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What Would I Do Next? - Neck Pain after an MVC

Charles Khoury, MD, Mike Weinstock, MD, and Matthew DeLaney, MD
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Both NEXUS and the Canadian C-Spine rule are evidence based tools that can be used to evaluate patients with potential cervical spine injuries. 

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Jessica S., MD -

ligamentous injuries can only be seen on MR, so even if negative CT- we’d place in a collar with spine clearance outpatient in a few weeks once the pain subsides if cannot clinically clear post CT. Had a case where no fracture seen on CT but unstable ligamentous injury in a patient with persistent posterior neck pain. No neurologic signs or exam findings. Thankfully I had kept in a Miami J inpatient. Any other thoughts on this, to add to this topic/discussion.

James L. -

Great episode. Just to build on Dr. Jessica's question - when are you getting a MRI on patients if their CT is clear?

Mike W., MD -

One of the primary reasons for emergent MRI would be neuro sx or signs, persistent numbness, weakness, etc.

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Hippo Urgent Care RAP - December 2019 Written Summary 273 KB - PDF

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