C5C6 Facet Rotation and Fractures, radiograph
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This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
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Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0985-C5C6 Facet Rotation and Fractures, radiograph
CA0985-C5C6 Facet Rotation and Fractures, radiograph
Case ReportHistory
Exam
Prior Study
Findings
Technique
The cranio-cervical junction is included, but C7 and T1 are underpenetrated.
The flexion and extension views are somewhat limited.
Prevertebral and paravertebral soft tissues
The soft tissues anterior to C5-C6 are prominent especially on the limited extension view, but measure within the normal range.
Spinal alignment
The occipital cervical alignment and the atlanto-axial joint distance are normal.
The anterior vertebral body line, posterior vertebral body line, articular pillar lines, and spinolaminar line are abnormal at C4-C5 and C5-C6. The articular pillars are rotated and displaced into the spinal canal including the interlaminar clear zone at C5-C6.
There is kyphotic angulation but no motion of the cervical spine at C5-C6 on the flexion and extension views.
Vertebral bodies, posterior elements, and base of skull
There are fractures of the facets at C5. There is no displacement of a fracture fragment into the soft tissues, spinal canal, or interlaminar clear zone of the spinal canal. There is no vertebral body fracture.
Disc spaces and facet joints
There is no distraction or focal widening of a disc space, but there is disc space narrowing at C5-C6.
There is grade 1 anterolisthesis of C4 on C5 and grade 2 anterolithesis of C5 on C6.
There is widening and rotational abnormality of the facets at C5-C6 with facet dislocations.
Additional soft tissues and bones (neck, airway, upper thorax, ribs)
The airway is not narrowed or displaced.
There are postsurgical changes of the anterior facial region.
Other findings
There are no degenerative changes or other existing conditions that might be contributing to symptoms.