Diagnosis Errors in the Imaging of Cervical Spine Trauma

Karam, Khalid Abd Elkarim; Abd Elbaset, Zakaria Moh; Iskandarani, Dalya Ayman; Iskandarani, Yara Ayman

doi:10.21608/ermhs.2025.364664.1049

Diagnosis Errors in the Imaging of Cervical Spine Trauma

Document Type : Original Article

Authors

¹ Assistant Professor, Radiology Consultant, Alazhar University, Egypt

² Assistant Professor, Neuropsychiatric Consultant, Psychiatric Department, Al-Azhar University

³ Intern Doctor, Department of Medicine, Bahçeşehir University, Turkey, Istanbul.

⁴ Medical Doctor, King Fahad Hospital Department of Internal Medicine, Saudi Arabia, Madinah.

10.21608/ermhs.2025.364664.1049

Abstract

Background: Systematic assessment of the multisystem blunt trauma case is the critical step of clearing the cervical spine (C-spine). Aim: To evaluate the clinical significance of diagnostic errors in the interpretation of cervical spine for trauma to describe and categorize them. Patients and methods: Retrospective analysis of the clinical records of 63 cases who were admitted to a trauma center with cervical spine fractures and/or dislocations has been performed in this investigation. Results: False negative cases were found in 90.47%; false positive cases were found in 9.523%; spinal cases were found in 80.95%; and extraspinal cases were found in 19.04%. Rib fractures were found in 25% of cases; lung nodules were found in 25%; hyoid bone fractures were found in 16.67%, cavicular fractures, dental caries, thyroid lobe nodules, and intraluminal tracheal debris were found in single cases. Based on the diagnostic error, does the necessity for surgery or the surgical approach change? In five cases, was it true that nonsurgical immobilization was altered as a result of a diagnostic error? Yes, in 23 patients, needing of a magnetic resonance imaging change has been a result of a diagnostic error. The answer was true in nineteen patients. Conclusion: Diagnostic errors were primarily false negatives (90.47%), with spinal fractures prevalent in vertebral bodies and transverse processes. In a variety of patients, extraspinal missed results have been identified.

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