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Joseph Junewick, MD FACR
over 7 years ago
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Multifocal Upper Cervical Spine Injury

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 8 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: CT MR
Activities:
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Case Images


Diagnosis

Multifocal Upper Cervical Spine Injury

Findings

CT – Sagittal reformatted image demonstrates precervical soft tissue swelling, type III odontoid fracture, inferior endplate fracture of C2, and widening of the posterior C2-C3 disc space.

MR – Sagittal T2 and IR images confirm the CT findings and also show anterior longitudinal ligament (atlantoaxial ligament), posterior longitudinal ligament (C2-C3) and posterior ligamentous complex (C1-C2 and C2-C3) injuries and disc separation at C2-C3.

Discussion

Injuries of the cervicocranium are usually complex, involving multiple vector forces. Fractures of the dens are usually isolated although ~13% are associated with other cervical injuries (most often posterior arch of C1, extension teardrop, traumatic spondylolisthesis, atlantoaxial dissociation). Displaced type III odontoid fractures account for the “fat axis body” sign on lateral radiographs.

Reference

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



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