![]() Does this radiographic “signal” also hold for males with fibromyalgia? Admittedly this a minority of patients with the disorder. This raises questions about the generalizability of the results. The patients with fibromyalgia who presented with neck pain for cervical spine X-rays had significantly decreased cervical lordosis, compared with patients with other rheumatic diseases who were also presenting with neck pain for cervical spine X-rays.įirst, all the fibromyalgia patients and all the “control” patients (ie, those with other rheumatologic diagnoses) were female. The findings from this point are quite clear. What happened then apparently was they were sorted out as to whether they had fibromyalgia or another rheumatic disease. It was a retrospective study of patients who presented to a single rheumatology clinic, with neck pain, and who had cervical spine X-rays. However, the paper does present some interesting findings. As much as we would all like an objective test for fibromyalgia, I don’t think this is the golden ticket. It is difficult to know what to take away from this article. “Increased muscle pressure and straight neck are two of them that I believe are important in assisting with the diagnosis and also in suggesting a potential etiology and therefore treatment.” “Very little has been observed about the diagnostic markers in fibromyalgia,” Katz said. In addition, muscle pressure was three times higher in patients with fibromyalgia, compared with the control group, the researchers wrote. Moreover, the researchers found that 50.3% of patients with fibromyalgia had a Cobb angle measurement of 5 degrees or less, compared to just 7.8% of the control group ( P <. Additionally, 83.2% of patients with fibromyalgia had a 10-degree or less cervical Cobb angle, compared with 32.2% in the control group ( P <. The researchers defined a visually straight cervical spine as one with a 10-degree Cobb angle measurement.Īccording to the researchers, patients with fibromyalgia demonstrated a mean curvature of 6.4 ± 5.2 degrees, compared with 13.8 ± 7.4 degrees in the control group ( P <. Katz and colleagues performed the statistical analysis using SPSS version 22.0. In total, 155 of the patients, with a mean age of 44.8 years, met the American College of Rheumatology guidelines for fibromyalgia, while 115 patients, with a mean age of 44 years, met the guidelines for another rheumatic disease and were used as a control group. The researchers retrospectively analyzed 270 lateral view cervical spine radiographs of adult female patients with neck pain from 2015 to 2018, using the Cobb angle measurement for cervical lordotic curve. To examine the cervical curvature via radiographs of patients with fibromyalgia, Katz and colleagues conducted a medical records review study. “The straight neck seemed to be so common that we decided to study it.” Katz, MD, of Rush Medical College, in Chicago, told Healio. “It caught my eye a long time ago when I visualized radiographs of fibromyalgia patients,” Robert S. Assessment requires a systematic approach.The researchers added that the loss of cervical spine curvature is approximately 6.5 times greater in those with fibromyalgia compared with control individuals.Īpproximately 83% of patients with fibromyalgia demonstrate visually straight cervical spines, according to data. The lateral view is often the most informative image. If the lateral view does not show the vertebrae down to T1 then a repeat view with the arms lowered or a ' Swimmer's view' may be required. In the context of trauma these images are all difficult to acquire because the patient may be in pain, confused, unconscious, or unable to cooperate due to the immobilisation devices. The 3 standard views are - Lateral view - Anterior-Posterior (AP) view - and the Odontoid Peg view (or Open Mouth view). Imaging should not delay resuscitation.įurther imaging with CT or MRI (not discussed) is often appropriate in the context of a high risk injury, neurological deficit, limited clinical examination, or where there are unclear X-ray findings. This is because normal C-spine X-rays cannot exclude significant injury, and because a missed C-spine fracture can lead to death, or life long neurological deficit.Ĭlinico-radiological assessment of spinal injuries should be managed by experienced clinicians in accordance with local and national clinical guidelines. Bones - Cortical outline/Vertebral body heightĬlinical considerations are particularly important in the context of Cervical spine (C-spine) injury.Alignment - Anterior/Posterior/Spinolaminar.Look at all views available in a systematic manner. ![]() Clinical considerations are of particular importance when assessing appearances of C-spine X-rays.Normal C-spine X-rays do not exclude significant injury.
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