Clinical considerations are particularly important in the context of Cervical spine (C-spine) injury. This is because normal C-spine X-rays cannot exclude significant injury, and because a missed C-spine fracture can lead to death, or life long neurological deficit.
Clinico-radiological assessment of spinal injuries should be managed by experienced clinicians in accordance with local and national clinical guidelines. Imaging should not delay resuscitation.
Further imaging with CT or MRI (not discussed) is often appropriate in the context of a high risk injury, neurological deficit, limited clinical examination, or where there are unclear X-ray findings.
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