Value of cervical spine radiographs as a screening tool

A review of the reports of 848 cervical spine radiographs was done to assess the yield of useful and critical information in a group of patients without trauma. In 470 of these patients the clinical record also was reviewed; 54.2% of the radiographs were read as having degenerative change, 35% were read as normal, and 8.5% were read as being consistent with muscle spasm. The remaining 2.3% included diagnoses of anatomic or congenital variants, soft tissue calcification, or old compression fractures. There were no serious diagnoses such as acute fracture, dislocation, or neoplasm that, had they not been identified, would have put the patient in jeopardy. Thus, for most outpatients with nontraumatic symptoms of a nonspecific or nonlocalizing nature, the use of cervical spine radiographs as a screening tool is not justified.