Pitfalls in multidetector computed tomography imaging of traumatic spinal injuries

The advent of multidetector computed tomography (MDCT) has largely supplanted plain radiography as the recommended primary imaging modality for the evaluation of acute spinal injuries. Although MDCT is highly sensitive and specific for bony injuries, errors in diagnosis can still occur. Knowledge of the possible imaging pitfalls on MDCT, leading to either misdiagnosis of fractures or missed fractures, is vital in ensuring an accurate diagnosis. This paper serves to highlight conditions that can mimic or reduce the sensitivity for the detection of acute spinal injuries, as well as demonstrate imaging findings which aid in the detection and diagnosis of subtle spinal injuries. Review areas for clinically relevant extra-spinal findings in the context of trauma will also be discussed.