Rosh Emergency Medicine Practice Test

What is a critical step in the evaluation of a patient with neck pain and potential spinal injury?

1. Perform a range of motion assessment

2. Obtain imaging of the spine

3. Conduct a neurological exam

4. Initiate intravenous fluids

The correct answer is: Obtain imaging of the spine

In the evaluation of a patient with neck pain and a potential spinal injury, obtaining imaging of the spine is crucial. This step is important because it helps identify any fractures, dislocations, or other structural abnormalities that could be responsible for the patient's symptoms. Imaging, typically performed through X-rays, CT scans, or MRI, allows for a detailed assessment of the cervical spine, ensuring any potentially life-threatening or debilitating conditions are recognized and addressed promptly. Assessing range of motion is less appropriate in the context of potential spinal injury; it could exacerbate any existing damage or instability. Conducting a neurological exam is indeed vital to understand the extent of any neurological compromise but does not provide the necessary imaging needed to confirm the presence or absence of structural injury. Initiating intravenous fluids does not directly address the evaluation of potential spinal injury and is more relevant in cases where fluid resuscitation is warranted, typically in scenarios involving trauma with hemorrhage or dehydration. Therefore, obtaining imaging stands out as the fundamental step in this clinical context.