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One hundred and twenty radiographs of the cervical spine were performed at the request of the Accident and Emergency (A & E) department over a 6 week period. These consecutive films were reviewed for adequacy of anatomical demonstration of the complete cervical spine. The initial series of three films presented to the A& E staff achieved this objective in only 55% of cases overall, although further radiographic examinations requested before the patient left the department raised this figure to 75% for the lateral view and to 70% for the combined anteroposterior (AP) views. From the data it can be predicted that if every patient whose first 3 films were inadequate had received further investigation, the cervical spine would have been well visualized on approximately 90% of radiographs in each plane. The availability of radiologists for advice and their involvement with senior A & E staff in teaching are important factors in improving this situation.