Demographics:
12 years old, Female
Indication:
Trauma, L3 fracture on prior CT
Findings
- Horizontally-oriented T2/STIR signal hyperintensity and corresponding T1 signal hypointensity extending through the L3 vertebral body and posterior elements bilaterally with approximately 25% anterior vertebral body height loss and widening of the L2-L3 interspinous distance
- T2/STIR signal hyperintensity in the ligamentum flavum bilaterally at L3 and in the L2-L3 interspinous ligament
- Disruption of the supraspinous ligament at L2-L3
- Uplifting of the posterior longitudinal ligament at the level of L3 without frank disruption
- Trace dorsal epidural collection at L3
- Mild right hydronephrosis
Diagnosis
Flexion-distraction injury (Chance fracture)
Sample Report
Acute flexion-distraction injury with a three-column, horizontally-oriented L3 fracture and splaying of the posterior elements at L2-L3.
Findings consistent with supraspinous ligament disruption, interspinous ligament injury, and disruption of the ligamentum flavum at L2-L3.
Trace dorsal epidural hematoma at L3 without significant mass effect on the thecal sac.
Mild right hydronephrosis, which can be further evaluated with ultrasound or CT.
Discussion