Abstract
ABSTRACT
Objective
To determine utility of cervical spine radiograph, clinical notes writing trends, and find out radiograph abnormalities seen.
Methods
One Thousand cervical spine X-Rays were studied at the department of radiology POF Hospital Wah Cantt from November 1, 2008 to April 25, 2009. Clinical notes provided with x-ray request and abnormalities seen on films were noted.
Results
Three major symptoms of patients were neck pain (21%), numbness (4.5%) and brachalgia (1.7%). No significant findings were seen in 48% films. Spondylosis (37 %) cervical rib (3.9%) congenital block vertebra (2%) and Kimmerle anomaly (2%) were the major radiological findings.
Conclusion
Neck pain was commonest reason for requesting cervical spine x-ray. Spondylosis was the commonest radiological finding seen in our study.
Key Words
Cervical spondylosis, brachalgia, cervical rib.
INTRODUCTION
Cervical spondylosis is a universal problem with aging. Symptoms include neck pain, numbness of the arms or limited neck movements. Foraminal encroachment by osteophytes causes cervical radiculopathy. Systemic diseases such as rheumatoid arthritis, spondyloarthritis and polymyalgia should be excluded in appropriate patients. Plain films are indicated in patients with neck complaints who are older than 50, have history of trauma or have signs of radiculopathy. Indications for further imaging studies by CT or MRI include neurological impairment. This study was designed to find out the workload share of radiology department made by cervical spine x-ray in tertiary care center, clinical notes writing trends of referring physicians and percentage of radiographs showing abnormalities.
PATIENTS AND METHODS
The study was carried out at POF Hospital, Wah Cantt from November 1, 2008 to April 25, 2009 and included 1000 cervical spine X-Rays. Patients of both genders and all ages and both indoor and outdoor were included.1000 mAs-150 KV general-purpose x-ray machine was used with vertical and horizontal Bucky. Radiographs were taken on 24cm into 30 cm size films. Automatic processing was done in all the cases. Age, gender and clinical information provided on the request form were noted. A record of radiographic views advised and referring OPD/Ward was kept. All the films were examined to determine radiological findings.



RESULTS
Total radiological investigations during the study were 25000 and C Spine x-ray made 4% of the workload. One thousand cervical spine x-ray were examined. Most of them (583) were female. Ages of patients ranged from 1 year to 80 years. Clinical information was provided in 40% of the cases (Table 1).

Table 1. Symptoms of the study subjects (n=1000).
Clinical Information available 394
No Clinical Information available 606
Neck pain 213
R/O Spondylosis 75
Numbness 45
Brachalgia 17
Chest Pain 10
Vertigo 16
Trauma 13
Dysphagia 05

Majority (647) had age more than 40 years (Table 2). About 54% ladies were wearing earrings or o

Key words: Cervical spondylosis, brachalgia, cervical rib.