DIAGNOSTIC ACCURACY OF PLAIN X-RAY IN THE DIAGNOSIS OF CERVICAL SPINE FRACTURE TAKING COMPUTED TOMOGRAPHY AS GOLD STANDARD

Abstract

The study relies on the evaluation of plain X-rays as a diagnostic tool to identify the presence of fractures in the cervical spine; computed tomography (CT) is viewed as the gold standard. Cervical spine traumas are one of the most widespread trauma causes in the population of patients, and this may have a strong neurological implication if it is not diagnosed early enough. This was a cross-sectional validation study conducted at the Radiology Department of Khyber Teaching Hospital, Peshawar, involving 195 patients aged between 18 and 65 years who were suspected of having fractures. The inclusion criteria involved individuals with severe pain and resulting limited neck movement. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of plain X-ray results in comparison to CT results were considered the main diagnostic parameters in the study. The results revealed that plain X-ray was sensitive by 85.7 percent and specific by 97.1 percent. The PPV and NPV were 92.3% and 94.4%, respectively. The CT scan identified 56 fractures, and the plain X-rays identified 52; hence, the false-negative rate was 14.3 percent. The findings support the observation that plain X-ray is an extremely sensitive diagnostic tool in the initial line of testing; nevertheless, its limitations make it unworthy to exclude extra imaging in at-risk individuals. This study has provided insight into the evolution of optimal imaging protocols and has reaffirmed the importance of clinical judgment in trauma centers.

Keywords: Cervical spine fracture, diagnostic accuracy, plain X-ray, computed tomography, sensitivity, specificity, predictive value, trauma.