MRI Detects Missed Cervical Injuries After Negative CT
MRI identified missed cervical spine injuries in 17% of patients with trauma who had negative CT results, prompting treatment changes in 4% of them.
METHODOLOGY:
Researchers conducted a meta-analysis of 36 studies involving 6784 patients with trauma who underwent cervical spine MRI after a negative CT scan.
Most included studies were retrospective (n = 29).
The primary outcome was the proportion of patients with missed injuries. Changes in treatment due to MRI findings were also evaluated.
TAKEAWAY:
MRI identified missed injuries in 17% of patients with initially negative CT findings. Most injuries were soft tissue injuries, with 40.1% involving the intervertebral disk and posterior ligamentous complex and 2% due to prevertebral edema.
Missed injuries were more common in children than in adults (32% vs 13%).
Alert patients had a higher rate of missed injuries than obtunded patients (28% vs 14%).
MRI findings led to treatment changes in 4% of patients, most of which were related to the intervertebral disk and the ligaments supporting the spine, highlighting the role of MRI in reducing missed injury rates through its superior soft tissue visualization compared with CT.
IN PRACTICE:
"While there was no established algorithm for the indication of MRI after negative CT findings, MRI should be considered under certain circumstances to prevent missing injuries. This includes the pediatric population, obtunded patients, patients experiencing persistent pain, and when there are uncertain clinical examination findings," the authors wrote.
SOURCE:
This study was led by Jung Hahn Yong, National University of Singapore, Singapore. It was published online on May 23, 2025, in European Spine Journal.
LIMITATIONS:
Most included studies were retrospective. Variability in patient age groups and incomplete reporting of MRI findings leading to treatment changes could have limited the generalizability of the results. Researchers also noted moderate-to-high heterogeneity between studies.
DISCLOSURES:
This study did not receive any funding. The authors declared having no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
CBS News
21 minutes ago
- CBS News
C4 mental health nonprofit struggles with late paychecks 5 years after similar crisis
Passionate mental health providers are fed up after multiple paychecks were delivered late, and they say it feels like déjà vu on top of it. CBS News Chicago has covered financial problems at the very same nonprofit before. At an all-staff meeting last week, Kerri Brown, the chief executive officer of the nonprofit Community Counseling Centers of Chicago — also known as C4 — said he knew everyone wanted to know about what was going on with payroll. "It has caused all types of anxiety, financial pain and stress to you guys," Brown told the staff. The meeting was recorded by someone whose loved one had just quit, after several weeks of emails with "difficult news" from Brown. "Temporary financial challenges," for the behavioral health provider led to late paychecks over and over. "Your job is supposed to be like the most stable thing," said a former C4 higher-up. "A dip in revenue" is how Brown initially explained the payroll problem. But the former higher-up, who asked to remain anonymous, could not stomach not knowing when her hard-earned cash would be in hand. "You kind of go into a panic," she said. "You're in shock because you're trying to think of all the things you had planned." Staffers were provided with letters to give to landlords and other bill collectors, confirming the delay in salaries for June. The problem persisted through July. In August, C4 began offering hardship assistance for rent late fees, overdraft or insufficient funds fees, utility shutoffs, and evictions or foreclosures. Another ex-employee said she had issues with her medical care, because C4 did not pay her health care premiums on time. "There's, you know, good workers there that are helping people in the community, and, you know, and no one deserves this," she said. This was not the first time C4 has run into financial issues. In 2019 and 2020, CBS News Chicago produced several stories that dug into C4's finances. Clinicians at that time also sounded the alarm on delayed paychecks. CBS News Chicago's reporting inspired the Illinois Attorney General's office to open an investigation. Five years later, the same questions are cropping up again — despite promises that the problem had been solved long before. "It was mentioned to me in an interview that I may see some reports from years ago about financial issues or struggles that the organization had, but that they were well beyond those," the former higher-up said. CEO Brown assured staff and CBS News Chicago that the nonprofit will weather the latest storm. "We're not in a place of shutdown," he told staff at the meeting. This time around, the money problems came up because unexpected flooding and broken heating and air conditioning systems decimated C4's rainy day fund. Brown said a reversal of hundreds of thousands of dollars in funding that "were certainly not our fault" also hurt. Another problem was that C4 was put on State of Illinois' "do not pay' list for about six months due to a late audit. That is now resolved, though some money still needs to be processed. The former higher-up said "at least 30 people" have resigned from C4 at this point. After a two-and-a-half-week wait for their July 25 paychecks, the therapists that remained were thanked for their "continued patience and commitment." "It's one thing to have a, you know, positive outlook in the darkness of things," said the second former employee. "It's another to ask people to buy it." Brown spoke with CBS News Chicago a few times by phone, but declined several opportunities to do an on-camera interview. He did issue this statement: "C4's story is a story of resilience, and unwavering commitment. C4's turnaround began four years ago, when C4 was losing $350-$400k per month. Despite that starting point, in the last 4 years since, this is the first occurrence of any payroll delays. In fact, C4 has been on sound financial footing. We've had three straight clean audits. We have diversified our revenue streams. C4 has significantly expanded its reach and presence in the community. We have grown in some of the most challenging times. We have repaired and restored our reputation and standing in the community by being an innovator in the industry, creating high profile, high impact therapeutic models. "Yes, we experienced tight cash flows in 2025. We had a series of large, unexpected borderline tragic events to include separate major flooding events and multiple HVAC replacements and other infrastructures issues/repairs that represented significantly large expenses. Additionally, there were unexpected obstructions of receivables and reversals of some funding channels that were not our doing and certainly not our fault. This is a mere snapshot in C4's existence; however, if you look at the entire story, you will know that this one moment does not define us! "C4 stands with Chicago's most vulnerable, delivering mental health, crisis, and substance use intervention where it is needed most. Like many nonprofits in these disruptive times, we face challenges. These hurdles are real, but they are not bigger than our mission or our determination. We continue to take decisive steps to strengthen C4 for the long haul. "We will work and overcome these temporary challenges and are grateful for our employees for their patience, commitment, and understanding."
CNN
21 minutes ago
- CNN
Cowboys owner Jerry Jones reveals decade-long battle with Stage 4 cancer diagnosis
Dallas Cowboys owner Jerry Jones credited an experimental trial drug for successfully treating advanced melanoma as he disclosed his cancer diagnosis publicly for the first time. Jones revealed his illness in a documentary series, 'America's Team: The Gambler and His Cowboys,' which will debut on Netflix next week. The 82-year-old Jones then told The Dallas Morning News how he was initially diagnosed in June 2010 and underwent two surgeries on his lung and two on his lymph nodes over the next 10 years after skin cancer cells metastasized to other parts of his body. 'Well, you don't like to think about your mortality, but I was so fortunate to have some great people that sent me in the right direction,' Jones said after practice on Wednesday. 'I got to be part of a trial that was propitious. It really worked. It's called PD-1 (therapy), and it really, really, really worked.' First-year Cowboys coach Brian Schottenheimer described Jones' fight with cancer as an 'amazing story' and praised him for going public. 'I'm glad that Jerry shared it, just because I think it gives people hope,' Schottenheimer said Wednesday. 'It gives people the strength to say … 'Hey, you can beat this.'' Schottenheimer, 51, used his last news conference of the Cowboys' nearly monthlong stay in Southern California to talk about his own cancer diagnosis. He underwent surgery in 2003 for thyroid cancer at the Mayo Clinic in Rochester, Minnesota. Then-Washington Commanders owner Dan Snyder helped arrange Schottenheimer's treatment two years after firing his father, Marty Schottenheimer, as coach. Brian Schottenheimer was Washington's quarterbacks coach during the 2001 season, the same year Snyder himself was treated for thyroid cancer. 'It doesn't discriminate against anybody,' Schottenheimer said. 'And mine was certainly less serious, but I was 28 when I was diagnosed with thyroid cancer. Nothing like Stage 4, nothing like what Jerry and other people have to go through. But you hear that word 'cancer,' and it scares the hell out of you.'
CBS News
21 minutes ago
- CBS News
Suspected meteorite hits Massachusetts home. Scientist says "it looks pretty convincing"
A Massachusetts couple suspects their home was hit by a meteorite. Late last week, Jim Dolan was sitting upstairs reading in his Gloucester townhouse when he heard something slam into the side of it. He ran out to the balcony to find his wife on the lower deck. She heard the same noise. "I said what's going on, what happened," Dolan recalled. "She says I don't know but there are all kinds of rocks down here on the deck." Dolan's wife Sue walked out and found a few rocks at her feet. "I am picking them up and I am looking around and I am like there is nobody here," Sue Dolan said. "There's nobody out on the water, there's nobody throwing rocks at the house." When she picked the rocks up, Dolan said they smelled of sulfur and had black markings on the exterior. With no one around she looked up and found damage to the corner of her house where the trim had recently been replaced. "There's no way a rock could've splashed up or come from anywhere else so it must be a meteor," she said. WBZ-TV sent a picture of the rocks to Boston College professor, and senior research scientist at the Weston Observatory, John Ebel. He noted the rocks mineral composition, where they appeared to have made contact with the house, and its reported smell as reason to conclude these rocks were the real deal. "It looks pretty convincing to me that is was a meteorite," said Ebel. "First of all, obviously it came down from above. There would be no reasons for rocks to fly out of the sky." Ebel compared the likelihood of one hitting your house to that of winning the lottery but said it's not uncommon for meteorites to make landfall. "Every day and every night there are meteorites coming into the atmosphere," he said.
