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Renal Cell Carcinoma
Joseph Junewick, MD FACR
over 8 years ago
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Facet Subluxation

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: CR MR
Activities:
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History

14 year old female unrestrained ejected passenger involved in motor vehicle accident.


Case Images


Diagnosis

Facet Subluxation

Clinical Notes

Scapulohumeral dissociation with brachial plexopathy (tearing of 3 trunks) and intimal injury of left subclavian artery.

Findings

CT – Left greater than right C6 facet subluxation; no fracture.
MR – Herniated disc with ligamentous disruption and paraspinous edema.

Discussion

Bilateral interfacetal subluxation/dislocation involves the facetal and apophyseal joints related to hyperflexion. All levels between C2 and C7 can be involved. Posterior longitudinal, ligamentum flavum and interspinous ligament disruption is often present. The superior vertebra is displaced anteriorly; the superior articular masses come to rest in the foramina with facetal dislocation. Impaction fractures are common but of little significance.

Reference

Harris JH and Mirvis SE. The Radiology of Acute Cervical Spine Trauma, 3rd Ed. 1996.



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