Imaging the cervical spine following rugby related injury

• Rugby as a participation sport represents a risk of cervical spine injury.
• Conventional radiography lacks sensitivity in identifying cervical spine injury.
• The body habitus of rugby players makes the imaging of the cervicothoracic junction challenging.
• CT scanning should replace radiography in the event of serious suspicion of cervical spine injury.
• The notion of CT being a high dose modality should be questioned.

Rugby Union and Rugby League are popular sports with high participation across the world. The high impact nature of the sport results in a high proportion of injuries. Rugby has an association with cervical spine injury which has potentially catastrophic consequences for the patient. Anecdotal evidence suggests that radiographers find it challenging to visualise the cervicothoracic junction on the lateral supine cervical spine projection in broad shouldered athletes. This paper intends to analyse the risk factors for cervical spine injuries in rugby and discuss the imaging strategy in respect to radiography and CT scanning in high risk patient groups such as rugby players who are suspected of suffering a cervical spine injury.