{
  "abstract": "Cervical spine clearance in trauma patients is frequently guided by strict protocols, particularly when patients present with midline cervical tenderness or cannot be reliably examined. Although a normal CT scan is often used to justify cervical collar removal, subtle but clinically significant injuries may be missed. This case report describes a polytrauma patient with altered consciousness in whom a C5/C6 bilateral facet dislocation was initially overlooked on CT imaging. A retrospective review revealed a subtle avulsion fragment, which was indicative of the underlying injury. This case highlights the limitations of CT alone for cervical spine clearance. While the CT-based protocols may reduce healthcare costs and streamline patient management, they carry the risk of missing critical injuries. In high-risk patients, continued immobilisation and additional imaging, such as MRI, are essential to prevent potentially serious neurological complications.",
  "authors": [
    {
      "affiliations": [
        "Orthopedic Department, Hospital Queen Elizabeth, Kota Kinabalu, Malaysia"
      ],
      "name": "Kai Hean Teh"
    },
    {
      "affiliations": [
        "Orthopaedic Surgery, Hospital Pulau Pinang, Georgetown, Malaysia"
      ],
      "name": "Han Sim Lim"
    },
    {
      "affiliations": [
        "Department of Orthopaedics, Penang General Hospital, Georgetown, Malaysia"
      ],
      "name": "Kamarul Bahrin Zairul Anuar"
    },
    {
      "affiliations": [
        "Surgery, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia"
      ],
      "name": "Khin Maung Ohn"
    }
  ],
  "title": "Missed subtle radiological sign on cervical computed tomography",
  "uid": "502519d1-12f3-5438-a4b1-46080c8437f7"
}