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Case of the Week 520



What is the most likely diagnosis?

  • 27 year-old with neck pain after fall



Lateral Radiograph of Cervical Spine

  1. Foreign Body Impaction
  2. Atlanto-axial Subluxation
  3. Lymphoma
  4. Paget Disease
  5. Atlanto-occipital Dislocation

Additional Images-None

 

Additional Images

 


None


Answer:

 

2. Atlanto-axial Subluxation

 

More (Click Discussion Tab)

 

 

Atlanto-axial Subluxation

General Considerations

  • Distance between the anterior surface of the dens and the posterior surface of the tubercle of C1 is usually 3 mm or less in adults and 5 mm or less in children
    • This space is called by many names: predentate space, predental space, atlantodental distance
  • The distance may increase slightly on flexion in children but is usually unchanged between flexion and extension in adults
  • Forward movement of the atlas on the axis is normally restricted by the transverse ligament

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