Pitfalls in plain film diagnosis of cervical spine injuries: false positive interpretation

Of 412 patients who were referred and admitted with acute cervical spine injury, 58 (14%) were subsequently found to have no fracture or dislocation when evaluated at our institution. These patients had no abnormal neurological findings or severe persistent pain in the neck. Their referral was based on false positive interpretations of radiographs of the cervical spine. The radiographs in these cases are analyzed, and conditions that had led to misinterpretation are described. The radiographic differential features from true acute traumatic injury are discussed.