Spine Case 13 Diagnosis

Clay Shoveler fractures are often diagnosed by x rays, but CT would also demonstrate these injuries. A lateral x-ray will show fracture fragments most commonly displaced posteriorly or posteroinferiorly. A double spinous process sign, where the fractured tip is displaced caudally, can also be seen on AP imaging.

These fractures can be missed by x ray due to poor sensitivity. CT scans are superior for diagnosing bony injury with far higher sensitivity (>95% as compared to about 50% for x-rays).