Cervical Spine Orthopedics I Practice Exam

If esophageal compression is suspected due to cervical spine pathology, which imaging test is indicated?

Barium swallow (x-ray) MRI CT Ultrasound

Correct Answer:

Barium swallow (x-ray)

Explanation:

When external compression of the esophagus from cervical spine disease is suspected, the test of choice is a contrast esophagram (barium swallow). This study directly outlines the esophageal lumen while the patient swallows, revealing any indentation or narrowing caused by posterior cervical osteophytes, disc-osteophyte complexes, or retropharyngeal soft tissue. It provides functional and anatomic information about how the esophagus is being compressed, which helps confirm the diagnosis and gauge severity. While MRI or CT can show the cervical pathology and its relationship to the esophagus, they don’t visualize the esophageal lumen during swallowing as effectively as a barium swallow. Ultrasound isn’t useful for evaluating the cervical esophagus in this context.

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