Abstract
Drawing on experience with over 400 cases of significant cervical spine trauma, we have noted 12 helpful roentgen signs that may serve to direct the physician's attention to such serious underlying changes as fractures and dislocations. These 12 anatomic alterations may provide both direct and indirect evidence of traumatic lesions which are not clearly identified on the initial radiographs. The changes fally into three principal groups: abnormal soft tissues, abnormal vertebral alignment, and abnormal articulations. Rarely do these signs occur in isolation; rather, several useful changes are usually present on the routine cervical spine series. Considering the recent marked increase in requests for skull and cervical spine films, as well as litigation arising from such studies, an appreciation of clues to occult traumatic alterations is mandatory for the practising radiologist and clinician.
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