Application of the Canadian C-Spine Rule during early clinical evaluation of a patient presenting in primary care with a C2 fracture following a motor vehicle collision: A case report

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BackgroundNeck pain related to a recent minor trauma could mask a cervical spine fracture, even in the absence of neurological signs and symptoms. ObjectiveThe purpose of this article is to report a case of safe management of a patient involved in a minor importance motor vehicle collision, concealing an odontoid fracture. Clinical featuresA patient involved in a minor blunt trauma self-referred to a physical therapist's outpatient clinic the day after, complaining of pain of medium – severe intensity, slight nausea, headache and cervical mobility restriction raised during the night, many hours after the collision. No neurological signs were present. Intervention and outcomeA detailed case history which aimed to screen for red flags and the Canadian C-Spine Rule application combined with clinical examination, facilitated the diagnosis of an odontoid fracture of the C2 vertebra. This led to a safe and effective management procedure of the patient and an adequate therapy with a rigid Philadelphia neck brace for 60 days. ConclusionImplementation of the Canadian C-Spine Rule in outpatient clinics can be very helpful to avoid unnecessary imaging and, in the meanwhile, to guarantee safe practice.