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Movement artefact – A pain in the neck!
Radiography (2007) 13, 81e82
a v a i l a b l e a t w w w. s c i e n c e d i r e c t . c o m
j o u r n a l h o m e p a g e : w w w. e l s e v i e r. c o m / l o c a t e / r a d i
SHORT COMMUNICATION
Movement artefact e A pain in the neck! Madhumita Dandapani a,*, S. Rajagopalan b a b
Department of Paediatrics, Royal Aberdeen Children’s Hospital, 8 Harcourt Road, Aberdeen AB15 5NZ, UK Aberdeen Royal Infirmary, Aberdeen, UK
Received 3 September 2005; accepted 27 October 2005 Available online 4 January 2006
KEYWORDS Radiological artefact; Croup
An 18-month-old child came to the Accident and Emergency department in the early hours of the morning with a brief history of sudden onset stridor and respiratory distress associated with a barking cough. This was his first hospital admission and he was a healthy child with normal development. He had been fully immunised for his age. The senior house officer in the department decided to perform a lateral cervical spine radiograph to establish the cause of stridor. It is important to note that as the history was typical of viral croup, a radiological examination was not necessary in this child. The film (Fig. 1) shocked the doctor who thought the child had a dislocated neck. A repeat examination was performed by the paediatric team as the clinical features were not in keeping with the radiological findings. The repeat film was reported as being normal. This was an unusual situation where there was superimposition of two consecutive images due to movement of the child while the film was being taken. This lead to the artefactual appearance of a dislocated cervical spine (two arrows). Artefacts may be caused by motion, as in this case
* Corresponding author. Tel.: C44 1224 325215. E-mail address: [email protected] (M. Dandapani).
Figure 1 Arrows showing position of vertebral bodies on the original and the double image.
1078-8174/$ - see front matter ª 2005 The College of Radiographers. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.radi.2005.10.009
82 or due to other objects such as endotracheal tubes1 and catheters. This may be particularly relevant in assessing injuries to the cervical spine. Double exposure artefacts can mimic fractures of the cervical spine.2 This case illustrates the importance of clinical assessment and the judicious use of investigative modalities. The moral of the story is e do not perform an unnecessary investigation as you might have to repeat it yet again!!
M. Dandapani, S. Rajagopalan
References 1. Fox BM, Harries SR, Defriend DE, Hughes PM. Pre-cervical soft tissues: a cautionary note. Eur J Emerg Med 2001 Jun;8(2): 151e2. 2. Burnside ES, Andriole KP, Dillon WP. Double-exposure artifact mimicking a cervical spine fracture on computed radiography. AJR Am J Roentgenol 2000 Jan;174(1):264.
a v a i l a b l e a t w w w. s c i e n c e d i r e c t . c o m
j o u r n a l h o m e p a g e : w w w. e l s e v i e r. c o m / l o c a t e / r a d i
SHORT COMMUNICATION
Movement artefact e A pain in the neck! Madhumita Dandapani a,*, S. Rajagopalan b a b
Department of Paediatrics, Royal Aberdeen Children’s Hospital, 8 Harcourt Road, Aberdeen AB15 5NZ, UK Aberdeen Royal Infirmary, Aberdeen, UK
Received 3 September 2005; accepted 27 October 2005 Available online 4 January 2006
KEYWORDS Radiological artefact; Croup
An 18-month-old child came to the Accident and Emergency department in the early hours of the morning with a brief history of sudden onset stridor and respiratory distress associated with a barking cough. This was his first hospital admission and he was a healthy child with normal development. He had been fully immunised for his age. The senior house officer in the department decided to perform a lateral cervical spine radiograph to establish the cause of stridor. It is important to note that as the history was typical of viral croup, a radiological examination was not necessary in this child. The film (Fig. 1) shocked the doctor who thought the child had a dislocated neck. A repeat examination was performed by the paediatric team as the clinical features were not in keeping with the radiological findings. The repeat film was reported as being normal. This was an unusual situation where there was superimposition of two consecutive images due to movement of the child while the film was being taken. This lead to the artefactual appearance of a dislocated cervical spine (two arrows). Artefacts may be caused by motion, as in this case
* Corresponding author. Tel.: C44 1224 325215. E-mail address: [email protected] (M. Dandapani).
Figure 1 Arrows showing position of vertebral bodies on the original and the double image.
1078-8174/$ - see front matter ª 2005 The College of Radiographers. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.radi.2005.10.009
82 or due to other objects such as endotracheal tubes1 and catheters. This may be particularly relevant in assessing injuries to the cervical spine. Double exposure artefacts can mimic fractures of the cervical spine.2 This case illustrates the importance of clinical assessment and the judicious use of investigative modalities. The moral of the story is e do not perform an unnecessary investigation as you might have to repeat it yet again!!
M. Dandapani, S. Rajagopalan
References 1. Fox BM, Harries SR, Defriend DE, Hughes PM. Pre-cervical soft tissues: a cautionary note. Eur J Emerg Med 2001 Jun;8(2): 151e2. 2. Burnside ES, Andriole KP, Dillon WP. Double-exposure artifact mimicking a cervical spine fracture on computed radiography. AJR Am J Roentgenol 2000 Jan;174(1):264.