Findings
- Acute three part C1 burst fracture (Jefferson fracture) without widening of the atlantodental interval or offset of C1 relative to C2
- Acute fracture through the base of the odontoid (type II) with mild posterior displacement of the odontoid fracture fragment
- Thin circumferential hyperattenuation in the epidural space at the levels of C1 and C2
- Offset of the bilateral atlantoaxial joints
- Anterolisthesis of C3 on C4 and C4 on C5
- Multilevel advanced cervical spondylosis and degenerative facet disease. Degenerative fusion of the left C4-C5 facet joint
- Osteopenia
Diagnosis
Jefferson fracture
Type II odontoid fracture
Epidural hematoma
Sample Report
Acute three part C1 burst fracture (Jefferson fracture) without widening of the atlantodental interval or offset of C1 relative to C2. No fracture extension into the transverse foramina.
Acute type II odontoid fracture with 2 mm posterior displacement of the odontoid fracture fragment.
Thin circumferential hyperattenuation in the epidural space at the levels of C1 and C2, likely representing an epidural hematoma without significant mass effect on the cord.
Offset of the atlantoaxial joints could be positional or related to ligamentous injury. Anterolisthesis of C3 on C4 and C4 on C5 is age-indeterminate but favored degenerative given multilevel advanced spondylosis and facet disease. Consider MRI for further evaluation.
Discussion