CAMRT Radiography Practice Exam

What type of fracture might be overlooked if the lateral projection does not capture the top of T1?

1. Comminuted fracture

2. Clay shoveler's fracture

3. Oblique fracture

4. Transverse fracture

The correct answer is: Clay shoveler's fracture

A clay shoveler's fracture is a specific type of fracture that typically occurs in the lower cervical or upper thoracic spine, often at the spinous process of C7 or T1. This fracture is associated with avulsion injuries due to the force exerted on the muscle attachments, commonly seen in individuals who perform heavy lifting or experience trauma to the upper back and neck. In the context of imaging, if the lateral projection does not adequately capture the top of T1, there is a significant risk of missing this type of fracture. Since the injury often occurs at or near T1, an incomplete view can lead to a misdiagnosis or overlook the injury altogether. In contrast, while other fractures such as comminuted, oblique, and transverse fractures could occur in the spine, they are not specifically associated with the upper thoracic region and would require different imaging considerations. Therefore, capturing the entire T1 area is particularly crucial for diagnosing a clay shoveler's fracture, as it directly relates to this location and mechanism of injury.