Is the open-mouth odontoid view necessary in children under 5 years?

Objectives. Questionnaires (984) were submitted to pediatric radiologists to determine how often odontoid fractures were missed on lateral views and detected on open-mouth odontoid views in children under 5 years. Other questions relating to imaging protocols of the odontoid also were included, and there were 432 respondents. Results. Of these, 161 respondents indicated that an open-mouth odontoid view was not routinely included in their imaging protocol. Conclusions. There was considerable variability on how the problem of imaging of the odontoid was addressed, but overall there were enough data to begin to consider the concept that the open-mouth odontoid might not be needed in patients under 5 years of age if a lateral view is normal.