposterior, and open-mouth radiographs of the cervical spine
• B)MRI of the cervical spine
• C)No cervical spine imaging is necessary
• D)Noncontrast CT scan of the cervical spine
• E)Portable lateral radiograph of the cervical spine

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