 When Joey stomps on Richies thugs throat, he spits blood (instead of it   welling up) and the sound effect of the neck breaking is louder. Both   shots last the same length of time and use the same take, the amount of   blood was simply toned down digitally for the MPAA. Most video versions   outside the U.S. use the international version but the shots appear in the   supplements on the U.S. DVD (In the featurette titled Violences History,   Cronenberg shows the U.S. and international cut scenes side by side and   explains the reason why there wasnt a standard unrated version in the   U.S. was because the changes were so small).