Investigations

Xray

• AP, Lat, odontoid & obliques
  • In a trauma situation the cross table lateral will still miss 23-26% in paediatrics
  • Get flexion & extension views after evaluation of the static films
  • Soft tissue space infront of C2  should be less than 3.5mm
  • Soft tissue in subaxial should be less than 7.9 mm
  • ADI in a child should be less than 5 mm – measured at the midpoint of the dens (ie. 4 mm is the upper limit of normal)
  • lower cspine is scrutenized for evidence of divergence & the posterospinolaminar line is very important
• Consideration to special studies including CT & MRI