A 51-year-old man presented to a direct-access physical therapy clinic with persistent neck pain for 5 days after a fall in shallow water while surfing. Based on "dangerous mechanism of injury" from the Canadian cervical spine rule as being a high risk factor, the physical therapist ordered radiographs of the cervical spine, which were suggestive of a more serious injury. Computed tomography suggested and magnetic resonance imaging confirmed vertebral artery dissection. J Orthop Sports Phys Ther 2016;46(10):929. doi:10.2519/jospt.2016.0416.
Keywords: cervical spine; computed tomography; magnetic resonance imaging; neck pain; radiography.