Computed tomographic artifact suggesting cervical facet subluxation

Area of Science:

• Radiology
• Medical Imaging
• Diagnostic Accuracy

Background:

• Computed tomographic (CT) scanning is a primary tool for detecting cervical spine injuries, with high sensitivity but variable specificity.
• CT artifacts can significantly decrease the specificity of cervical spine injury detection.
• Misinterpreting artifacts can lead to incorrect diagnoses and patient management.

Observation:

• A case report details a patient with neck trauma initially diagnosed with cervical facet dislocation based on CT scans.
• The diagnosed cervical facet dislocation was ultimately determined to be an artifact on repeat CT scans.
• The patient presented with neck pain but no neurological deficit following trauma.

Findings:

• Movement artifact on initial CT scans mimicked a unilateral facet fracture subluxation at C5-C6.
• Key indicators of the artifact included an ill-defined tracheal margin and a double bone margin on axial views.
• These subtle signs were missed on the initial review, leading to a false positive diagnosis.

Implications:

• Motion artifacts are a significant factor reducing CT scan specificity for cervical spine injuries.
• Awareness of artifact indicators is essential to prevent misdiagnosis and unnecessary interventions.
• Improved recognition of CT artifacts can enhance diagnostic accuracy and patient safety in trauma care.