Demographics:
75 years old, Male
Indication:
Trauma
Findings
- Acute comminuted C1 burst fracture (Jefferson fracture) with fracture lines extending through the anterior arch, right lateral mass, and both lamina. On the right, the fracture extends into the C1-C2 articulation with associated asymmetric widening
- Comminuted impacted fracture of the basiocciput
- Anterior displacement of the anterior arch of C1 and odontoid process relative to the basion with mild associated mass effect on the nasopharynx
- Lateral masses of C1 still articulate with the occipital condyles
- Multilevel moderate to advanced cervical spondylosis, most advanced at C5-C6. Multilevel ankylosis of the posterior elements in the cervical spine
- 3 cm right thyroid nodule
- Osteopenia
Diagnosis
Jefferson fracture
Sample Report
Acute comminuted C1 burst fracture (Jefferson fracture) with fracture lines extending through the anterior arch, right lateral mass, and both lamina. On the right, the fracture extends into the C1-C2 articulation with associated asymmetric widening. Lateral masses of C1 still articulate with the occipital condyles. Consider MRI to further assess for ligamentous injury.
Comminuted impacted fracture of the basiocciput.
Anterior displacement of the anterior arch of C1 and odontoid process relative to the basion with mild associated mass effect on the nasopharynx.
3 cm right thyroid nodule. Recommend nonemergent outpatient thyroid ultrasound for further assessment.
Discussion