Demographics:
66 years old, Male
Indication:
Trauma
Findings
- Acute fractures of the inferior right aspect of the T4 vertebral body and superior left aspect of the T5 vertebral body
- Left lateral subluxation of T4 on T5 with slight rotation and perched right T4-T5 facet joint
- Several tiny fracture fragments in the left aspect of the epidural space at T4-T5, which may arise from a fracture of the left T5 superior articular facet
- Acute nondisplaced fracture of the right T4 transverse process
- Acute fractures of the left posterior third rib and bilateral posterior fifth ribs
- Extensive paraspinal edema/hemorrhage at upper thoracic levels
- Extensive contusion and/or aspiration in the right lung
- Small bilateral pleural fluid collections
- Debris layering in the central airways
Diagnosis
Perched facet
Sample Report
Acute fracture/subluxation at T4-T5 with fractures of the inferior right aspect of the T4 vertebral body and superior left aspect of the T5 vertebral body. Left lateral subluxation of T4 on T5 with slight rotation and perched right T4-T5 facet joint. Several tiny fracture fragments in the left aspect of the epidural space at T4-T5, which may arise from a fracture of the left T5 superior articular facet. Consider MRI to further evaluate for cord injury/compression and epidural hematoma if clinically indicated.
Acute nondisplaced fracture of the right T4 transverse process.
Acute fractures of the left posterior third rib and bilateral posterior fifth ribs.
Discussion