Geriatric patients (> age 65) account for almost 1 in 5 of all cervical spine fractures, with 50% of cervical spine fractures occurring at the C1/C2 level.  Recent literature has questioned whether these clinical decision rules may be applied in the geriatric population, where over half of identified cervical spine fractures result from ground level falls.  Furthermore the reliability of physical exam, specifically midline tenderness, has been questioned in elderly patients.  January's journal club examined three articles that addressed this specific population of blunt trauma patients at risk for cervical spine injury.