- Discussion:
- soft tissue swelling is indirect indicator of significant trauma, esp when the soft tissue swelling is above the epiglottis;
- retropharyngeal soft tissue swelling should not exceed:
- anterior to C3 should not exceed 3 mm.
- if > than 5 mm at C3 consider minimally displaced C2 fracture;
- w/ children, crying increases the C3 distance;
- below C4 the thickness varies from 8 to 10 mm & is less reliable;
- distance between tracheal air column & anterior aspect of vertebral body should be No greater than:
- Adults: no > than 7 mm at C2 or 22 mm at C6;
- Child: no > than 14 mm at C6
- during x-ray child should be in neutral or sl extension and w/ a full inspiration;
- fullness and laxity of child's prevertbral soft tissues may simulate traumatic swelling if film is obtained during expiration or flexion;
- Diff Dx:
- Hyperextension dislocation
- combination of prevertebral soft tissue swelling in assoc w/ normal alignment of C spine suggests Hyperextension dislocation;
- Hangman's frx
- Jefferson frx