Alternatives to an x Ray ?

[CharlesChickens]

My daughter was injured last week. She had a ct scan- at the time of scanning we thought she had fallen from standing , but we later found out she had fallen from a table.
She has been saying her neck hurts, not badly but now and then. (If anyone remembers my thread on how she got injured then you will know what happened). I’ve checked with the hospital and they only did a ct scan of her head, not her neck. I’ve called my GP, who says to take her back to casualty for an x Ray of her neck, but as she’s just had the whacking dose of radiation from the ct scan, I am worried about an x Ray on top. Also we have thyroid issues as a family so a neck x-ray isn’t great from that point either. Would an ultrasound show up any issues ? I’m happy to pay for one if necessary, to avoid putting her through more radiation.

I’m not sure but I believe that therapeutic ultrasound causes a lot of pain when directed on to fracture sites. I’m not sure whether diagnostic US would be the same. Ultimately though the amount of radiation is equivalent to a few flights abroad and if there’s any need to worry about the level the hospital will flag it up. I hope all is well with your daughter r

I read your first thread so am familiar with he mechanism of injury she suffered....

My son fell from 5 ft up off climbing aparatus at the park onto bark - onto his head/neck. The ambulance strap and boarded him - he immediately stood after the accident.

At A&E they examined him, observed him and said at the age he was (3 at the time) that they do not like to expose the children to x-rays or scans. He was alert, not complaining of major pain and luckily has no ill effects.

He said a day or two later that his head and eyes hurt. Clearaly, being 3 I couldn't ascertain whether he meant as a result of the injury or headache. I called the GP who said I would need to take him to A&E which I did. He was again examined and I was reassured he was fine and it might be soft tissue swelling causing a sore neck/headache/tenderness. Again, they did not want to scan/x-ray him.

If she is alert, not being sick, double vision etc I would be minded to think, given the mechanism of injury, it is soft tissue damage.

She would benefit most from an x Ray for sure.

Whilst it’s important to consider radiation damage, having two doses (CT and x ray) isn’t As severe as you might think and the benefit of knowing if there is a neck injury certainly outweighs the risk.

I’d go down for x Ray and discuss concerns with radiologist and they will be able to explain

I remember your last thread, hope your daughter is doing ok

An MRI scan would not require any more ionizing radiation. An x-ray of her neck would be a very small additional exposure:

www.health.harvard.edu/cancer/radiation-risk-from-medical-imaging

Ask your GP about the ultrasound option.

Ultrasound won’t look at bones.

An x-Ray is very little radiation. If you’re worried, take her back to A&E to be assessed.

It’s almost certainly muscular damage, especially if it happened a day or so after she fell. People who have been in car accidents etc feel ok for a day then absolute agony kicks in. It’s like having a really heavy work out - pain comes a day or two later.

Thanks for posting everyone. We are waiting a chat with our solicitor so didn’t want to post any more details here. I assumed that they’d scanned the whole area of head and neck and it only occurred to me this morning that they might not have done, as they didn’t have the full information about her injury. We still don’t know the truth of the position of the fall as her injuries don’t tally with the report.
Hmm. I’m not sure what to do now. She will get into a panic about going back to hospital, and it is some distance away. I am worried about the x Ray triggering thyroid problems as any radiation is very bad for the thyroid. However I obviously don’t want to take a risk on a fracture. The pain isn’t very bad, so I think it probably is tissue damage, but still.... if she had a fracture anywhere in her neck would it be very painful or might it not be too bad ?

She was injured on the 13th, her head has been hurting all week, obviously, as she has a fractured skull, but she is saying that certain positions make her neck hurt. It isn’t painful all the time.

Think about whiplash and how that effects the body Charles She could effectively have a similar injury.

FWIW, I've had all sorts of scans through my life - CT, Xray, MRI - also have a family history of thyroid issues. I still ot it when I had my son (UAT). As unpleasant as it is, it's better safe than sorry for her to get checked out. And one scan in the grand scheme of things won't effect her

Yes, I do think it could be similar to whiplash. She fell backwards from a standing position on a table, onto a very hard floor. She is about four foot ten I think.

And thanks for the good wishes. She has gone into school today. She is ok but not totally recovered, still in a bit of pain. Emotionally she is not good at all. Very anxious, frightened of falling again, very clingy, can’t sleep.

I'd rather a dose of radiation then leaving a potential unstable c-spine fracture undiagnosed. Why didn't they order a ct head and neck? That's fairly routine if they were looking at a traumatic head injury?!

I don’t know why not head and neck. I assumed it had been head and neck, but DH has called them and apparently it was just her head. Her head had hit the floor, she was very concussed, Maybe they felt as her neck hadn’t actually hit the floor, then it would be fine ? Her neck didn’t get any impact, could she have a fracture without neck impact ?

A fall directly onto a head is a red flag for a c-spine injury. We immobilise patients who have hit their head from a height as there is increased risk to the neck.

She hit the back of her skull, very slightly off centre, at the widest point of the skull if looking side on.

Have the x Ray. I've had numerous ones plus around 10 MRI scans now and no issues. My family all have thyroid issues on the female side. The benefits outweigh any tiny risk in this situation

I think she should get the x-ray. I'mSh

ocked at the lies you've been told about her accident.

Her consultant is calling us in the morning , if he wants the x-ray then we can have it done at the local cottage hospital in the morning rather than having to go back to Casualty in the proper hospital.
The whole thing has been a massive shock, I will post an update when we’ve had legal advice.

Take her for the x ray. It's less risk from the radiation than from a potential neck fracture. If there is a break and she moves wrong she could paralyze herself. You do not piss about with spines. I rode a bike with a broken arm and didn't know it. You don't always feel when you break something and I think fretting about radiation should be the lower priority tbh.

It’s a balance of risks.

There is a risk to her having an X-ray, but there is also a risk to her not.

What is the greater risk?

Yes, I do agree that radiation is less of an immediate issue than a spinal fracture. I just wasn’t sure if the reason they hadn’t scanned was because they didn’t know the fall height, or if her injuries were such that a fracture wasn’t a worry. If it was extremely unlikely and an ultrasound would do the same job, then I would have paid for an uktrasound if possible. Now I know that an ultrasound doesn’t image the bones well, I’m expecting her to need an x Ray in the morning.

Ok, so after a review of where the pain is, and of what was checked on arrival in A and E, they have decided that she doesn’t need a neck x Ray as they feel sure that the neck pain is due to soft tissue injury. Thanks for all the help and advice. She is still recovering from the concussion, and the skull fracture will take time to heal, so it is a relief.