Cervical X-ray (musculoskeletal imaging in primary care)

• Cervical spine x-rays
  • should be performed in trauma, to assess bony alignment - e.g. in rheumatoid patients (flexion and extension lateral views) - and to delineate osteoarthritis (OA)
    
    
  • in non-traumatic acute neck pain x-ray examination is not usually helpful as most resolves on conservative management, but after 6-8 weeks with no improvement, or if lifestyle is affected or focal neurology demonstrated, or in those with a history of malignancy, specialist referral is indicated

General Indications for x-ray examination

• Bony tenderness
• Inability to weight-bear
• Acute joint pain
• Gross joint deformity
• Acute spinal pain in elderly (to rule out osteoporotic wedge fracture)

Reference:

• 1) Arthritis Research UK (Summer 2013). Hands on - Musculoskeletal imaging for GPs.