Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Case 19 Variants of the upper cervical spine
- Case 20 Atlantoaxial rotatory fixation versus head rotation
- Case 21 Cervical flexion and extension radiographs after blunt trauma
- Case 22 Pseudosubluxation of C2–C3
- Case 23 Calcific tendinitis of the longus colli
- Case 24 Motion artifact simulating spinal fracture
- Case 25 Pars interarticularis defects
- Case 26 Limbus vertebra
- Case 27 Transitional vertebrae
- Case 28 Subtle injuries in ankylotic spine disorders
- Case 29 Spinal dural arteriovenous fistula
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Case 24 - Motion artifact simulating spinal fracture
from Section 2 - Spine
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Case 19 Variants of the upper cervical spine
- Case 20 Atlantoaxial rotatory fixation versus head rotation
- Case 21 Cervical flexion and extension radiographs after blunt trauma
- Case 22 Pseudosubluxation of C2–C3
- Case 23 Calcific tendinitis of the longus colli
- Case 24 Motion artifact simulating spinal fracture
- Case 25 Pars interarticularis defects
- Case 26 Limbus vertebra
- Case 27 Transitional vertebrae
- Case 28 Subtle injuries in ankylotic spine disorders
- Case 29 Spinal dural arteriovenous fistula
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Summary
Imaging description
Many patients undergoing spine evaluation in the emergency department are intubated or otherwise unable to hold still while undergoing CT. Misregistration is a CT artifact caused by patient or physiologic motion during helical or sequential image acquisition [1–3]. Slight movement may cause blurring on axial CT images (Figure 24.1). If greater physical displacement occurs, motion artifact can result in double edges on images or ghosting (Figure 24.2A). The cervical spine is the most mobile portion of the spinal column, and images of the cervical spine are prone to motion artifact.
CT images of the spine degraded by patient motion can be mistaken for fractures. When an equivocal fracture is suspected on axial views confirmation of the finding on multiplanar reformations (usually obtained in the sagittal and coronal planes) is advised. Multiplanar image reformations improve clinical accuracy for the detection of spine fractures [4, 5], intracranial hemorrhage [6], and pulmonary embolism [7]. In the spine, orthogonal image reformation in the sagittal and coronal plane increases sensitivity, when compared to axial image review alone [4]. Thin axial image reconstruction (1 mm) also improves sensitivity to 95% for the detection of spine fractures compared to thicker slice reconstruction in the osteoporotic patient [5].
- Type
- Chapter
- Information
- Pearls and Pitfalls in Emergency RadiologyVariants and Other Difficult Diagnoses, pp. 84 - 86Publisher: Cambridge University PressPrint publication year: 2013