The effect of PACS on the visualization of the lateral cervical spine and the management of patients presenting with trauma.

In patients presenting with trauma, early diagnosis of neck injuries is likely to affect long-term outcome. This paper reports a study that compared lateral images of the cervical spine produced by a Picture Archiving and Communication System (PACS) with the same images produced using computed radiography (CR). The study was undertaken at the Hammersmith Hospital, London. Data were collected on 100 patients who presented with trauma. Both soft copy (PACS) and hard copy (CR) images of the cervical spine were produced for each patient from the same radiographic exposure. The images were viewed by five clinical members of the Accident and Emergency Department. Data were collected on the level of the cervical spine that could be viewed, the clinical management following the viewing of the image and the use of PACS 'tools'. Overall no statistically significant differences between modalities were found in the level of visualization. Within viewer differences were found for three viewers: one indicating better visualization with PACS and two indicating better visualization with CR. The results relating to patient management indicate greater clinician confidence following the viewing of PACS images for two viewers. The use of PACS 'tools' improved visualization of the cervical spine for one viewer.