Case #1
Findings
- Multiple tiny acute displaced fractures along the anterior aspects of both C1 superior articular facets with mild anterior subluxation of the occipital condyles relative to C1 and widening of the posterior aspect of both atlanto-occipital joints
- Widening of the C1-C2 interspinous interval and of the superior aspect of the median atlantodental interval
- Extensive prevertebral edema extending from the skull base through the C5 level
- Comminuted, displaced acute left posterior first through fourth rib fractures
- Left chest tube terminates in the medial left apex, passing immediately posterior to the left subclavian artery and contacting the left lateral aspect of the trachea
- Tiny left pneumothorax. Extensive left apical pulmonary contusion with small layering hemothorax
- Deep soft tissue emphysema in the base of the neck
- Partially imaged left clavicular fracture
Diagnosis
Fracture-subluxation at the craniocervical junction
Sample Report
Acute fracture-subluxation at the craniocervical junction with multiple tiny acute displaced fractures along the anterior aspects of both C1 superior articular facets, mild anterior subluxation of the occipital condyles relative to C1, widening of the posterior aspect of both atlanto-occipital joints, widening of the C1-C2 interspinous interval, and widening of the superior aspect of the sagittal atlantodental interval. MRI could further evaluate the extent of ligamentous injury.
Extensive upper and mid cervical prevertebral edema.
Comminuted, displaced left first through fourth rib fractures with left apical pulmonary contusion and a small left hemopneumothorax. Left chest tube terminates in the medial left apex, passing immediately posterior to the left subclavian artery and contacting the left lateral aspect of the trachea.
Partially imaged left clavicular fracture.
Discussion