Figure 4. (a) Plain lateral radiograph of the cervical spine showing marked prominence of the pre-vertebral soft tissues following trauma. Pre-vertebral haemorrghage is suspected. There are degenerative changes at C5/6 with narrowing of the disc space and sclerosis at the endplates. (b) Sagittal multislice CT showing osteophytes at C6/7 and disc space narrowing consistent with degenerative changes. No fracture is identified and the pre-vertebral soft tissues are not adequately visualized. (c) A sagittal T₂ weighted MR image with fat suppression showing bright signal within the pre-vertebral soft tissues with central areas of low signal. Bright signal is also present posteriorly and between the spinous processes. The appearances are consistent with haemorrghage and oedema due to soft tissue and ligament injury (anteriorly and posteriorly). There is linear signal across the C5 vertebral body in keeping with marrow haemorrghage or a fracture.