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Joseph Junewick, MD FACR
over 9 years ago
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Case Detail

Anatomy: Brain-Spine
Joseph Junewick, MD FACR
Diagnostic Category: Normal variant
Created: over 8 years ago
Updated: over 8 years ago
Tags: PEDS
Modality/Study Types: CT
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2 year old male with recent fall.

Case Images



Clinical Notes

Initially difficult to clinically evaluate. Subsequently found to be neurologically intact.


CT – Sagittal reformatted images demonstrate minimal apparent anterior translation of C2 vertebral body relative to C3; spinolaminar line is intact.


Posttraumatic anterior subluxation of the cervical spine may be difficult to differentiate from “pseudodubluxation”. Pseudosubluxation is commonly observed in children. At C2-C3 this is seen in 19% of children between 1 and 7 years of age but can also be seen at C3-C4. Pseudosubluxation can be confidently diagnosed if the spinolaminar line is intact or divergent by less than 2 mm.


Cattell HS, Filtzer DL. Pseudosubluxation and other normal variations in the cervical spine in children: a study of 160 children. JBJS 1965; 47:1295-1309.

Lustrin ES, et al. Pediatric cervical spine: normal anatomy, variants and trauma. Radiographics 2003; 23:539-560.

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