1. Visual Inspection
If you think you have suffered any kind of neck trauma, no matter how minor it may seem, it is best to see a doctor immediately. Only a physician is qualified to determine the appropriate steps to keep your neck and spinal cord safe. If you are unable to get to a doctor, or if you are uncertain if the neck is stabilized, call an ambulance. The very first thing the doctor will do, after getting a history and determining how the injury occurred, is examine your neck visually. He is looking for signs of bruising, bleeding, discoloration, swelling or anything else that might indicate something is wrong under the skin. For instance, a red swollen area that is slowly growing larger is a good indicator of internal bleeding.
2. Neurological Examination
In order to determine if a traumatic neck injury has compromised the spinal cord, a doctor or neurologist will look for evidence of nerve involvement. He may ask you to move your arms or touch your finger to your nose. The speed and accuracy of your movements helps him to determine if there is a problem with your coordination, reflexes or strength. He might also poke you with a sharp pin or touch your arms with cotton to determine if your sensation has been compromised. Dramatic differences in sensation or strength in one area of your body versus another indicates nerve involvement, while lack of sensation or movement below a certain level in your body is indicative of a spinal cord injury.
3. Diagnostic Image
If the doctor suspects a fracture in your neck, he will order an immediate X-ray of the spine in your neck and upper back. This scan will show any problems in the bony areas of the spine, including broken bones vertebrae that have shifted out of alignment. Even hairline fractures will show up on an X-ray, though they are more difficult to see. If the results are negative, or if the doctor suspects soft tissue damage--which does not show up on an X-ray--he may order further diagnostic imaging. You may have to have an MRI or a CT scan of the head, neck and shoulders. These scans can pick up evidence of damaged ligaments or tendons and can also determine if any of the surrounding structures, such as the esophagus or vocal cords, have also been damaged.
