Findings
- Acute minimally displaced fracture extending through both C2 pedicles and through the posterior base of the odontoid process. The fracture extends into the lamina and C2-C3 facet joint on the left and into the transverse foramen on the right
- Perched left C2-C3 facet joint
- Focal kyphosis and mild anterolisthesis at C2-C3
- Thin ventral epidural hematoma at this level contributing to mild central stenosis
- Mild prevertebral edema
Diagnosis
Facet joint malalignment
Sample Report
Acute minimally displaced fracture extending through the C2 pedicles and posterior aspect of the base of the odontoid process into the lamina and C2-C3 facet joint on the left and into the transverse foramen on the right. Associated 3 mm anterolisthesis of C2 on C3, focal kyphosis, and perched left C2-C3 facet joint, concerning for extensive ligamentous injury, which could be further assessed with MRI.
Thin ~2 mm ventral epidural hematoma at this level, which in combination with the above described traumatic malalignment contributes to mild central stenosis. MRI could assess for cord injury.
Given traumatic malalignment and fracture extension into the transverse foramen on the right at C2-C3, neck CTA is recommended to assess for vascular injury.
Discussion