National Board of Chiropractic Examiners (NBCE) Practice Test

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When plain film radiographs indicate a C5 posterior element fracture, which imaging method is most appropriate?

  1. CT Scan

  2. Bone Scan

  3. MRI

  4. Ultrasound

The correct answer is: Bone Scan

In cases of a C5 posterior element fracture, a CT scan is the most appropriate imaging method. CT scans provide detailed cross-sectional images of bone and are highly effective in evaluating complex fractures, particularly in areas like the cervical spine where subtle fractures may be missed on plain film radiographs. Additionally, CT can reveal associated canal compromise or pathology that may not be readily apparent on conventional X-rays. While a bone scan can detect increased metabolic activity in bone, it is less specific and typically used in cases where there is suspicion of pathology that may not be visible on other imaging modalities. MRI is excellent for evaluating soft tissue structures and nerve root impingement but is not the primary method for assessing bony injuries such as fractures. Ultrasound, while useful for soft tissue assessments and some dynamic studies, is not appropriate for visualizing deep structures within the cervical spine. In summary, the CT scan is the preferred imaging modality for confirming and assessing the extent of a posterior element fracture in the cervical spine, which provides the necessary detail to guide further management.