Cervical spine injuries to children under 11: should we use radiography more selectively in their initial assessment?

OBJECTIVES To assess the effectiveness of cervical spine radiography in injured children under 11 years old, and suggest improvements. METHODS Retrospective survey of radiographs and accident and emergency records for children examined during a one year period in a large teaching hospital. RESULTS No cervical spine fractures occurred in this age group during the year. The recorded clinical findings did not always justify radiography. CONCLUSIONS Clinical examination appears undervalued by those assessing injured children and is poorly recorded. Radiography can be used more selectively. Initial assessment using a single lateral projection can be followed in doubtful cases by cross sectional imaging.