Mr. Robert Scott is a 29 year old refrigerator engineer originally from southern Poland. He had been out horse-riding, when his horse had bolted (after a truck carrying oats) and he was thrown off, hitting his head on the branch of a Norwegian pine tree. Definitely Norwegian.

The paramedics have him immobilised on a spinal board with a rigid cervical collar in place. According to them there was no loss of consciousness at any time, and he is responding appropriately to commands. He is complaining of mild neck pain and tingling in both arms.

On general examination you find weakness in both arms, proximally more than distally, with some associated loss of light touch and pain sensation. With an assistant manually stabilising his neck, you remove the collar and examine the patient. There is no bony tenderness, deformity or defect. His neck is not tender to palpation.